Introduction:
Yellow nail syndrome is a very rare disorder that has been noticed since
1927 (1). It affects both sex equally, with age of more than 40 years is
typical (2). The exact pathogenesis remains unclear but lymphatic system
anatomical and functional abnormalities remain as the predominant
theory, while other hypotheses suggest autoimmune, cancer and
paraneoplastic roles (3). Also a very rare familial case has been
reported (1).
Although it’s only found in 27%_60% of patients The diagnosis depends
on the presence of 2 out of; characteristic nail changes, respiratory
tract infection and lymphedema. The latter occurs in up to 80% of cases
and may be the first sign (1). The common Nail changes that have been
described include nail discoloration (pale yellow to dark green), nail
hyperkeratosis with loss of the lunula, onycholysis, proximal nail-fold
erythema over curvature, cross-ridging, very hard and difficult-to-trim
nail , increased nail thickness, and slowed longitudinal growth (1,3).
Respiratory manifestations that are encountered include pleural
effusion, bronchiectasis, chronic cough and frequent sinusitis (1).The
condition may resolve spontaneously especially when it is paraneoplastic
or cancerous (1).
Oral vitamin E, and fluconazole showed a good response, while
intralesional steroids, oral zinc sulphate, and subcutaneous
immunoglobulins showed promising data (1). Although The prognosis
appears to be favourable; it requires extensive research.