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Deformed Fingernail

Poll

Is thyroid hormone medication associated with nail plate deformity, or is something else going on?

A 55-year-old woman seeks treatment of a deformed, slightly tender nail plate and swollen, erythematous nail folds; she first noticed the condition several months earlier. The only medication she takes is thyroid hormone.

What is your initial approach?

Measure the patient's thyroxine level
Measure the patient's thyroid-stimulating hormone level
Order a bacterial culture
Order a fungal culture
Order a radiograph of the finger
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