Dr. Dhepe Snehal Madhav
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My mother is 53 years old. From the last 15 days, nail in her left-hand ring finger turned brownish. It seems there is some wound from inside and it has been paining since then. However, there was no burn or injury in that finger previously. The nail started turning brown on its own with pain. She is applying Betnovate-N antiseptic cream.
Hello,
Welcome to icliniq.com.
It is a fungal infection of the nail. Betnovate is a steroid which worsens it. Stop using Betnovate immediately. Is she a diabetic? Any loss of nail cuticle? Is there a history of chronic paronychia? Is excess contact with water, washing clothes, utensils, etc? Any contact with irritant? Or any trauma?
Patient's Query
Thank you doctor,
No my mother is not a diabetic. I did not find any nail cuticle on my mothers finger as per the internet image. No history of chronic paronychia. And yes, there is excess contact with water. She is busy in the kitchen the whole day, but she does not have any trauma.
Hi,
Welcome back to icliniq.com.
Loss of nail cuticle and prolong contact with water can lead to nail infection. Take tablet Itraconazole 200 mg once in a day for seven days, or Terbinafine 250 mg once daily for 15 days, Luliconazole 1 percent lotion twice daily for 15 days, 5 percent Amorolfine nail lacquer twice weekly for 12 weeks, tablet Widcet 5 mg twice daily for seven days (if itching), and Emanzen D (Serratiopeptidase and Diclofenac sodium) twice daily for three days (if pain). Avoid excess contact with water.
Patient's Query
Thank you doctor,
There is no itching on the nail but there is swelling in that brownish part of that nail. Are all the medicines have to be taken simultaneously by the patient? She had a gallbladder related operation last year. Should I give details regarding that? Is it relevant in this case?
Hello,
Welcome back to icliniq.com.
It is paronychia (swelling) abscess collection near nail (attachment removed to protect patient identity). Antibiotic treatment helps. Take tablet Ciplox (Ciprofloxacin) 500 mg once in a day for three days. Apply Fucidin cream (Fusidic acid) twice daily for seven days. Terbinafine or Itraconazole cannot be given as she has liver and gall bladder issues. Do not take that. Thanks for the information. Rest cream, lotion, and tablet Widcet can be taken.
Patient's Query
Thank you doctor,
Her gallbladder was removed due to stones. She is overweight. Presently she is having burning sensation while urinating and is taking a medicine named Menojoy. This burning sensation came lasts year also but got cured and started now again. I request you to please send me the list of all medicines that my mother has to take.
Hello,
Welcome back to icliniq.com.
Take Tablet Zifi 200 mg twice daily for five days. (for urethritis as well as paronychia). Use Luliconazole 1 percent lotion twice daily for 15 days (on nail), 5 percent Amorolfine nail lacquer twice weekly for 12 weeks, Fucidin cream at night for 10 days (on swollen area). Take Tablet Widcet 5 mg twice daily for seven days (if itching) and Tablet Emanzen D twice daily for 3 days (if pain). Take Terbinafine 250 mg once in a day for 15 days, but before taking it do all lab tests LFT (liver function test), RFT (renal function test), and lipid profile. If within normal range then can take Terbinafine otherwise continue only topical treatment.
Patient's Query
Thank you doctor,
With these medicines, should she continue using Menojoy?
Hello,
Welcome back to icliniq.com.
Sha can take Cital syrup (Disodium Hydrogen citrate) two teaspoons twice daily for five days instead of Menojoy.
Patient's Query
Thank you doctor,
I shall give these medicines to my mother and will let you know about her finger nail condition.
Hi,
Welcome back to iclniq.com.
You are welcome. Do report her condition.
Patient's Query
Thank you doctor,
Instead of 5% Amorolfine nail lacquer the chemist handed me Ciclopirox olamine topical solution and 8% W/V Nailrox nail lacquer. Should I use this one? I have attached an image of this product.
Hi,
Welcome back to icliniq.com.
Yes, you can use it.
Patient's Query
Hi doctor,
Thank you so much for your help.
Hi,
Welcome back to icliniq.com.
You are welcome. Keep in touch for further doubts.
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Venereology
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