Yellow nail syndrome: a review

Abstract

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.

Immunoglobulin replacement therapy for yellow nail syndrome

“…Symptomatic relief, such as topic vitamin E and antifungal therapy, has been proposed, without clear benefits. 7 Here, we report the history of a 74-year-old patient presenting with chronic cough, bronchiectasis, idiopathic recurrent pleural effusion, thickened yellow nails associated with pathological nail discoloration, lower limb lymphedema and immunoglobulin G deficiency. The examination revealed lower limb lymphoedema, especially below the knees.…”

“…YNS is a suggested paraneoplastic syndrome. 3,7 Unfortunately, there is no specific therapy for the disease. Symptomatic relief, such as topic vitamin E and antifungal therapy, has been proposed, without clear benefits.…”

Yellow Nail Syndrome

“…Mukopürülan burun akıntısı, burun tıkanıklığı ve geniz akıntısı gibi semptomlar eşlik etmektedir. 9 Hastaların çoğunda görülen solunum yolu patolojileri STS'nin en tehlikeli komponentidir. Akciğer tutulumu, hastaların %56-71'inde görülmektedir.…”

CHAPLE syndrome uncovers the primary role of complement in a familial form of Waldmann's disease

“…Clinical features of yellow nail syndrome (OMIM#153,300; ORPHA662) include yellow nails, chylothorax, and congenital adulthood limb lymphedema. Very rarely, YNS cases with associated with PIL have been described …”