Yellow nail syndrome
The yellow nail syndrome (YNS) is rare disorder principally affecting lymphatic system
It is characterised by
- nail discolouration: yellow slow growing dystrophic nails
- peripheral / primary lymphoedema
- pulmonary manifestations
Other associated features include
There may be a slightly increased female predilection 5. While clinical onset varies from birth to late adult life, it is thought to typically those in early middle age 5.
The syndrome can sometimes be associated with
- malignancy 1
- rheumatological conditions 1
- Hashimoto's thyroiditis 7
- Raynaud's disease 7
The exact pathogenesis is not well known although anatomical or functional lymphatic drainage abnormalities have been proposed as an underlying mechanism.
Clinical features can be variable among individuals with this disorder, and these features can vary over time.
Imaging is often performed in the evaluation of pulmonary manifestations.
While individual features are non specific, there may be evidence of
- sequelae of recurrent pulmonary infections
- pleural effusions
Treatment and prognosis
While there is no specific treatment for the syndrome, most patients are often managed with supportive measures targeted at ameliorating the various clinical manifestations (e.g. treating respiratory infections).
The general clinical course is benign but can depend on underlying associations.
- 1. Dornia C, Johst U, Lange T et-al. Yellow nail syndrome: dystrophic nails, peripheral lymphedema and chronic cough. Can. Respir. J. 2012;18 (4): e68-9. Free text at pubmed - Pubmed citation
- 2. Maldonado F, Ryu JH. Yellow nail syndrome. Curr Opin Pulm Med. 2009;15 (4): 371-5. doi:10.1097/MCP.0b013e32832ad45a - Pubmed citation
- 3. Fields CL, Roy TM, Ossorio MA et-al. Yellow nail syndrome: a perspective. J Ky Med Assoc. 1992;89 (11): 563-5. Pubmed citation
- 4. Hoque SR, Mansour S, Mortimer PS. Yellow nail syndrome: not a genetic disorder? Eleven new cases and a review of the literature. Br. J. Dermatol. 2007;156 (6): 1230-4. doi:10.1111/j.1365-2133.2007.07894.x - Pubmed citation
- 5. Nordkild P, Kromann-Andersen H, Struve-Christensen E. Yellow nail syndrome-the triad of yellow nails, lymphedema and pleural effusions. A review of the literature and a case report. Acta Med Scand. 1986;219 (2): 221-7. Pubmed citation
- 6. Venencie PY, Dicken CH. Yellow nail syndrome: report of five cases. J. Am. Acad. Dermatol. 1984;10 (2 Pt 1): 187-92. Pubmed citation
- 7. Penneys N. Skin Manifestations Of Aids, Second Edition. CRC Press. (1995) ISBN:1853172421. Read it at Google Books - Find it at Amazon