Pt. present for routine PE. Notes single nail on dominant ha | Figure 1

Pt. present for routine PE. Notes single nail on dominant hand with this appearance for "months." minor pain from split skin at distal nail. no other nails involved (hand/feet). ROS essentially negative. denies biting / chewing / trauma / exposure. no rashes on exam.

There was no discernable nail edge on exam, could not lift nail plate. Nail appeared to be splitting halfway down plate. almost appeared buried inyo tip of finger.

Dx? Tx? Does presentation necessitate removal of nail for workup of potential underlying lesion? ot is going to do some nail care / soaks and I plan to call back about additional needs / ideas

appreciate any advice, no one at the practice had seen a nail like this, and I can't fit it into any particular category of nail abnormality aside from onnychomydesis / onnychorrhexis?

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