Thickened nails are not necessarily gray nails, but may be caused by a condition such as chilblains, which can be clarified by a doctor.
Pachyonychia may be caused by heredity, or it may be caused by extrusion or inflammation. Clinical symptoms are obvious hypertrophic enlargement of the nail plate, hardening, brittleness, loss of luster, easy to break.
The biggest difference between gray nails with fungal infection and thick nails caused by other reasons is that the surface is not smooth, and the gray nails will have stains, turbidity and thinning.
Thickened nails can do fungal microscopy or culture to exclude fungal causes, if diagnosed with gray nails, can be under the guidance of the physician oral itraconazole capsules, terbinafine hydrochloride tablets and other antifungal drug treatment.