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Bronchiectasis in yellow nail syndrome.

Georgia Woodfield1, Mitzi Nisbet1, Joe Jacob2

  • 1Host Defence Unit, Royal Brompton Hospital, London, UK.

Respirology (Carlton, Vic.)
|August 24, 2016
PubMed
Summary

Yellow nail syndrome (YNS) causes less severe bronchiectasis than idiopathic bronchiectasis (IBx), but features increased mucus plugging. Treatment focusing on secretion clearance may benefit both nail and chest symptoms in YNS patients.

Keywords:
Pseudomonas aeruginosaidiopathic bronchiectasislymphoedemapleural effusionyellow nail syndrome

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Area of Science:

  • Pulmonology
  • Dermatology
  • Rare Diseases

Background:

  • Yellow nail syndrome (YNS) is a rare condition with limited descriptive data.
  • This study compares clinical and HRCT findings in YNS with idiopathic bronchiectasis (IBx).

Purpose of the Study:

  • To elucidate the clinical characteristics and high-resolution computed tomography (HRCT) findings of YNS.
  • To compare YNS with idiopathic bronchiectasis (IBx) in a case-control study.

Main Methods:

  • A case-control study identified 25 YNS patients and matched IBx patients (2:1 ratio) from an adult bronchiectasis clinic (2007-2013).
  • Clinical features and HRCT findings were compared between the two groups.

Main Results:

  • YNS patients had a median age of 53 years, with respiratory symptoms preceding nail changes in 68%.
  • HRCT revealed symmetrical, lower-lobe predominant bronchiectasis in both groups, but less severe in YNS (lower extent, severity, bronchial wall thickness scores).
  • Increased mucus plugging was independently associated with YNS, with similar Pseudomonas aeruginosa prevalence and mild lung function abnormalities compared to IBx.

Conclusions:

  • Bronchiectasis in YNS is less severe than IBx, characterized by increased mucus plugging and middle-age onset without female predominance.
  • Treatments aimed at improving secretion clearance may benefit both respiratory and nail symptoms.
  • Consideration of long-term macrolide antibiotics is suggested for YNS management.