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Yellow Nail Syndrome
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Michela Starace, Aurora Alessandrini, Bianca Maria Piraccini
The pathogenesis of the nail and systemic changes of yellow nail syndrome remains obscure. Anatomic and functional lymphatic abnormalities have been proposed as the underlying cause. Impaired lymphatic drainage appears to play a central role in the various clinical findings seen, with the presence of abnormal findings such as atresia, hypoplasia, and varicose abnormalities of peripheral lymphatics at lymphangiograms. In a study of quantitative lymphoscintigraphy in subjects with yellow nail syndrome, the authors underlined that the lymphatic impairment is not due to anatomical abnormalities, but rather to a functional disorder due to the reversibility of lymphedema in this condition.3 While this hypothesis might explain lymphedema and pleural effusions, yellow nails and other respiratory manifestations are more difficult to understand. Capillaroscopic observation of dilated and tortuous nail fold capillary loops suggests microangiopathy as the cause for the nail changes.1 Another possible explanation recently described is titanium exposure, but this hypothesis is not confirmed.4,5,6
Nail disorders (onychoscopy)
Published in Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides, Dermoscopy in General Dermatology, 2018
Michela Starace, Aurora Alessandrini, Bianca Maria Piraccini
The yellow nail syndrome is a rare disorder usually arising in adult age that is characterized by a typical triad of manifestations, i.e., yellow nails (usually involving all 20 nails), respiratory problems, and lymphedema.38 Albeit its pathogenesis is still unknown, it has been related to anatomic and/or functional lymphatic abnormalities.38 Congenital variants transmitted as autosomal dominant or recessive trait or paraneoplastic cases have also been described.38
Lymphoedema – pathology and clinical features
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
This accounts for 80% of primary lymphoedemas. It becomes clinically evident in females during puberty, often after trauma or infection or with body mass change, and before about the age of 35 years, suggesting that oestrogen plays a role in its pathogenesis. Lymphatics are hypoplastic and reduced in number. It usually presents in one lower limb but becomes bilateral in 50%, and the arms and face can be affected. It may be associated with the yellow-nail syndrome.
Advances in pleural effusion diagnostics
Published in Expert Review of Respiratory Medicine, 2020
Lucía Ferreiro, María E. Toubes, María E. San José, Juan Suárez-Antelo, Antonio Golpe, Luis Valdés
If PF is an exudate, investigate whether the patient has a neoplasm, anorexia, or weight loss. Physical examination should be performed to seek for adenopathies or masses supporting the presence of malignancy. In female patients, breast examination is recommended. The patient may have had an infection, productive cough, pleural pain, fever, or have used antibiotics. These findings are suggestive of IPE. Patients should be asked about their work history to determine potential exposure to asbestos. It is recommended to investigate the presence of a systemic disease (systemic lupus erythematosus, rheumatoid arthritis) and perform a physical examination to identify subcutaneous nodules, joint deformities or skin lesions suggestive of diseases such as systemic lupus erythematosus or yellow nail syndrome. In the presence of a recent risk factor, signs of pulmonary embolism and deep venous thrombosis should be investigated. Finally, the use of medicines that may cause PE should be determined by revising the medical history of the patient (www.pneumotox.com).
Yellow nail syndrome
Published in Baylor University Medical Center Proceedings, 2018
Allie Preston, Kirstin Altman, Gregory Walker
Yellow nail syndrome (YNS) is a rare condition characterized by a clinical triad of slow-growing, yellow, dystrophic nails, lymphedema, and recurring respiratory symptoms.1 It typically presents between the fourth and eighth decades with a slight male predominance, and the greatest incidence occurs after the age of 50.2 YNS was first described in 1964, and fewer than 400 cases have been reported since.2–4 The diagnosis of YNS is made when two out of three characteristic symptoms, including nail changes, lymphedema, and respiratory symptoms, are present. Only one-third of patients with this condition have all three symptoms simultaneously, and occasionally the individual symptoms may appear alone and sequentially, which can make diagnosis difficult.2,4,5
Chronic interstitial lung diseases in children: diagnosis approaches
Published in Expert Review of Respiratory Medicine, 2018
Nadia Nathan, Laura Berdah, Keren Borensztajn, Annick Clement
Lymphatic disorders can be classified as primary or secondary. Congenital errors of lymphatic development can lead to primary pulmonary lymphatic disorders that include lymphangiomas and lymphangiomatosis, lymphangiectasis, and lymphatic dysplasia syndrome (congenital, yellow nail syndrome). Secondary forms of lung lymphatic disorders result from a variety of processes such as chronic airway inflammation that impair lymph drainage and increase lymph production [52].