10th August 2020

You are called to examine a 64-year-old male patient on the general medical ward

You are called to examine a 64-year-old male patient on the general medical ward. On examination of his hands you note 2 distinct transverse bands on all 10 of his fingernails: a distal brown-red band and a proximal white band. He denies any history of nail trauma. You decide to examine his toenails which reveal the same abnormality.

For the patient above, please select the SINGLE most likely underlying cause of the presentation. Select ONE option from the list above.