A 36-year-old computer engineer came to the clinic complaining of itchy and scaly fingernails chipped and fell off easily. It started ten years ago, is getting worse, and all of his fingernails are affected. The nails are not painful but do not look normal. He had patches of dry, scaly skin on his scalp and low back. He denies taking medication and his family history was unremarkable. His physical examination reveals a pink area with scale on his left temporal scalp, as well as other patches on his back. The majority of the nails were intact but had some proximal erosion; some nails had separation from the nail bed, as well as scaling and yellowing distally. However, most of the nails had pitted, with the periungual area intact, as is shown in the image below. Which of the following is the most likely diagnosis,

Based on the patient’s history and physical examination findings?

Real-Life cases to ensure you are ready for your MCCQE1 Exam!

Ace Qbank Clinical Edge


Ace Qbank Clinical Edge

Making the proper diagnosis is one of the most important aspects of any medical student’s or junior doctor’s clinical training and hence we created Clinical Edge Cases.

Ace Qbank Clinical Edge helps our students put their knowledge of symptoms and physical findings to test by applying clinical reasoning and assessment concepts to a series of common clinical vignettes. Problem-based learning is being used to focus on the cause behind the presentation of a simulated clinical case.

Each simulated Clinical Edge case contains a list of common causes of the presented condition, offers abundant references to the presented case, making additional information easy to find

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