Introduction:
Yellow nail syndrome is a very rare disorder that has been noticed since 1927 (1). It affects both sex equally, with age of more than 40 years is typical (2). The exact pathogenesis remains unclear but lymphatic system anatomical and functional abnormalities remain as the predominant theory, while other hypotheses suggest autoimmune, cancer and paraneoplastic roles (3). Also a very rare familial case has been reported (1).
Although it’s only found in 27%_60% of patients The diagnosis depends on the presence of 2 out of; characteristic nail changes, respiratory tract infection and lymphedema. The latter occurs in up to 80% of cases and may be the first sign (1). The common Nail changes that have been described include nail discoloration (pale yellow to dark green), nail hyperkeratosis with loss of the lunula, onycholysis, proximal nail-fold erythema over curvature, cross-ridging, very hard and difficult-to-trim nail , increased nail thickness, and slowed longitudinal growth (1,3). Respiratory manifestations that are encountered include pleural effusion, bronchiectasis, chronic cough and frequent sinusitis (1).The condition may resolve spontaneously especially when it is paraneoplastic or cancerous (1).
Oral vitamin E, and fluconazole showed a good response, while intralesional steroids, oral zinc sulphate, and subcutaneous immunoglobulins showed promising data (1). Although The prognosis appears to be favourable; it requires extensive research.