Sue presents with green nails. She works as a nurse on the General Surgical and Infectious Diseases wards and has recently been using Prednisone to manage her intermittent Rheumatoid Arthritis.

What are the causes of green discolouration of the nail plate?

1. Pseudomonas infection
2. Aspergillus infection

What is the treatment of nail pseudomonas?

1. acetic acid 2% (white vinegar diluted 1:1 with water) topically, soaking nails for 5 to 10 minutes twice daily for 3 to 4 weeks.

Reading

1. etG – Onycholysis – https://tgldcdp.tg.org.au/viewTopic?topicfile=psoriasis&guidelineName=Dermatology#toc_d1e187
2. Murtaghs General Practice Chapter 129 – http://murtagh.mhmedical.com/content.aspx?bookid=1522&sectionid=116046129
3. Murtaghs Practice Tips – Chapter 8 – Nail Problems – http://murtagh.mhmedical.com/content.aspx?bookid=1920&sectionid=143276631

Podcast

1. GP Core Content Podcast Episode 150 – Dermatology | Nails