title: Yellow nail syndrome: clinical experience in a series of 21 patients.
abstract: OBJECTIVE
  The pathogenesis and the therapy of the yellow nail syndrome (YNS) are poorly defined. Our aim was to assess the clinical features, associated diseases and response to treatment of patients with YNS, to help clinicians to better diagnose and treat YNS patients.
  
  
  METHODS
  We studied the medical records of all patients with YNS diagnosed at the Outpatient Nail Clinic of the University of Bologna in the last 28 years. All patients were re-evaluated to assess the evolution of the disease.
  
  
  RESULTS
  We diagnosed YNS in 21 patients; average age was 57 ± 12.3 years at the time of diagnosis. In most patients YNS involved all 20 nails. Sixteen patients had chronic respiratory manifestations and 6 had lymphedema; 12 patients had other concomitant diseases. Ten of the 20 patients treated had a good nail response to systemic vitamin E 1 200 IU/day, while other symptoms were not modified.
  
  
  CONCLUSIONS
  YNS is a rare disorder in which the nail alterations are often the symptom that leads to medical consultation. Due to its association with potential serious comorbidity, physicians should be able to diagnose and order further investigations to assess presence of lymphedema and/or lung disease.
authors.affiliation: Dermatology, Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Italy.
authors.forename: Bianca Maria
authors.initials: BM
authors.lastname: Piraccini
authors.forename: Beatrice
authors.initials: B
authors.lastname: Urciuoli
authors.forename: Michela
authors.initials: M
authors.lastname: Starace
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Balestri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007558:Italy; D008209:Lymphedema / Q000175:diagnosis* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012120:Respiration Disorders / Q000175:diagnosis* / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D014810:Vitamin E / Q000627:therapeutic use*; D056684:Yellow Nail Syndrome / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000935:Antifungal Agents; D014810:Vitamin E