Yellow nail syndrome: symptoms, cause and treatment

Yellow nail syndrome is a rare, hereditary condition. With yellow nail syndrome, the nails turn yellow. Two other symptoms that also occur with yellow nail syndrome are lymphedema and breathing problems. Usually all nails are affected at the same time, but it is also possible that only the fingernails show the abnormality. The cause of the condition is not known. Yellow nail syndrome is associated with respiratory disease and lymphedema of the legs. These problems can really interfere with your daily life and also affect the quality of life. Without treatment, spontaneous healing occurs in approximately thirty percent. It is no small feat to effectively treat yellow nail syndrome. It was Samman and White who first described this disease in 1964.

  • What is yellow nail syndrome?
  • Yellow nail syndrome cause
  • Symptoms of yellow nail syndrome
  • Most important features
  • Nails
  • Diagnosis and research
  • Classical clinical manifestations
  • Differential diagnosis
  • Treat and remedy yellow nail syndrome
  • Complications
  • Prognosis


What is yellow nail syndrome?

Yellow nail syndrome is a rare condition characterized by three symptoms: yellowish discoloration of usually all nails, lymphedema (an unwanted accumulation of lymphatic fluid) and breathing problems. The cause is unknown, but hereditary factors appear to play a role. The condition is more common in women. The anomaly was first described by Samman and White in 1964.ยน

Yellow nail syndrome cause

The cause of yellow nail syndrome is (still) unknown in 2023, but hereditary factors may play a role. Yellow nail syndrome is associated with respiratory disease and lymphedema of the legs. But there are also people without respiratory problems who can develop the nail abnormality. Very occasionally, a connection is made between yellow nail syndrome and conditions associated with reduced immune function. The average age at which you get it is 40 years old, but that varies greatly

Symptoms of yellow nail syndrome

Most important features

The three main characteristics of yellow nail syndrome are described in the following table.



Nail changes

  • All nails can be affected;
  • Nails grow slowly or appear to have stopped growing;
  • Nails are thicker and have a light yellow or greenish-yellow color with edges that are slightly darker;
  • The cuticle has disappeared;
  • The nail plate has become more convex and is also slightly thickened;
  • Onycholysis or loosening of the nail also occurs.


  • These swellings are the result of the accumulation of lymph;
  • Lymphedema occurs in approximately 80% of patients and most commonly affects the legs;
  • These swellings often appear several months after the nail changes have taken place;
  • Swelling occurs less often in the face, hands, or genitals.

Breathing problems

  • Pleural effusion occurs in approximately 36% of patients;
  • Pleural effusion is the pathological accumulation of fluid between the two pulmonary membranes, the pleura parietalis and the pleura visceralis;
  • In approximately 30% of patients, the first symptom is due to pleural effusion: an abnormal accumulation of fluid in the pleural space;
  • Patients often have a history of recurrent bronchitis, chronic sinusitis, and pneumonia.



Yellow nail syndrome is characterized by nails that are discolored light yellow to light green, with the nail edges often slightly darker. Usually all nails are affected, but it also happens that only the fingernails show abnormalities. The growth of the affected nails is greatly reduced. Typically, the edge of skin that connects to the nail, the cuticle, has disappeared and the nail plate has become more convex and has also thickened slightly. In addition, loosening of the nail occurs. Furthermore, there may be redness or edema of the cuticle, as well as chronic inflammation of the nail wall (chronic paronychia).

Diagnosis and research

Classical clinical manifestations

The diagnosis is usually based on the presence of two of the three classic clinical manifestations, including nail changes, respiratory disease and lymphedema, or very characteristic nail changes. The diagnosis can also be based solely on the characteristic nail changes.

Differential diagnosis

The main differential diagnoses are chronic paronychia (an inflammation of the nail wall, also called ‘circulation’), and onychomycosis (fungal infection of the nails, nail fungus).

Treat and remedy yellow nail syndrome

There is no specific treatment for yellow nail syndrome. Possible health problems underlying yellow nail syndrome are detected and treated. In addition, the following treatments may provide improvement in some cases: vitamins A and E, zinc sulphate and nutritional supplements. In roughly a third of cases of yellow nail syndrome, spontaneous healing of the nails occurs. There is little convincing evidence that antifungals (antifungal medications), antibiotics, and corticosteroids (powerful anti-inflammatories) help yellow nail syndrome.


A large amount of pleural fluid can be life-threatening. Surgical treatment of pleural effusion can cause complications. Finally, lymphedema can seriously affect the quality of life.


The nail changes can disappear on their own in half of the cases. Breathing problems are usually manageable with adequate treatment. Progressive respiratory failure is uncommon. The most problematic manifestation appears to be the presence of a lot of pleural fluid, which can return after treatment.

  1. Samman PD, White WF; The “Yellow nail” syndrome. Br J Dermatol. 1964 Apr;76:153-7.


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