A rare medical syndrome known as "primary lymphedema accompanied with yellow nails and pleural effusion" combines pleural effusions, lymphedema (caused by underdevelopment of the lymphatic vessels), and yellow dystrophic nails.
The most defining characteristic of YNS is slow or stopped growth of nails. The nails are yellow to yellow-green in color and have become noticeably thicker. The white crescent may be reduced, the nail may be detached from the nailbed, and the nails may have ridges and increased side-to-side curvature. These abnormalities on the nails may also alter over time.
Yellow nail syndrome can have serious symptoms but rarely results in death. The outlook is typically favorable, particularly if you seek treatment as soon as you begin to experience symptoms. The majority of people with yellow nail syndrome live a normal life. It has been suggested that there may not be a genetic connection, despite the fact that it has been described in families.
Yellow nail syndrome can sometimes affect more than one person in the same family. Although it has not been demonstrated, this suggests a possible genetic connection. Yellow nail syndrome may be more common in people who have immune system disorders, thyroid disease, rheumatoid arthritis, and certain types of cancer. It is definitely a disorder that is painful but it is not a threat to life in any way.
Symptoms
Three primary symptom categories describe yellow nail syndrome:
- Your nails could stop growing or grow more slowly. They frequently become thicker, become yellow or green, and have the potential to split away from your nail bed and disappear. Modifications may affect one nail or all of them.
- Swelling- About 8 out of 10 persons with yellow nail syndrome experience fluid retention and swelling (lymphedema). Most frequently, a few months after changing your nails, your legs expand.
- Breathing problems- Nearly 2 in 5 sufferers of yellow nail syndrome have fluid accumulation in their lung tissue (pleural effusions). Additionally, you can suffer from pneumonia, recurrent sinus infections, or chronic cough.
- Other symptoms usually refer to peripheral lymphedema and pleural effusion. Dyspnea, a cough, and chest pain are signs of the first; significant edoema in various body areas is a sign of the second. Lymphedema initially causes the skin in afflicted areas to become soft and swollen, but chronic lymphedema is linked to fibrotic changes, which cause the skin to stiffen. Lower limbs are most usually affected by lymphedema.
- Refractory respiratory tract infections affect many YNS patients. It is common to see pneumonia, bronchitis, and chronic or recurring sinusitis. CT scans for bronchiectasis may show the condition. Recurrent airway infections may be the earliest sign of yellow nail syndrome; however this cannot be determined until after the start of other symptoms.
Diagnosis
Typically, depending on your symptoms, your doctor can determine if you have yellow nail syndrome.
- Pulmonary function tests to evaluate the condition of your lungs.
- Tests on the nails to rule out other nail issues, like an infection.
Yellow nails could indicate a variety of illnesses, including psoriasis or a fungal infection. However, your doctor may need to rule out yellow nail syndrome if you also have respiratory symptoms in addition to yellow nails.
YNS is a clinical diagnosis based on distinctive physical and history examination findings. According to reported histological findings, the subungual stroma is substituted by a dense fibrous tissue with ectatic, endothelium-lined arteries.
The patient's medical history and physical examination serve as a basis for evaluating pulmonary abnormalities and lymphedema. Lymphangiography, lymphoscintigraphy, pulmonary function tests, imaging (chest radiography, computed tomography, Doppler ultrasonography), and imaging-related tests may help with the diagnosis. A pleural effusion typically has a high protein content, chylothorax, and lymphocytosis if it is present.
Physical examination is used to make the diagnosis of YNS. Patients may or may not have peripheral lymphedema, pleural effusion, or nail dystrophy; all three conditions are not necessary for the diagnosis of YNS. Thus, even if nail alterations cannot be seen, patients may still be diagnosed with YNS.
The major goals of additional workup are to rule out alternative diagnosis and find any potential underlying diseases. The medical background of a patient could be very helpful in achieving this. Although an apparent propensity for airway infections is frequently noted, additional complaints can point to a primary illness.
When blood samples are analysed in a lab, hypoalbuminemia is a highly frequent finding in YNS patients. A concomitant respiratory infection may change the characteristics of inflammation.
To determine the degree of pleural effusion, diagnostic imaging is used. Lymphangiography is a procedure that can be used to assess lymphatic system performance and pinpoint the cause of lymphedema, but it comes with a high risk of further harm. As a result, lymphoscintigraphy frequently takes the place of lymphangiography.
Clinical examination is the foundation for diagnosis. It should be noted that YNS patients may not always exhibit all three symptoms indicated above. To determine the severity of the lesions and rule out alternative diagnoses, additional diagnostic procedures may be used. Plain radiography, computed tomography scans, and laboratory analysis of blood samples can all be used to achieve this.
Causes of Yellow Nails
In persons over 50, yellow nail syndrome most frequently manifests. Yellow nail syndrome can occasionally affect kids, though less frequently. If harsh treatments or dyes have damaged your nails, the new nail growth should be a healthy, clear colour. If your nails still appear yellow, your body might be experiencing another issue. Yellow nails might occasionally be a sign of more serious issues. Nails can seem yellow due to vitamin or mineral shortages, so adding a multivitamin supplement to your routine may help.
Sometimes, despite repeated treatments, yellow nails can be a sign of diabetes, psoriasis, or thyroid disorders. Yellow nails may occasionally be an early sign of skin cancer. Consistently yellow nails and respiratory or lymphatic issues are symptoms of a disorder known as yellow nail syndrome (YNS). Fluid buildup in the pleural cavity, or the narrow space between the lungs and rips, as well as in other tissues, can result from lymphatic system dysfunction. It could be brought on by inherited dysfunction or developmental flaws in lymphatic vessels. The pathogenesis of nail alterations and airway infections is poorly understood.
A fungal infection of the nails is one of the most frequent causes of yellow toenails. Men are more likely to have them. These infections can be acquired from contact with environmental fungus, frequently in public areas where people wear bare feet, such as swimming pools and gym locker rooms. Yellow toenails can also appear if you have an athlete's foot-like fungal infection that has migrated to your nails.
- Use of Nail Lacquer in Excess: Some varieties of nail polish rob the nails of oxygen, which can cause discolouration. Give your nails a break from nail paint to combat this, or you can try using a clear base coat to perhaps prevent discolouration.
- Wearing nail art over artificial nails that are attached over natural nails is known as wearing nail extensions. The nail bed might be harmed by leaving these fake nails on for an extended period of time or by setting them incorrectly. Artificial nails also prevent the nails from receiving natural air and light, which increases the risk of fungus infections and, consequently, yellow nails.
- Soda: Occasionally, taking too much soda can harm your nails. Because soda naturally bleaches things, it is utilised to lighten darker colours. Regular contact with caustic soda causes your fingernails to become brittle and develop some sort of discoloration. can eventually result in discoloration and frequent nail outbreaks.
- Smoking- As nails are susceptible to the same damaging agents that make skin texture appear dimpled, including smoking, which can produce ridges and discoloration on the nail plate, frequent exposure of fingers to tobacco tar can reportedly lead to discolouration.
- Aging: It's common for nails to start to change in appearance as you become older. It occurs as a result of poor blood circulation in the hands and feet, which restricts oxygen flow to the feet and results in thick, brittle, discoloured, and slowly growing nails. Your entire set of nails will often yellow as you become older.
- Titanium- Another potential cause of yellow nail condition is titanium exposure. Many commonplace things, such as sunscreen, cosmetics, medications, food, dental fillings, implants, and joint replacements, include titanium.
Treatment for Yellow Nails
While there is no cure for congenital YNS, if the underlying condition can be found and well treated, acquired YNS may resolve on its own. The goal of further therapy is symptom relief, and it must be tailored to each patient's unique problems.
- Topical and systemic vitamin E supplementation has been used to treat nail dystrophy, while its efficacy is still debatable and placebo oil has reportedly had comparable effects. It is noteworthy that reports of spontaneous remission of nail alterations exist. Antifungal treatments may be recommended if a fungal infection is the reason for your yellow nails. These drugs can be either swallowed or topically applied. Up to weeks or even a year may pass throughout the course of treating a fungus infection.
- Treatment with laser therapy may be recommended by your doctor if the fungal infection is severe.
- Restricted use of nail polish: Your doctor may advise keeping your nails bare for at least a week to give them time to breathe and recover if the discolouration in your nails is the result of excessive usage of nail lacquer.
- Vitamin E: You can apply vitamin E-containing nail cream or gel or take vitamin E tablets. Typically, nail symptoms cannot be reversed, however vitamin E can decrease or stop the development of nail abnormalities.
- Other pharmaceuticals Treating underlying health conditions like thyroid disease and diabetes that may be the source of your yellow nails will eventually improve the condition of your nails. Combining vitamin E with an antifungal medication like fluconazole. The most effective treatment for problems connected to nails, according to study, is vitamin E therapy.
- Respiratory infections that can be treated with antibiotics include chronic bronchitis, sinus infections, and cough. Surgery to treat a pleural effusion may involve draining extra fluid to ease symptoms.
- Lymphedema in the legs can be treated with specialised bandages and elastic compression clothing. Manual lymph drainage massages and exercises may also be advantageous. The use of corticosteroids to treat the symptoms.
- Surgical removal of a pleural effusion.
- Antibiotics for the treatment of lung infections, sinusitis, or mucus production brought on by bronchiectasis.
- Exercises, massage, elastic compression stockings, and low-stretch bandages can all help reduce edoema.
- Manually draining the fluid from engorged lymphatic regions.
- Medications specifically prescribed to address underlying conditions like cancer or rheumatoid arthritis.
How To Treat Yellow Nails At Home
- Tetracycline oil Tea tree oil is a simple remedy you can attempt if a bacterial infection or fungus is the source of your nails' discoloration. Tea tree oil is combined with a carrier oil, such as olive oil, coconut oil, or jojoba oil, and then applied to the damaged nail with a cotton swab. According to a study, tea tree oil is an excellent way to prevent the spread of common nail fungus types.
- Soda bicarbonate Only an acidic environment can support the growth of fungi. Baking soda and hot water can be used to soak your feet or toes to stop the fungus from spreading. Over the course of a few soaks, baking soda develops an alkaline environment that could make your nails considerably cleaner.
- Oregano oil: It has been discovered that oregano oil has antibacterial qualities. If you're not sure what's causing your nails to become yellow, this therapy is excellent because it's powerful against germs and fungi. Oregano oil should be diluted with a carrier oil, much like tea tree oil, before being administered topically to the afflicted nail or nails.
- Lemon: Lemon is a natural bleach that can be used to get rid of yellow nail discoloration. Additionally, it has astringent properties that might help mend the pores and the region under the nail. Your fingernails and toenails can be cleaned of stains by soaking them in lemon juice. Lemon can be used to make simple home cures, but you'll need patience because the stains won't go in a day or two.
- Use of toothpaste with a whitening ingredient, such as hydrogen peroxide or baking soda, is another remedy for yellow toenails or fingernails. The same substances that can be used to whiten your teeth can also be used to remove light yellow stains from your nails.
- Citric acid and vitamin C, which are abundant in orange peel, help remove stains and spots from the nails. Additionally, orange peel's antioxidants nourish your nails, enhancing their strength and health.
- Hydrogen peroxide: This substance can be used for a variety of purposes, but it can also be used to whiten discoloured fingernails. To ensure that the hydrogen peroxide you purchase won't be too potent for your fingernails, look for brands that contain 3 percent hydrogen peroxide.
- Glycerine: You may be aware with glycerine from its use to hydrate skin, but it also works wonders on your nails. When you use glycerine as a home treatment, anticipate seeing brighter, shinier nails as a result.
- Listerine—This can be particularly helpful for yellowed nails caused by a fungal infection. Some of the chemicals in Listerine are useful for removing stains from your nails. Thymol, eucalyptol, and menthol are the chemicals that are active.
- Juniper berries are quite good at treating your yellowed nails, which can be caused by a fungus infection. Juniper berries' antiseptic qualities might help you instantly brighten the colour of your nails. Before putting juniper berries in water, you must smash them. Spend around 15 minutes soaking your nails in the mixture. Use warm water to rinse your nails.
- Denture cleaning tablets- These are an efficient way to get rid of the yellow nail stain. Tablets for cleaning dentures are made of citric acid and bicarbonate. These are quite good in getting rid of unsightly stains.
Prevention
- Maintaining good nail cleanliness will help you avoid nail discolouration. Customers may contract diseases and fungal infections from beauty parlours and swimming pools. Every client should receive a fresh or clean manicure from a professional nail technician.
- Use nail polish remover on your nails no more frequently than once a week. Additionally, since it causes less of a problem, use nail polish remover free of acetone. Poor-quality dark nail paints may have a long wear period, but they can discolour and stain your nails. It is suggested that milder, natural hues be preferred over dark ones. Applying a base layer shields your nails from the nail polish's dark-staining colours, preventing discolouration. Make sure you will occasionally take breaks from painting your nails with nail polish. As your nails are exposed to oxygen, they will feel free. Additionally, they will appear healthier.
- Regularly scrub your nails, once or twice every week. To prevent toenail infections, always wear clean socks and periodically expose your feet to fresh air.
- To maintain the health of your cuticles and nails, it is advisable to incorporate foods high in keratin and biotin in your diet. Omega-3 fatty acids, eggs, almonds, blueberries, red meat, oysters, and avocados are a few of these foods. Consuming fresh fruits and vegetables can also help you receive more vitamin B and E, iron, calcium, and zinc into your system. Additionally, drink a lot of water every day.
- Regular physical activity can promote blood circulation to the extremities, preserving the health of the nails.
- To avoid nail yellowing and to improve your general health, you must stop smoking.
- Yellow nail syndrome occasionally goes away on its own. With the right care, the symptoms might be controlled or gone altogether.
- Although its symptoms might be uncomfortable and painful, yellow nail syndrome does not seem to be a life-threatening condition.
- Although this treatment has not always been demonstrated to be effective, in some circumstances, removing titanium dental implants may be able to alleviate a person's problems. To find out if the implants may have contributed to yellow nail condition and whether different dental surgery may be done to replace them, it is best to consult with medical and dental experts.
- Most symptoms of yellow nail syndrome can be controlled or even eliminated in many cases with the proper care.
- Your issue ought to start to get better after adopting a home remedy for yellow nails. Make an appointment with your doctor if it doesn't get better in ten to two weeks. Your doctor can perform tests to identify whether fungus, yeast, bacteria, or anything more serious is to blame for your yellow nails.
- You should consult your doctor as soon as possible if you notice any new, darkly coloured streaks in your nails. A dermatologist may need to be consulted about you.
Conclusion
Yellow nails can be a cause for worry due to both their appearance and the possibility that they represent a medical issue. To avoid issues, it is best to undergo treatment for nail discolouration. Dark nail paints and fungus treatments are just two of the many causes of yellow nails. It probably won't last forever. Depending on the cause, you can try various home cures, get a professional manicure, change your eating habits, and use drugs for a fungal infection. Once you've identified the source of your yellow tint, you can either come up with a quick remedy at home or seek medical attention from a professional who can address the underlying reason. But if the issue persists despite receiving the recommended care and employing home remedies, it is preferable to see a doctor for a proper diagnosis and effective treatment.
