Brief Answer:
Consult another dermatologist and do investigations

Detailed Answer:
Hi,

Thanks for your query.

Based on my experience I usually carry out detailed history taking ,physical examination and various tests for my patients to rule out chronic and infectious diseases that make prognosis of nail plate infections bad.

First I check for presence of heart diseases, kidney diseases, diabetes because these conditions if not treated well will worsen nail bed infections.

Secondly I do culture and sensitivity of the nail bed to discover what microbe is causing the problem and what drugs its sensitive to.

Third I usually do tests for infectious diseases like HIV because their presence will worsen prognosis of nail bed infections.

One of patients referred to me had similar complain, I investigated and found he had HIV and when I started him on ARV and anti fungal infection for nail bed he markedly improved.

I would strongly advise you to see another XXXXXXX dermatologist before you give up and the above investigations are done. Hope I answered your question, will be happy to help you if you have more questions

Regards,

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