Yellow nail syndrome in an elderly man

A case of yellow nail syndrome is described. Yellow nail syndrome is an uncommon disorder, which is characterized by the triad of slow-growing yellow nails, peripheral edema, and pleural effusions. An 80-year-old man was admitted to University of Tokyo Hospital for the evaluation of pretibial edema lasting over 35 years. Marked bilateral pretibial edema, discoloration of the nails, and onycholysis were noted on physical examination. Chest X-ray showed pleural effusions. The biopsy of the skin revealed ectatic lymph vessels with peripheral interstitial edema. Thorough examination should be emphasized in treating patients with unexplained peripheral edema or pleural effusions.