[Answered]: A 60 -year old man with a history of diabetes…

A 60 -year old man with a history of diabetes presents to your office with thickened and divcolored toenails. He tells you that his toenals have had this appearance for over a year, and now he is experiencing discomfort when wearing tightfitting shoes. Physical exam reveals hyperkeratoris and orycholysis of bilsteral great and second toes. Which of the following is the most appropriate next step? A. Advise watchful waiting 8. Begin treatment with oral terbinafine C. Check serum aminotransferases 0. Perform potassium loydroxide examination of toenal scrapings E. Refer the patient to a podiatrist for surgical toenail removal