Q: I am a 50 years old housewife suffering from green colour infection under my nails and tiny brown spots on the skin of my hands for the last two years. I am taking Fluconazole for the last six months. Now the spots on the hand have become white but the green colour infection under my nails still remains unchanged. How can it be treated?

A:Nail changes can be produced by a number of conditions. Non-infectious causes include psoriasis, lichen planus etc. Inflammation of the surrounding skin can also lead to changes in the nail. Fungi of various kinds can affect a previously damaged skin (by some other disorder) or can affect a perfectly normal skin. In the former situation, eradication of the fungus will not make the nail OK. Fungal nail infections due to dermatophytes are generally easier to treat; others are more difficult. Green discoloration is usually not a feature of dermatophyte infection.