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yellow nail syndrome (lymphedema & yellow nails)
Etiology:
- chronic pulmonary disease
- dermatophyte infection
- lymphedema
- cancer
- aging
Pathology:
Clinical triad of:
1) opaque yellow & dystrophic nails
2) lymphatic abnormalities
a) aplasia
b) ectasia
c) lymphedema
d) lymphangitis
3) systemic illness
a) pulmonary disease
1] bronchiectasis (20%)
2] pleural effusion (30-40%)
b) cancer
1] Hodgkin's lymphoma
2] endometrial carcinoma
3] melanoma
4] lymphoma
Genetics:
- autosomal disorder
- associated with defects in FOXC2 gene
Clinical manifestations:
1) diffuse yellow to green discoloration of the fingernails & toenails
2) nail thickening
3) slowed growth
4) excessive curvature from side to side
5) edema of the fingertips, ankles & face may occur
6) sinusitis may be present
7) Raynaud's phenomenon may be present
8) pleural effusion (30-40%)
a) lymphocyte predominant
b) may appear years after nail changes occur
c) tend to be small to moderate in size
d) tend to be bilateral
e) exudative or transudative
9) lymphedema
a) lower extremities
b) may affect breasts
* images [4]
General
nail disease
lung disease
syndrome
Database Correlations
OMIM 153300
References
- Color Atlas & Synopsis of Clinical Dermatology, Common
& Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY,
1997, pg 498
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 179
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018.
- DermNet NZ. Yellow nail syndrome (images)
http://www.dermnetnz.org/hair-nails-sweat/yellow-nails.html