Clinical Quiz
The Hong Kong Practitioner VOLUME 27 / October 2005

A man presenting with nail deformity
Wai-Sun Lam ªL´ô·s


A monthly clinical quiz is published in The Hong Kong Practitioner. Readers are invited to participate and a prize draw, sponsored by Pfizer Corporation Hong Kong Limited, will be undertaken among the successful entries each month. For entry into the draw, simply answer the question, fill in the reply slip and return it to the College by 16 November, 2005. Each reader is allowed to submit one entry only. The name of the winner and the answer will be published in the November issue.

Clinical history:

A 73 year-old man presented with a transverse depression on all finger nails. He had a history of diabetes mellitus, hypertension and renal impairment. Four months ago, he was admitted to hospital for fever, generalised skin rash and oral ulcers after taking allopurinol. He was managed conservatively and was discharged three months later. Apart from the nail deformity, he was also noted to have asteatotic eczema over the limbs and seborrheic dermatitis over the scalp.
The slide and the question were prepared by:
Dr Wai-Sun Lam, FHKAM(Med)
Specialist in Dermatology and Venereology,
Hong Kong Dermatology Centre, Unit 502, Hing Wai Building, 36 Queen's Road Central, Hong Kong.

What is the most likely diagnosis for his nail deformity?

A. Tinea unguium
B. Beau's lines
C. Psoriasis
D. Koilonychia

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