Progressive Nail Dystrophy

A 40-year-old computer programmer comes to the clinic complaining of embracing nails. Nail changes started gradually two years ago and slowly progressed. It first appeared on the thumbnail and then appeared on all other fingernails. It is not painful on palpation; no Erythema was observed, and it is not pruritic. He denies any trauma. His past medical history was unremarkable. Physical examination revealed hyperkeratotic nails with a whitish-yellowish appearance. The lesions localized especially on the tips of his fingers, with a clear demarcation point between the normal nail and the dystrophic region and subungual deposit, as shown in the image. The rest of the examination was normal, and the mycological examination result also returned negative.