Nail disease, rather like cosmetic dermatologic surgery and obstetric and gynecologic dermatology, remains cursorily treated in general dermatology texts. Fracturing information about nails into innumerable chapters and subsections, such texts typically obscure knowledge and confuse the reader. Yet paradoxically, this academic deemphasis is not endorsed by our patients, who are severely troubled by nail ailments and highly motivated to seek therapy. The advent of effective oral antifungals has been a cautionary tale to those of us skeptical about the relevance of nail appearance in the life of the average person. Ordinary people, not just hand models, want their nails fixed, and this may be motivated in part by the social stigma associated with nail dystrophies.