Yellow Nail Syndrome With Dramatic Improvement of Nail Manifestations After Endoscopic Sinus Surgery

Hosokawa, Yu; Kuboki, Akihito; Mori, Aya; Kanaya, Hiroaki; Haruna, Shinichi

doi:10.1177/1179550617718184

Cited by 4 publications

(3 citation statements)

References 12 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With regard to sinus disease, resolution of a patient’s yellow nails following endoscopic sinus surgery alone has been previously reported in 1 patient by Hosokawa et al. 17…”

Section: Discussionmentioning

confidence: 87%

“…1 Interestingly, within their case series of 41 YNS patients, they saw an association of improved nail pathology with improvement of patient's pulmonary function. With regard to sinus disease, resolution of a patient's yellow nails following endoscopic sinus surgery alone has been previously reported in 1 patient by Hosokawa et al 17…”

Section: Treatment Of Patients With Ynsmentioning

confidence: 88%

See 1 more Smart Citation

Characterization of Sinus Disease in Patients with Yellow Nail Syndrome

Gutierrez

Low

Stokken

et al. 2019

Am J Rhinol�Allergy

View full text Add to dashboard Cite

Objective Yellow nail syndrome (YNS) is characterized by the triad of thickened yellow nails, primary lymphedema, and respiratory manifestations including bronchiectasis, chronic cough, pleural effusions, and sinusitis. The purpose of this study is to describe the manifestations of chronic rhinosinusitis (CRS) in patients with YNS and the comorbid manifestations. Methods A retrospective review of patients with YNS with CRS from January 1, 1998 to January 1, 2018 was conducted. Their symptoms, comorbidities, and labs were reviewed. The patient’s sinus computed tomography (CT) scans were then scored using the Lund–Mackay (LM) scoring system. Result Thirty-six patients met the inclusion criteria. The average LM score was 10.2 ± 0.5 (mean ± SD). Sinus involvement included “frothy” dependent sinus secretions in 32 of 36 subjects. The most common location of sinus involvement was the maxillary sinuses (85%), then posterior ethmoid (81%), anterior ethmoid (76%), sphenoid (74%), and frontal sinuses (54%). Comorbid chronic cough (86%), bronchiectasis (65%), lymphedema (39%), and pleural effusion (19%) were also identified. Three patients (8%) had immunodeficiencies. Conclusion This is the largest series describing the sinus manifestations of CRS in patients with YNS. Sinus CT scans showed frothy dependent secretions in the maxillary sinuses and posterior ethmoid sinuses most commonly. YNS patients with sinusitis more commonly presented with chronic cough or bronchiectasis than with pleural effusions or lymphedema. Otolaryngologists should consider the possibility of YNS in patients with CRS, chronic cough, yellow or thickened nail, and CT findings of frothy, dependent sinus secretions.

show abstract

“…With regard to sinus disease, resolution of a patient’s yellow nails following endoscopic sinus surgery alone has been previously reported in 1 patient by Hosokawa et al. 17…”

Section: Discussionmentioning

confidence: 87%

Section: Treatment Of Patients With Ynsmentioning

confidence: 88%

Characterization of Sinus Disease in Patients with Yellow Nail Syndrome

Gutierrez

Low

Stokken

et al. 2019

Am J Rhinol�Allergy

View full text Add to dashboard Cite

show abstract

“…A case of a patient affected by YNS with rhinosinusitis cured with combination treatment with triamcinolone injection, oral vitamin E, oral fluconazole, and robust medical regimen for rhinosinusitis has been reported, although the variety of treatment administered makes it is difficult to assess the relevance of each agent in the resolution of symptoms [50]. A single case of YNS with rhinosinusitis whose nail manifestations were dramatically improved after endoscopic sinus surgery has been reported [63].…”

Section: Associated Conditionsmentioning

confidence: 99%

Nails: The Window to the Nose? Update on Yellow Nail Syndrome

Vollono

Chessa

Bruno

et al. 2020

Dermatol Pract Concept

View full text Add to dashboard Cite

Background: Yellow nail syndrome is a rare condition characterized by typical nail alterations and variable presence of lymphedema and respiratory disease. The pathogenesis is still obscure, with most of the literature deriving from case reports and few investigations. The most reported respiratory conditions associated with yellow nail syndrome are pleural effusion and bronchiectasis, whereas association with rhinosinusitis is rarer. Objectives: To describe a case of yellow nail syndrome and to provide a literature review regarding this condition, discussing pathogenetic hypothesis, associated conditions, and therapeutic options. Patients/Methods: A 49-year-old man presented with arrested growth and alterations of his nails, without any history of previous trauma or inflammation but with a severe nasal septum deviation and a history of chronic rhinosinusitis. A diagnosis of yellow nail syndrome was made. Results: Six months after undergoing rhinoseptoplasty and treatment with oral vitamin E, the patient’s nails were cured. Conclusions: This case emphasizes the role of the dermatologist in detecting systemic conditions. The correct diagnosis led to complete resolution of both nail alterations and associated respiratory condition.

show abstract

Sinonasal mucosal vasculature in yellow nail syndrome and chronic rhinosinusitis with or without polyps

Chatzopoulos

Gutierrez

García

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

BackgroundLymphatic dysfunction is hypothesized to be an underlying factor in the pathophysiology of yellow nail syndrome (YNS) (yellow nails, lymphedema, pleural effusions, and frequently chronic rhinosinusitis [CRS]). It is unclear why some YNS patients develop CRS. We quantified lymphatic and total vasculature of sinonasal mucosa in YNS patients and compared it to controls from CRS patients with (CRSwNP) or without polyps (CRSsNP).MethodsImmunohistochemistry was performed on archival sinonasal mucosal samples from 5 patients with YNS and 14 controls with antibodies against podoplanin and CD31, markers of lymphatics. Morphometric assessment was performed on digital images using ImageJ software.ResultsIn YNS, the number of lymphatics/mm2 ranged from 7 to 18/mm2 (controls: 6 to 43/mm2, p = 0.343), with a mean perimeter between 92 and 201 µm (controls: 42 to 280 µm, p = 0.482). Total vasculature density was higher than lymphatics, ranging between 189 and 1159 vessels/mm2, average 669 (controls: 139 to 1467/mm2, average 503, p = 0.257) with smaller average perimeter, 40 to 117 µm, mean 64.8 µm (controls: 42 to 92 µm, mean 65.3 µm, p = 0.965). Lymphatics constituted only a small fragment of the total vasculature, ranging from 1.15% to 4.76%, average 2.34% (controls: 0.81% to 10.58%, average 4.88%, p = 0.156). CRSwNP patients had significantly higher lymphatic density (p = 0.011) and ratio of lymphatics to total vasculature (p = 0.045) than patients with YNS or CRSsNP.ConclusionThis is the first histological analysis of sinus mucosa in patients with YNS. Vascular type, density, size, and distribution in the sinonasal mucosa of YNS patients are not statistically significantly different from those of the CRSsNP group. Lymphatic density and ratio to total vasculature is higher in CRSwNP patients.

show abstract

Yellow Nail Syndrome With Dramatic Improvement of Nail Manifestations After Endoscopic Sinus Surgery

Cited by 4 publications

References 12 publications

Characterization of Sinus Disease in Patients with Yellow Nail Syndrome

Characterization of Sinus Disease in Patients with Yellow Nail Syndrome

Nails: The Window to the Nose? Update on Yellow Nail Syndrome

Sinonasal mucosal vasculature in yellow nail syndrome and chronic rhinosinusitis with or without polyps

Contact Info

Product

Resources

About