Onychomycosis (or tinea unguium)
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The central core, with interruption of skin lines but no punctate vessels on the plantar surface = Clavus. They are painful because repeat trauma, ill fitting shoes cause reactive hyperkeratosis which makes a cone structure that points in and impinges on nerves. You tx by removal of the core, or warm water w/ pumice stone, compound W.
What is this picture identifying specifically re this dx? And why are they painful? And what is the tx?