Yellow Nail Syndrome - Causes, Symptoms and Treatment Tips

Yellow nail syndrome is characterised by slow growing, thickened yellow nails which are excessively curved in both the longitudinal and lateral planes. Yellow nail syndrome is categorised by primary lymphoedema, recurrent pleural effusion and yellow discoloration of the nails. Although mechanical lymphatic obstruction is pseudonymoused to be the underlying pathology, it cannot explain the common finding of high albumin concentration in the pleural space.

Most patients have disease of the lower lobe of the lung that may be because of obstruction and/or infection. (Bronchiectasis is an irreversible enlargement of one or more of the bronchi due to the destruction of the muscular and elastic supporting tissues.

Symptoms of Yellow Nail Syndrome

Yellow nail syndrome most generally starts in middle age, though a similar condition has been described in younger children.

• All nails may be affected
• Nails are slow growing or appear to have stopped growing
• Nails become thicker and turn a pale yellow or greenish-yellow colour with edges slightly darker
• Nails mainly remain smooth but may be cross-ridging and nail humped with loss of cuticles
• Onycholysis (separation of nail from the nail bed) may affect one or more nails
• Swelling occurs in about 80% of patients and most frequently affects the legs
• Signs of swelling generally occur after nail changes appear and may not been seen for some months later
• Swelling less often affects the hands, face or genitals

Causes of Yellow Nail Syndrome

It basically runs in families with the typical pattern of an autosomal dominant. Sporadic cases have been reported. The cause of yellow nail syndrome is unknown. Nonetheless, it is seen in patients with chronic bronchiectasis or sinusitis, pleural effusions, internal malignancies, immunodeficiency syndromes, and rheumatoid arthritis. In few cases the lymphatic deformities may be congenital (occur during development) but in most it is probably related to the other associated conditions.

Treatment of Yellow Nail Syndrome

Patients should receive felicitous medical treatment for their respiratory symptoms and oedema. Prescription drug therapy might include oral antibiotics to control infection in the airway, such as amoxicillin/clavulanate, cephalexin, clarithromycin, and azithromycin.

Treatment may involve physical therapy, such as postural drainage, clapping, and vibration. Healthcare practitioners typically recommend avoiding cigarette smoke and other respiratory irritants, cough suppressants, and sleeping pills.