The correct answer is A. Chronic renal insufficiency.

Answer: a. chronic renal insufficiency (General Dermatology 2.5 Nail Disorders of the Skin DIR Review book page 155) Explanation: The image shows Terry’s nails (see image Figure 2.5.8 in DIR). This condition presents with apparent leukonychia involving the entire nail bed except the narrow distal end. It is commonly associated with liver failure, congestive heart failure (CHF), diabetes, age. Chronic renal insufficiency is more commonly seen with Half-and-half nails (Lindsay’s nails) which presents as apparent leukonychia involving half of the nail bed.

A. Chronic renal insufficiency is the correct answer. This is not routinely seen with Terry’s nails. It is more commonly seen with Half-and-half nails (Lindsay’s nails). B. Liver failure is associated with Terry’s nails C. Congestive heart failure is associated with Terry’s nails D. Diabetes is associated with Terry’s nails E. Age is associated with Terry’s nails

References:

General Dermatology 2.5 Nail Disorders of the Skin DIR Review book page 155