Yellow nail syndrome

Area of Science:

• Dermatology
• Internal Medicine
• Pulmonology

Background:

• Yellow nail syndrome (YNS) is a rare disorder characterized by a triad of yellow, dystrophic nails, chronic respiratory symptoms, and lymphedema.
• Diagnosis can be challenging, particularly when respiratory symptoms are absent or pulmonary workup is negative.

Observation:

• A patient presented with classic YNS features: yellow, thickened nails unresponsive to antifungals, lower-extremity lymphedema, and chronic cough with a negative pulmonary evaluation.
• The nail dystrophy was refractory to standard antifungal therapy.

Findings:

• Treatment with vitamin E demonstrated significant improvement in nail appearance and quality.
• A regimen of pulsed fluconazole in conjunction with vitamin E further enhanced nail recovery.

Implications:

• This case suggests that vitamin E and pulsed fluconazole are effective therapeutic options for refractory yellow nail syndrome.
• Further research into the underlying mechanisms and optimal treatment strategies for YNS is warranted.