Yellow nail syndrome

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Not to be confused with Green nail syndrome.
Yellow nail syndrome
Yellow nail syndrome: This patient has a 20-year history of severe lymphedema of her legs; thick, ridged, yellowish, hypercurved thumbnails (top right); similarly affected, yellow-green to brown toenails (bottom right); and bilateral, chylous pleural effusions. A sample of her chylous pleural fluid is shown to the left of the radiograph.
Classification and external resources
Specialty dermatology
ICD-10 L60.5
OMIM 153300
MedlinePlus 003247
eMedicine article/109403

Yellow nail syndrome (also known as "Primary lymphedema associated with yellow nails and pleural effusion"[1]:849) is a very rare medical syndrome that includes pleural effusions, lymphedema (due to lymphatic hypoplasia) and yellow dystrophic nails. Approximately 40% will also have bronchiectasis. It is also associated with chronic sinusitis and persistent coughing. It usually affects adults.[2][3]:665

Restated, yellow nail syndrome is characterized by marked thickening and yellow to yellow-green discoloration of the nails often associated with systemic disease, most commonly lymphedema and compromised respiration.[1]:792[4]

Although it has an OMIM number, it has been suggested that it might not have a genetic link.[5]

There is some evidence it may be caused by titanium, either implanted for medical reasons or through eating various foods containing titanium dioxide. In patients where titanium exposure was thought to be causative, recovery occurred over a period of several months.[6]


Dramatic improvement in nail discoloration is achieved by oral clarithromycin.[7] Normal treatment for swelling and any respiratory problems is appropriate. Nutritional supplementation with Vitamin E in some studies has been shown to be effective in controlling nail changes.[2]


  1. ^ a b James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  2. ^ a b "Yellow nail syndrome. DermNet NZ". Retrieved 2008-03-19. 
  3. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  4. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1020. ISBN 1-4160-2999-0. 
  5. ^ Hoque SR, Mansour S, Mortimer PS (June 2007). "Yellow nail syndrome: not a genetic disorder? Eleven new cases and a review of the literature". Br. J. Dermatol. 156 (6): 1230–4. doi:10.1111/j.1365-2133.2007.07894.x. PMID 17459037. 
  6. ^ Berglund F, Carlmark B (October 2011). "Titanium, Sinusitis, and the Yellow Nail Syndrome". Biol. Trace Elem. Res. 143 (1): 1–7. doi:10.1007/s12011-010-8828-5. PMC 3176400. PMID 20809268. 
  7. ^ Suzuki, M; Yoshizawa, A; Sugiyama, H; Ichimura, Y; Morita, A; Takasaki, J; Naka, G; Hirano, S; Izumi, S; Takeda, Y; Hoji, M; Kobayashi, N; Kudo, K (Sep 2011). "A case of yellow nail syndrome with dramatically improved nail discoloration by oral clarithromycin.". Case reports in dermatology 3 (3): 251–8. doi:10.1159/000334734. PMC 3250669. PMID 22220146.