A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin
Identifieur interne : 002134 ( Pmc/Curation ); précédent : 002133; suivant : 002135A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin
Auteurs : Manabu Suzuki [Japon] ; Atsuto Yoshizawa [Japon] ; Haruhito Sugiyama [Japon] ; Yasunori Ichimura [Japon] ; Akane Morita [Japon] ; Jin Takasaki [Japon] ; Gou Naka [Japon] ; Satoshi Hirano [Japon] ; Shinyu Izumi [Japon] ; Yuichiro Takeda [Japon] ; Masayuki Hoji [Japon] ; Nobuyuki Kobayashi [Japon] ; Koichiro Kudo [Japon]Source :
- Case Reports in Dermatology [ 1662-6567 ] ; 2011.
Abstract
An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS). She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS), based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM)] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.
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DOI: 10.1159/000334734
PubMed: 22220146
PubMed Central: 3250669
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin</title><author><name sortKey="Suzuki, Manabu" sort="Suzuki, Manabu" uniqKey="Suzuki M" first="Manabu" last="Suzuki">Manabu Suzuki</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation><affiliation wicri:level="3"><nlm:aff id="aff2">Internal Medicine, Department of Pulmonary Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Internal Medicine, Department of Pulmonary Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3">Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata</wicri:regionArea></affiliation></author><author><name sortKey="Yoshizawa, Atsuto" sort="Yoshizawa, Atsuto" uniqKey="Yoshizawa A" first="Atsuto" last="Yoshizawa">Atsuto Yoshizawa</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Sugiyama, Haruhito" sort="Sugiyama, Haruhito" uniqKey="Sugiyama H" first="Haruhito" last="Sugiyama">Haruhito Sugiyama</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Ichimura, Yasunori" sort="Ichimura, Yasunori" uniqKey="Ichimura Y" first="Yasunori" last="Ichimura">Yasunori Ichimura</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Morita, Akane" sort="Morita, Akane" uniqKey="Morita A" first="Akane" last="Morita">Akane Morita</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Takasaki, Jin" sort="Takasaki, Jin" uniqKey="Takasaki J" first="Jin" last="Takasaki">Jin Takasaki</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Naka, Gou" sort="Naka, Gou" uniqKey="Naka G" first="Gou" last="Naka">Gou Naka</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Hirano, Satoshi" sort="Hirano, Satoshi" uniqKey="Hirano S" first="Satoshi" last="Hirano">Satoshi Hirano</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Izumi, Shinyu" sort="Izumi, Shinyu" uniqKey="Izumi S" first="Shinyu" last="Izumi">Shinyu Izumi</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Takeda, Yuichiro" sort="Takeda, Yuichiro" uniqKey="Takeda Y" first="Yuichiro" last="Takeda">Yuichiro 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Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22220146</idno><idno type="pmc">3250669</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250669</idno><idno type="RBID">PMC:3250669</idno><idno type="doi">10.1159/000334734</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002135</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002135</idno><idno type="wicri:Area/Pmc/Curation">002134</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002134</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin</title><author><name sortKey="Suzuki, Manabu" sort="Suzuki, Manabu" uniqKey="Suzuki M" first="Manabu" last="Suzuki">Manabu Suzuki</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation><affiliation wicri:level="3"><nlm:aff id="aff2">Internal Medicine, Department of Pulmonary Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Internal Medicine, Department of Pulmonary Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3">Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata</wicri:regionArea></affiliation></author><author><name sortKey="Yoshizawa, Atsuto" sort="Yoshizawa, Atsuto" uniqKey="Yoshizawa A" first="Atsuto" last="Yoshizawa">Atsuto Yoshizawa</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Sugiyama, Haruhito" sort="Sugiyama, Haruhito" uniqKey="Sugiyama H" first="Haruhito" last="Sugiyama">Haruhito Sugiyama</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Ichimura, Yasunori" sort="Ichimura, Yasunori" uniqKey="Ichimura Y" first="Yasunori" last="Ichimura">Yasunori Ichimura</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Morita, Akane" sort="Morita, Akane" uniqKey="Morita A" first="Akane" last="Morita">Akane Morita</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Takasaki, Jin" sort="Takasaki, Jin" uniqKey="Takasaki J" first="Jin" last="Takasaki">Jin Takasaki</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Naka, Gou" sort="Naka, Gou" uniqKey="Naka G" first="Gou" last="Naka">Gou Naka</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Hirano, Satoshi" sort="Hirano, Satoshi" uniqKey="Hirano S" first="Satoshi" last="Hirano">Satoshi Hirano</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Izumi, Shinyu" sort="Izumi, Shinyu" uniqKey="Izumi S" first="Shinyu" last="Izumi">Shinyu Izumi</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Takeda, Yuichiro" sort="Takeda, Yuichiro" uniqKey="Takeda Y" first="Yuichiro" last="Takeda">Yuichiro Takeda</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Hoji, Masayuki" sort="Hoji, Masayuki" uniqKey="Hoji M" first="Masayuki" last="Hoji">Masayuki Hoji</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Kobayashi, Nobuyuki" sort="Kobayashi, Nobuyuki" uniqKey="Kobayashi N" first="Nobuyuki" last="Kobayashi">Nobuyuki Kobayashi</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Kudo, Koichiro" sort="Kudo, Koichiro" uniqKey="Kudo K" first="Koichiro" last="Kudo">Koichiro Kudo</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</nlm:aff><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName><wicri:orgArea>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School</wicri:orgArea></affiliation></author></analytic><series><title level="j">Case Reports in Dermatology</title><idno type="eISSN">1662-6567</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS). She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS), based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM)] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Samman, Pd" uniqKey="Samman P">PD Samman</name></author><author><name sortKey="White, Wf" uniqKey="White W">WF White</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Emerson, Pa" uniqKey="Emerson P">PA Emerson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nordkild, P" uniqKey="Nordkild P">P Nordkild</name></author><author><name sortKey="Kromann Andersen, H" uniqKey="Kromann Andersen H">H Kromann-Andersen</name></author><author><name sortKey="Struve Christensen, E" uniqKey="Struve Christensen E">E Struve-Christensen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mambretti Zumwalt, J" uniqKey="Mambretti Zumwalt J">J Mambretti-Zumwalt</name></author><author><name sortKey="Seidman, Jm" uniqKey="Seidman J">JM Seidman</name></author><author><name sortKey="Higano, N" uniqKey="Higano N">N Higano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Doi, R" uniqKey="Doi R">R Doi</name></author><author><name sortKey="Okamoto, H" uniqKey="Okamoto H">H Okamoto</name></author><author><name sortKey="Horio, T" uniqKey="Horio T">T Horio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tanoue, M" uniqKey="Tanoue M">M Tanoue</name></author><author><name sortKey="Satoh, T" uniqKey="Satoh T">T Satoh</name></author><author><name sortKey="Yoshizawa, Y" uniqKey="Yoshizawa Y">Y Yoshizawa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ayres, S" uniqKey="Ayres S">S Ayres</name></author><author><name sortKey="Mihan, R" uniqKey="Mihan R">R Mihan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arroyo, Jf" uniqKey="Arroyo J">JF Arroyo</name></author><author><name sortKey="Cohen, Ml" uniqKey="Cohen M">ML Cohen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Toyoshima, M" uniqKey="Toyoshima M">M Toyoshima</name></author><author><name sortKey="Chinda, K" uniqKey="Chinda K">K Chinda</name></author><author><name sortKey="Suda, T" uniqKey="Suda T">T Suda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tamaoki, J" uniqKey="Tamaoki J">J Tamaoki</name></author><author><name sortKey="Isono, K" uniqKey="Isono K">K Isono</name></author><author><name sortKey="Sakai, N" uniqKey="Sakai N">N Sakai</name></author><author><name sortKey="Kanemura, T" uniqKey="Kanemura T">T Kanemura</name></author><author><name sortKey="Konno, K" uniqKey="Konno K">K Konno</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ikeda, K" uniqKey="Ikeda K">K Ikeda</name></author><author><name sortKey="Wu, D" uniqKey="Wu D">D Wu</name></author><author><name sortKey="Takasaka, T" uniqKey="Takasaka T">T Takasaka</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morikawa, K" uniqKey="Morikawa K">K Morikawa</name></author><author><name sortKey="Oseko, F" uniqKey="Oseko F">F Oseko</name></author><author><name sortKey="Morikawa, S" uniqKey="Morikawa S">S Morikawa</name></author><author><name sortKey="Iwamoto, K" uniqKey="Iwamoto K">K Iwamoto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ianaro, A" uniqKey="Ianaro A">A Ianaro</name></author><author><name sortKey="Ialenti, A" uniqKey="Ialenti A">A Ialenti</name></author><author><name sortKey="Maffia, P" uniqKey="Maffia P">P Maffia</name></author><author><name sortKey="Sautebin, L" uniqKey="Sautebin L">L Sautebin</name></author><author><name sortKey="Rombola, L" uniqKey="Rombola L">L Rombola</name></author><author><name sortKey="Carnuccio, R" uniqKey="Carnuccio R">R Carnuccio</name></author><author><name sortKey="Iuvone, T" uniqKey="Iuvone T">T Iuvone</name></author><author><name sortKey="D Acquisto, F" uniqKey="D Acquisto F">F D'Acquisto</name></author><author><name sortKey="Di Rosa, M" uniqKey="Di Rosa M">M Di Rosa</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Dermatol</journal-id><journal-id journal-id-type="publisher-id">CDE</journal-id><journal-title-group><journal-title>Case Reports in Dermatology</journal-title></journal-title-group><issn pub-type="epub">1662-6567</issn><publisher><publisher-name>S. Karger AG</publisher-name><publisher-loc>Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22220146</article-id><article-id pub-id-type="pmc">3250669</article-id><article-id pub-id-type="doi">10.1159/000334734</article-id><article-id pub-id-type="publisher-id">cde0003-0251</article-id><article-categories><subj-group subj-group-type="heading"><subject>Published: November, 2011</subject></subj-group></article-categories><title-group><article-title>A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Suzuki</surname><given-names>Manabu</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref><xref ref-type="aff" rid="aff2"><sup>b</sup></xref><xref ref-type="aff" rid="aff3"><sup>c</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Yoshizawa</surname><given-names>Atsuto</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sugiyama</surname><given-names>Haruhito</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ichimura</surname><given-names>Yasunori</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Morita</surname><given-names>Akane</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Takasaki</surname><given-names>Jin</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Naka</surname><given-names>Gou</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hirano</surname><given-names>Satoshi</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Izumi</surname><given-names>Shinyu</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Takeda</surname><given-names>Yuichiro</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hoji</surname><given-names>Masayuki</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kobayashi</surname><given-names>Nobuyuki</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kudo</surname><given-names>Koichiro</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib></contrib-group><aff id="aff1"><sup>a</sup>Department of Respiratory Medicine, National Center for Global Health and Medicine, Infection, Oncology, Nippon Medical School, Tokyo</aff><aff id="aff2"><sup>b</sup>Internal Medicine, Department of Pulmonary Medicine, Infection, Oncology, Nippon Medical School, Tokyo</aff><aff id="aff3"><sup>c</sup>Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan</aff><author-notes><corresp id="cor1">*Manabu Suzuki, MD, Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, 1-754, Asahimachi-dori, Chuo-ku, Niigata 951-8520 (Japan), Tel. +81 25 227 2022, E-Mail <email>manabu@nms.ac.jp</email></corresp></author-notes><pub-date pub-type="collection"><season>Sep-Dec</season><year>2011</year></pub-date><pub-date pub-type="epub"><day>30</day><month>11</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>30</day><month>11</month><year>2011</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<volume>3</volume><issue>3</issue><fpage>251</fpage><lpage>258</lpage><permissions><copyright-statement>Copyright © 2011 by S. Karger AG, Basel</copyright-statement><copyright-year>2011</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/">http://creativecommons.org/licenses/by-nc-nd/3.0/</ext-link>). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on <ext-link ext-link-type="uri" xlink:href="http://www.karger.com">http://www.karger.com</ext-link> and the terms of this license are included in any shared versions.</license-p></license></permissions><abstract><p>An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS). She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS), based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM)] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.</p></abstract><kwd-group><title>Key words</title><kwd>Nail discoloration</kwd><kwd>Yellow nail syndrome</kwd><kwd>Sinobronchial syndrome</kwd><kwd>Clarithromycin</kwd></kwd-group><counts><fig-count count="3"></fig-count><table-count count="1"></table-count><ref-count count="13"></ref-count><page-count count="8"></page-count></counts></article-meta></front><floats-group><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Laboratory data on admission</p></caption><table frame="hsides" rules="groups"><thead><tr valign="bottom"><th align="left" colspan="2" rowspan="1">Hematology</th><th align="left" colspan="2" rowspan="1">Serology</th><th align="left" colspan="2" rowspan="1">Immune serum</th><th align="left" colspan="2" rowspan="1">Atrial blood gas</th></tr></thead><tbody><tr valign="top"><td align="left" rowspan="1" colspan="1">WBC</td><td align="left" rowspan="1" colspan="1">10,560/μl</td><td align="left" rowspan="1" colspan="1">Alb</td><td align="left" rowspan="1" colspan="1">2.8 g/dl</td><td align="left" rowspan="1" colspan="1">(β-D glucan</td><td align="left" rowspan="1" colspan="1">6.6 pg/ml</td><td align="left" rowspan="1" colspan="1">PH</td><td align="left" rowspan="1" colspan="1">7.369</td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Neu</td><td align="left" rowspan="1" colspan="1">87.6%</td><td align="left" rowspan="1" colspan="1">AST</td><td align="left" rowspan="1" colspan="1">43U/l</td><td align="left" rowspan="1" colspan="1">BNP</td><td align="left" rowspan="1" colspan="1">5.9 pg/ml</td><td align="left" rowspan="1" colspan="1">PCO<sub>2</sub></td><td align="left" rowspan="1" colspan="1">38.3 mm Hg</td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Lym</td><td align="left" rowspan="1" colspan="1">8.3%</td><td align="left" rowspan="1" colspan="1">ALT</td><td align="left" rowspan="1" colspan="1">28U/l</td><td align="left" rowspan="1" colspan="1">IgG</td><td align="left" rowspan="1" colspan="1">1,744.7 pg/dl</td><td align="left" rowspan="1" colspan="1">PO<sub>2</sub></td><td align="left" rowspan="1" colspan="1">69.5 mm Hg</td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Mon</td><td align="left" rowspan="1" colspan="1">4.2%</td><td align="left" rowspan="1" colspan="1">LDH</td><td align="left" rowspan="1" colspan="1">211 U/l</td><td align="left" rowspan="1" colspan="1">IgA</td><td align="left" rowspan="1" colspan="1">169.8 pg/dl</td><td align="left" rowspan="1" colspan="1">HCO<sub>3</sub></td><td align="left" rowspan="1" colspan="1">23.5 mmol/l</td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Eos</td><td align="left" rowspan="1" colspan="1">0.1%</td><td align="left" rowspan="1" colspan="1">yGTP</td><td align="left" rowspan="1" colspan="1">23U/l</td><td align="left" rowspan="1" colspan="1">IgM</td><td align="left" rowspan="1" colspan="1">46.3 pg/dl</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Bas</td><td align="left" rowspan="1" colspan="1">0.1%</td><td align="left" rowspan="1" colspan="1">BUN</td><td align="left" rowspan="1" colspan="1">13.8 mg/dl</td><td align="left" rowspan="1" colspan="1">T-IgE</td><td align="left" rowspan="1" colspan="1">15.0 U/ml</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">RBC</td><td align="left" rowspan="1" colspan="1">399×10<sup>4</sup>/μl</td><td align="left" rowspan="1" colspan="1">Cre</td><td align="left" rowspan="1" colspan="1">0.52 mg/dl</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Ht</td><td align="left" rowspan="1" colspan="1">33.1%</td><td align="left" rowspan="1" colspan="1">Na</td><td align="left" rowspan="1" colspan="1">135 mEq/l</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Hb</td><td align="left" rowspan="1" colspan="1">10.0 g/dl</td><td align="left" rowspan="1" colspan="1">K</td><td align="left" rowspan="1" colspan="1">3.6 mEq/l</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr valign="top"><td align="left" rowspan="1" colspan="1">Plt</td><td align="left" rowspan="1" colspan="1">28.4×10<sup>4</sup>/μl</td><td align="left" rowspan="1" colspan="1">Cl CRP</td><td align="left" rowspan="1" colspan="1">99 mEq/l 18.01 mg/dl</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr></tbody></table><table-wrap-foot><fn><p>WBC = White blood cell; Neu = neutrophil; Lym = lymphocyte; Mon = monocyte; Eos = eo-sinophil; Bas = basophil; RBC = red blood cell; Hb = hemoglobin; Ht = hematocrit; Plt = platelet; Alb = albumin; AST = aspartate aminotransferase; ALT = alaninę aminotransferase; LDH = lactate dehydrogenase; γGTP = γ glutamyl transpeptidase; BUN = blood urea nitrogen; Cr = creatinine; Na = sodium; K = potassium; Cl = chloride; CRP = C-reactive protein; BNP = brain natriuretic peptide; IgG = immunoglobulin G; IgA = immunoglobulin A; IgM = immunoglobulin M; T-IgE = total immunoglobulin E; HCO<sub>3</sub> = bicarbonate ion; PCO<sub>2</sub> = partial pressure of arterial carbon dioxide; PO<sub>2</sub> = partial pressure of arterial oxygen.</p></fn></table-wrap-foot></table-wrap><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label><caption><p>Chest X-ray on admission showed bilateral lower lobe infiltration. ‘Tramline’ revealed in the right lower lobe.</p></caption><graphic xlink:href="cde0003-0251-f01"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label><caption><p>Clinical history of the patient with regard to nail discoloration and sinobronchial syndrome (SBS).</p></caption><graphic xlink:href="cde0003-0251-f02"></graphic></fig><fig id="F3" orientation="portrait" position="float"><label>Fig. 3</label><caption><p>The yellow nails improved dramatically after 9 months of CAM treatment. <bold>a</bold> Pretreatment. <bold>b</bold> Posttreatment.</p></caption><graphic xlink:href="cde0003-0251-f03"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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