yellow nail syndrome (lymphedema & yellow nails)
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Etiology
- chronic pulmonary disease
- dermatophyte infection
- defects in lymphatic vessel development
- cancer
- aging
Epidemiology
- rare[5]
Pathology
Clinical triad of:
- opaque yellow & dystrophic nails
- lymphatic abnormalities
- systemic illness
- pulmonary disease
- bronchiectasis (20%)
- pleural effusion (30-40%)
- cancer
- pulmonary disease
Genetics
- autosomal disorder
- associated with defects in FOXC2 gene
- biallelic variants in CELSR1 or FZD6 identified in all patients with congenital yellow nail syndrome but none of the patients with sporadic yellow nail syndrome
* both CELSR1 & FZD6 are core molecules in the Wnt/planar cell polarity (PCP) pathway
Clinical manifestations
- most patients present as adults
- diffuse yellow to green discoloration of the fingernails & toenails
- nail thickening
- slowed growth
- excessive curvature from side to side
- edema of the fingertips, ankles & face may occur
- sinusitis may be present
- Raynaud's phenomenon may be present
- pleural effusion (30-40%)
- lymphocyte predominant
- may appear years after nail changes occur
- tend to be small to moderate in size
- tend to be bilateral
- exudative or transudative
- lymphedema
- lower extremities
- may affect breasts
* images[4]
More general terms
References
- ↑ Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 498
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 179
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
- ↑ Jump up to: 4.0 4.1 DermNet NZ. Yellow nail syndrome (images) http://www.dermnetnz.org/hair-nails-sweat/yellow-nails.html
- ↑ Jump up to: 5.0 5.1 Kurolap A, Chai Gadot C, Eshach Adiv O et al Impaired Wnt/Planar Cell Polarity Signaling in Yellow Nail Syndrome. Ann Intern Med. 2024 Dec 24. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39715557 https://www.acpjournals.org/doi/10.7326/ANNALS-24-01101