Harry presents with yellow nails on a history of poorly managed psoriasis.

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

1. Fungal infections
2. Psoriasis
3. Tetracyclines

Straight Murtaghs list. We’re down in the weeds here but lets cover everything.

What is the most likely cause of this presentation?

1. Psoriasis

Kind of a gimme given the stem

What are the contraindications to tetracyclines?

Pregnancy (category D)

This question often comes up in multiple forms in the exams. High yield.

How would you treat this? (List medication name, strength, freq)

1. calcipotriol+betamethasone dipropionate 50+500 micrograms/g ointment topically, in proximal nail fold and under nail, once daily at night for up to 3 months.
2.  betamethasone dipropionate 0.05% lotion topically, twice daily under nail for up to 3 months.

https://tgldcdp.tg.org.au/viewTopic?topicfile=psoriasis&guidelineName=Dermatology#toc_d1e187

Reading

1. etG – Nail Psoriasis – 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