‘Yellow nail syndrome’ could be a warning sign of tumour squishing the lungs, doctors warn
DOCTORS were shocked to discover a man’s yellowing nails were a sign of a tumour squishing his lungs and heart.
The 73-year-old suffered from breathlessness, discoloured nails, and leg swelling for years before finally seeking help.
What seemed like several unrelated issues turned out to be the classic signs of yellow nail syndrome (YNS), a rare condition affecting fewer than one in every 1,000 people.
Yellow nails are usually seen as a minor cosmetic issue and are often linked to fungal infections.
However, they can also indicate chronic lung conditions and diabetes.
This case is the first known instance where stained nails were connected to a tumour, according to German doctors and scientists.
For two years, the man noticed his fingernails and toenails slowly turning yellow, thick, and brittle.
Around the same time, swelling appeared in his lower legs, making it uncomfortable to walk.
After visiting a hospital, doctors carried out chest X-rays and fluid tests, which revealed a large amount of milky fluid in the man’s lungs, known as chylothorax.
This happens when the lymphatic system – responsible for draining excess fluids from the body – is disrupted.
A CT scan then revealed a benign tumour called a lipoma sitting next to his lungs.
Though non-cancerous, the 7cm fatty lump pressed on his thoracic duct, the largest and most important lymphatic vessel in the body.
This pressure was blocking fluid from leaving the body and causing it to back up into his chest and limbs.
To treat him, specialists performed a groundbreaking technique that didn’t involve major surgery called a percutaneous lymphatic embolisation.
Through a small cut, doctors sealed off the problematic lymphatic vessels, drastically reducing the fluid leakage.
For the leg swelling, he was given compression bandages and manual drainage therapy.
To address his yellow nails, doctors prescribed vitamin E cream and zinc supplements to promote healthier growth.
His breathing improved, the swelling reduced, and he began seeing slow progress with his nail condition.
Writing in Journal of Medical Case Reports, the experts said: “The complexity of the underlying pathophysiology in yellow nail syndrome and the lack of treatment guidelines demonstrate the necessity for more research on this rare disorder.”
Here's what the colour of your hand and toenails reveals about your health
We asked Dina Gohil, podiatrist and Nailner brand ambassador, to reveal the truth behind nail colours, and when it’s best to speak to your doctor…
YELLOW NAILS
Although discolouration might simply be a case of needing to take a break from the nail polish, Dina says thick discoloured nails are likely to mean a fungal infection.
Discolouration can appear white, yellow, or even darker brown, depending on the individual.
She says: “When a fungal infection begins, you may start to notice discolouration on a small aspect of your nail and notice it gets larger over time.
“For chronic cases, this may already have spread to the majority of the nail if not the entire nail.
“As the fungus spreads, the nail can become brittle, ‘chalky’, and you may notice it breaks easily, and there may be an odour present.
With chronic infection, the nail may become thickened.
“The nail may start to separate from the nail bed, causing pain, and odour may be more prominent.”
Dina adds that if yellow nails continue to get worse it can also be a sign of diabetes, psoriasis, or even thyroid disorders, so visit your GP if you are concerned.
An over-the-counter anti-fungal treatment can help with fungal infections, to not only treat the infection but the appearance of the nail too.
PALE NAILS
White or nails bleached of their colour can signal a potential blood issue.
Dina says: “Pale nails could be a sign of poor circulation, anaemia or malnutrition.
“They can also be caused by malfunctions in the liver or heart, so it is important to get this issue checked out.”
BLUISH NAILS
If you have painted your nails navy and they’re still looking bruised or blue, speak to you doctor.
Dina says: “These are often an indicator that there’s not enough oxygen getting to them, suggesting there may be a breathing problem associated with the lungs, or a heart disorder.”
WHITE SPOTS
Have a look at your nails – chances are you currently have, or in the past, have noticed white spots on them.
Dina says: “White spots on the nails can be down to injury or micro trauma to the nail, which is fairly common.
“They can also be associated with a zinc deficiency or fungal infection.”
BLACK NAILS
Very bruised looking, or entirely black nails are worth getting looked at.
Dina says: “Also linked to trauma of the nails, these are caused by the blood vessels in the nail bed breaking and showing on the nail bed under the nail.
“In other cases, it can be signs of anaemia, diabetes, kidney disease or heart disease.”