Yellow nail syndrome as a cause of unexplained edema

  • C. Cimini Institute of Internal Medicine, Second University of Naples Medical School, Naples, Italy.
  • R. Giunta Institute of Internal Medicine, Second University of Naples Medical School, Naples, Italy.
  • R. Utili Institute of Internal Medicine, Second University of Naples Medical School, Naples, Italy.
  • E. Durante-Mangoni | emanuele.durante@unina2.it Institute of Internal Medicine, Second University of Naples Medical School, Naples, Italy.

Abstract

Yellow nail syndrome is a rare cause of edema due to a disordered lymphatic drainage. We recently observed two cases of long-standing, chronic edema, whose nature could not be understood despite innumerable diagnostic procedures. The diagnosis was suspected based on an attentive clinical exam and confirmed by radionuclide lymph scan. Yellow nail syndrome has to be considered in the differential diagnosis in cases of systemic edema, as well as long standing pleural effusions, particularly in patients with bronchiectasis or sinusitis. Clues to diagnosis are the presence of dystrophic, yellowish nails, peripheral lymphedema and relapsing pleural effusions and/or ascites. Long-term control of symptoms is difficult to achieve and may benefit from the judicious use of diuretics and intravenous albumin and by topical alpha-tocopherol. Pleurodesis may be needed. Other pathologic conditions are often associated to yellow nail syndrome and should be ruled out.

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Published
2016-01-21
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Issue
Section
Case Reports
Keywords:
Edema, Pleural effusion, Differential diagnosis, Onicopathy, Lymphedema
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How to Cite
Cimini, C., Giunta, R., Utili, R., & Durante-Mangoni, E. (2016). Yellow nail syndrome as a cause of unexplained edema. Monaldi Archives for Chest Disease, 71(4). https://doi.org/10.4081/monaldi.2009.350