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Dermatologist can't figure out what is wrong my sons big toe nail

When my son was 2 years old he was diagnosed with a mild form of hand foot mouth disease. It went away on its own, but shortly after (1-2 months) he developed what we thought was fungus of some sort on the big right toenail. The nail has essentially split in half and has raised ridges and dead skin type of feel look to it. We thought this was the result of the hand food mouth disease.

The dermatologist we were referred to said its not fungus or bone spur, or related to the earlier hand foot mouth he had, but he also doesn't know what it is either. He has suggested a topical cream if that helps.  The dermatologist wants to do a CT scan to rule out a cyst. We are waiting for that appointment.

It appears that an experienced dermatologist would clinically diagnose this on first look as he seemed confused.
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It does sound like a fungal infection.  Do dermatologists do toenails?  I really don't know, usually podiatrists do feet.  I guess any doc can diagnose a toenail fungus, though, and either he's a really good doc who doesn't pretend to know what he doesn't know and docs in general don't know or he's a bad doc and missed the obvious, but I think with a fungus there would have been a precursor period where the toenail turned black or started to look odd and kept getting worse.  If it just happened suddenly it's probably different.  But you know, what topical cream did he suggest?  I mean, creams are for making us feel better, but they only do that by what's in them and what they're intended to treat, and so what is it he said a cream would treat?  That in effect is a kind of diagnosis.  Peace.
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