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A 45-year-old woman presents with the complaint that her toenails are thick and yellow. She is otherwise healthy and takes no medications. On examination, two toenails on the right foot and the great toenail on her left foot are affected. There is no periungual erythema, and her peripheral pulses are good. What is the best advice for this patient?
This nail disease will spontaneously remit.
CBC, comprehensive metabolic profile, chest x-ray, and abdominal CT scan should be ordered to look for underlying malignancy.
Oral therapies will need to be used for months until the nails have grown out.
Sampling the nail is unnecessary for definitive diagnosis.
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