Titanium Pigment and Yellow Nail Syndrome

Santos, Vitorino Modesto dos

doi:10.1159/000445722

Cited by 8 publications

(3 citation statements)

References 3 publications

(17 reference statements)

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“…This report also showed that yellow nail syndrome was associated with titanium. Dos Santos [83] also reported the association of yellow nail syndrome with titanium in 2016, and De Lima and Dos Santos et al [84] reported the observation of titanium accumulation in the liver, spleen, lung, lymph nodes, and bone marrow in the autopsy results of five drug-addicted patients; titanium pigmentation was observed under a microscope. This report revealed a systemic accumulation of titanium, but with no change in the nails.…”

Section: Resultsmentioning

confidence: 99%

General review of titanium toxicity

et al. 2019

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Background Titanium is a commonly used inert bio-implant material within the medical and dental fields. Although the use of titanium is thought to be safe with a high success rate, in some cases, there are rare reports of problems caused by titanium. In most of these problematic reports, only individual reports are dominant and comprehensive reporting has not been performed. This comprehensive article has been prepared to review the toxicity of titanium materials within the medical and dental fields. Methods We used online searching tools including MEDLINE (PubMed), Embase, Cochrane Library, and Google Scholar by combining keywords such as “titanium implant toxicity,” “titanium implant corrosion,” “titanium implant allergy,” and “yellow nail syndrome.” Recently updated data has been collected and compiled into one of four categories: “the toxicity of titanium,” “the toxicity of titanium alloys,” “the toxicity of titanium implants,” and “diseases related to titanium.” Results Recent studies with regard to titanium toxicity have been increasing and have now expanded to the medical field in addition to the fields of environmental research and basic science. Problems that may arise in titanium-based dental implants include the generation of titanium and titanium alloy particles and ions deposited into surrounding tissues due to the corrosion and wear of implants, resulting in bone loss due to inflammatory reactions, which may lead to osseointegration failure of the dental implant. These titanium ions and particles are systemically deposited and can lead to toxic reactions in other tissues such as yellow nail syndrome. Additionally, implant failure and allergic reactions can occur due to hypersensitivity reactions. Zirconia implants can be considered as an alternative; however, limitations still exist due to a lack of long-term clinical data. Conclusions Clinicians should pay attention to the use of titanium dental implants and need to be aware of the problems that may arise from the use of titanium implants and should be able to diagnose them, in spite of very rare occurrence. Within the limitation of this study, it was suggested that we should be aware the rare problems of titanium toxicity.

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Section: Resultsmentioning

confidence: 99%

General review of titanium toxicity

et al. 2019

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“…Other sources of titanium ions were also suggested: joint implants, surgical staples, foods (chewing gum to try to explain YNS in children), medication excipients, cosmetics (sunscreen, moisturizers, shampoo, toothpaste) [ 50 , 52 ]. Titanium’s hypothetical role remains possible, but probably not sufficient, because its presence in other organs (liver, spleen, lymph nodes, lung) of autopsied patients was not accompanied with nail yellowing [ 53 ].…”

Section: Pathogenesismentioning

confidence: 99%

Yellow nail syndrome: a review

Vignes¹,

Baran

2017

Orphanet J Rare Dis

114

136

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Yellow nail syndrome (YNS; OMIM 153300, ORPHA662) is a very rare disorder that almost always occurs after 50 years of age but a juvenile or familial form has also been observed. YNS is diagnosed based on a triad associating yellow nail discoloration, pulmonary manifestations (chronic cough, bronchiectasia, pleural effusion) and lower limb lymphedema. Chronic sinusitis is frequently associated with the triad. YNS etiology remains unknown but a role of lymphatic impairment is usually evoked. YNS is more frequently isolated but may be associated in rare cases with autoimmune diseases, other clinical manifestations implicating lymphatic functions or cancer and, hence, is also considered a paraneoplastic syndrome. YNS management is symptomatic and not codified. YNS can resolve spontaneously. Oral vitamin E alone or even better when associated with triazole antifungals may achieve partial or total disappearance of nail discoloration. Pleural effusion can be treated surgically, with decortication/pleurectomy or pleurodesis. Antibiotic prophylaxis is prescribed for bronchiectasia with chronic sputum production. Lymphedema treatment is based on low-stretch bandages and the wearing of elastic compression garments combined with skin care, exercises and, as needed, manual lymph drainage.

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“…After removing their titanium implants, four patients experienced complete recovery [ 15 ]. Dos Santos in their research questioned the association of titanium exposure with YNS [ 16 ]. Their study on the relationship between titanium pigment autopsied patients with significant titanium exposure found that in some patients even though the titanium pigment was found in several organs including the liver, spleen, lymph nodes, and lungs, it was not accompanied by yellowish discoloration of nails in these patients [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Four-Year Follow-Up of a Case of Yellow Nail Syndrome With IgM Deficiency

Nagpal,

Pokhriyal,

Magacha

et al. 2024

Cureus

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Yellow nail syndrome is a rare condition occurring sporadically, with an extremely low prevalence rate. This syndrome classically presents with a triad of lower extremity edema, yellow nails, and mucosal issues such as pleural effusion and/or chronic sinusitis. Two out of the three features are deemed sufficient to diagnose a person with yellow nail syndrome. We present a rare case of yellow nail syndrome that began with chronic leg swelling and later progressed to the development of an asymptomatic pleural effusion and finally discoloration of nails. In our case, the patient did have a significant recent history of a total knee replacement with a titanium implant. Of note was the chronology of events including leg edema and asymptomatic pleural effusion which were present even before the titanium knee implant. The third feature of the hardening and yellow discoloration of the nails was found to have developed following the knee replacement. Interestingly, on further evaluation, he was found to have IgM deficiency.

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Titanium Pigment and Yellow Nail Syndrome

Cited by 8 publications

References 3 publications

General review of titanium toxicity

General review of titanium toxicity

Yellow nail syndrome: a review

Four-Year Follow-Up of a Case of Yellow Nail Syndrome With IgM Deficiency

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