AKT2-073

Miss Spears is a 29 year old solicitor who has requested an appointment for review of her nails. She informs you that she first noticed a discolouration of her fourth and fifth nails on her right foot a few months ago and over time they became thickened and friable. She denies any pain, redness or effect on her mobility. She is not bothered by the appearance of the nails but just wonders why they look this way. Miss Spears has mild Asthma and Eczema but is otherwise fit and well. She is a non-smoker and drinks ten units of alcohol each week. On examination, her fifth toenail is white and has pits on the top of the nail plate. Her fourth toenail has marked thickening and hyperkeratosis, but the nail plate is intact.

What is the most appropriate management option?

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