Yellow nail syndrome

Title

Other Names:

Lymphedema with yellow nails; YNS

Categories:

Blood Diseases; Congenital and Genetic Diseases; Lung Diseases; Blood Diseases; Congenital and Genetic Diseases; Lung Diseases; Skin Diseases See More

Summary Summary

Yellow nail syndrome is a very rare disorder characterized by three features: yellow nail discoloration, respiratory problems, and lower limb swelling (lymphedema). It usually occurs in people over age 50 but can occur in younger people.^[1] In addition to being yellow, nails may lack a cuticle, grow very slowly, and become detached (onycholysis).^[2] Respiratory problems may include chronic cough, bronchiectasis, and pleural effusion.^[1] Chronic sinusitis may also occur.^[1] The cause of yellow nail syndrome remains unknown. It usually occurs on its own but is rarely associated with autoimmune disease, or lymphatic diseases or cancers. Some researchers have hypothesized that titanium may play a role in the development of yellow nail syndrome (for example, in dental or joint implants or other environmental exposures). Treatment addresses each symptom present. In some cases, yellow nail syndrome goes away on its own.^[1]

Last updated: 6/14/2018

Symptoms Symptoms

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
80%-99% of people have these symptoms
Bronchiectasis		0002110
Fingernail dysplasia	Abnormal fingernail development	0100798
Hypoplasia of lymphatic vessels	Underdeveloped lymphatic vessels	0003759
Lymphedema		0001004
Toenail dysplasia	Abnormal toenail development	0100797
Yellow nails		0011367
30%-79% of people have these symptoms
Cough	Coughing	0012735
Dyspnea		0002094
Pleuritis		0002102
Recurrent respiratory infections	Frequent respiratory infections Multiple respiratory infections respiratory infections, recurrent Susceptibility to respiratory infections [ more ]	0002205
Rhinitis	Nasal inflammation	0012384
Sinusitis	Sinus inflammation	0000246
5%-29% of people have these symptoms
Biliary tract neoplasm		0100574
Generalized abnormality of skin	Generalised abnormality of skin	0011354
Immunodeficiency	Decreased immune function	0002721
Neoplasm of the lung	Lung tumor	0100526
Nephropathy		0000112
Onycholysis	Detachment of nail	0001806
Pulmonary arterial hypertension		0002092
Renal neoplasm	Renal tumors	0009726
Sarcoma		0100242
Percent of people who have these symptoms is not available through HPO
Abnormality of the musculature	Muscular abnormality	0003011
Autosomal dominant inheritance		0000006
Predominantly lower limb lymphedema		0003550
Slow-growing nails		0008383

Showing of 25 |

Do you have more information about symptoms of this disease? We want to hear from you.

Last updated: 6/1/2018

Cause Cause

The exact cause of yellow nail syndrome remains unknown. Lymphatic impairment or reduced lymphatic drainage has been proposed, as it may explain lymphedema, pleural effusion, or nail discoloration. However, it is hard to justify as a cause for bronchiectasia and sinusitis. Additionally, lymphatic impairment is not easy to confirm.^[1]

While most cases of yellow nail syndrome occur randomly, a few cases have run in families. While this suggests that genetic factors may play a role in some cases, no known genetic factors have been identified.^[2]

Rarely, yellow nail syndrome has occurred in people with autoimmune disease, or lymphatic diseases or cancers. Some researchers have hypothesized that titanium exposure may play a role in the development of yellow nail syndrome in some people (for example, in dental or joint implants; drugs that contain titanium dioxide; candy or gum; or other environmental exposures).^[1]^[3]^[4] However, additional research is needed to confirm whether there is a direct association between titanium exposure and yellow nail syndrome.^[4]

Last updated: 6/14/2018

Diagnosis Diagnosis

Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources

Orphanet lists international laboratories offering diagnostic testing for this condition.

Treatment Treatment

Yellow nail syndrome management aims to address each of the symptoms. Treatment for nail discoloration may include oral vitamin E and/or triazole antifungals. Pleural effusion may be treated with surgery. Antibiotic prophylaxis may be prescribed for bronchiectasia with chronic mucus production. Lymphedema treatment may involve low-stretch bandages and elastic compression garments combined with skin care, exercises and manual lymph drainage as needed.^[1]

In some cases, yellow nail syndrome goes away on its own or when an underlying, associated condition is treated.^[1]

Last updated: 4/17/2017

Do you have updated information on this disease? We want to hear from you.

Find a Specialist Find a Specialist

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.

Research Research

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

The Centers for Mendelian Genomics program is working to discover the causes of rare genetic disorders. For more information about applying to the research study, please visit their website.
ClinicalTrials.gov lists trials that are related to Yellow nail syndrome. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.
Orphanet lists European clinical trials, research studies, and patient registries enrolling people with this condition.

Organizations Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Lymphedema People
E-mail: lymphedemapeople@aol.com
Website: http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema
National Lymphedema Network (NLN)
2288 Fulton Street
Suite 307
Berkeley, CA 94704
Toll-free: 800-541-3259
E-mail: nln@lymphnet.org
Website: http://www.lymphnet.org

Organizations Providing General Support

American Lung Association
1301 Pennsylvania Ave NW
Suite 800
Washington, DC 20004
Toll-free: 1-800-548-8252
Telephone: 202-785-3355
Fax: 202-452-1805
E-mail: http://www.lung.org/about-us/contact-us.html
Website: http://www.lung.org/

Do you know of an organization? We want to hear from you.

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

DermNet NZ is an online resource about skin diseases developed by the New Zealand Dermatological Society Incorporated. DermNet NZ provides information about this condition.
MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Yellow nail syndrome. Click on the link to view a sample search on this topic.

GARD Answers GARD Answers

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

How is yellow nail syndrome treated? Can it be treated or not? See answer
Has a genetic cause of familial yellow nail syndrome been discovered? See answer
What lung conditions are commonly associated with yellow nail syndrome? How are they treated? See answer

Have a question? Contact a GARD Information Specialist.

References References

Vignes S and Baran R. Yellow nail syndrome: a review. Orphanet J Rare Dis. February, 2017; 12:42:https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0594-4.
Yellow Nail Syndrome. National Organization for Rare Disorders (NORD). 2015; https://rarediseases.org/rare-diseases/yellow-nail-syndrome/.
Berglund F, Carlmark B. Titanium, Sinusitis, and the Yellow Nail Syndrome. Biol Trace Elem Res. October, 2011; 143(1):1-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176400/.
Decker A, Daly D, Scher RK. Role of Titanium in the Development of Yellow Nail Syndrome. Skin Appendage Disord. March, 2015; 1(1):28-30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857837/.