History: Fungal infection of the nails are usually due to a dermatophyte fungus although yeasts such as candida can cause nail dystrophy particularly in immunosupressed individuals.Often only part of a nail is involved but in this long standing case both the nail and the nail bed are severely damaged. Nail clippings or subungual material can be sent for culture. The most effective drug to treat this would be Terbinafine orally  for at least 3 months.