Hopefully this helps. It almost looks like pieces of the white are hanging off. I havent noticed behavioral changes and he is still eating but I did notice that he is being bullied by one of my tangs. The tang keeps backing into him with his tail. Both of these fish have been in the tank the longest out of all fish, about 2 years, and I havent noticed this behavior before. I have a 120w UV on the tank that is plumbed into my return which runs at a gph that is supposed to be for disease mgmt, for what its worth. tank is about 220 gallons, and 260 inclusive of sump
This is happening because of the aggression – the trigger's immune system is toast (or close) if it is succumbing to something like this.
For what it's worth, this is an important distinction to the usual "new fish" situation with Ich (Crypto), where the swarmers play the part of aggressor too. They (the repeated assaults) are the reason for the fishes' immunity failure. In your case, there's only one "bad" fish to deal with, *and you can see him*. In the usual case, there are 1x10^8 swarmers, and *they are invisible* under normal viewing conditions.
All to say that your situation is more manageable than "the usual".
Fact: If you don't stop the aggression, it won't matter what else you do, this trigger will end up a victim.
(You can't do ich management AND permit a high stress situation as this degrades the immune system.)
So, no matter what,
at least one of these fish has to come out.
If you determine an actual outbreak seems to be happening (like Jay described with active indicatinos of infection, esp. on fins)...
IMO,
if you can get them both out, the rest of the fish might still be fine. I'd try to run a micron filter for at least a few days to help the UV filter out. Ruby Reef makes an in-tank treatment that could also be helpful. Decide which, if any, you want to put back in the display....perhaps let them both go to new homes post-recovery.
Getting the trigger treated specifically would be a good idea and it would give him a stress break (if you do the QT right) and give you the opportunity for better observation during treatment.
You *can* pull and treat all the fish, but you have apparently been successful up to now with managing things....and thankfully in your case, the reason for this situtation is not mysterious and can be addressed directly.
More "if's"...
*IF* the trigger is still eating well and *IF* you can get the offending Tang out, even he might recover in the tank, with the supports I mentioned. A good option to consider if you cannot catch him....Triggers can be very difficult – it's kinda their life purpose after all. ;)
But you also might end up being forced to more drastic means if you can't catch the offending Tang on the sly – eliminating that aggression is absolutely crucial. In that case (eg breaking down rockwork), you might still consider the treat-em-all route, if you're able to.