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Yellow nail syndrome in Adult
See also in: Nail and Distal Digit
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Yellow nail syndrome in Adult

See also in: Nail and Distal Digit
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Contributors: Shari Lipner MD, PhD, Susan Burgin MD, Bertrand Richert MD, Robert Baran MD
Other Resources UpToDate PubMed

Synopsis

Yellow nail syndrome (YNS) is a rare idiopathic disorder characterized by the triad of yellow nails, lymphedema, and respiratory tract involvement. The latter is usually a pleural effusion, but other conditions of the upper or lower respiratory tract may be observed (eg, sinusitis, bronchitis).

The classic triad occurs only in about one-third of patients, and involvement of the nails only is observed in about 10% of cases. Lymphedema and respiratory tract involvement may develop before, during, or after the nail dystrophy.

YNS affects men and women equally. It usually presents in the fourth to sixth decade of life.

The pathophysiology is not well understood, but microangiopathy and titanium have both been implicated as being responsible for the disease.
  • Microangiopathy as the cause of the nail changes is proposed because dermoscopy of the nail fold capillaries in some patients with YNS showed dilated and tortuous capillary loops.
  • Reports have implicated titanium in the development of YNS. Elevated levels of titanium have been found in patients with YNS, and this exposure may be from medications and dental implants. It is thought that the interaction between amalgam and gold leads to the yellow nail color.
For more information, see also OMIM.

Codes

ICD10CM:
L60.5 – Yellow nail syndrome

SNOMEDCT:
45342007 – Yellow nails

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

If confined to one nail:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 02/20/2017
Last Updated: 04/03/2017
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Yellow nail syndrome in Adult
See also in: Nail and Distal Digit
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Yellow nail syndrome : Arrested nail growth, Diffuse yellow nails, Pleural effusion, Dyspnea, Nail thickening
Clinical image of Yellow nail syndrome
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