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62-year-old concerned about nail appearance and slow growth

Last reviewed: December 2022

Author: Dr Ian Coulson, Consultant Dermatologist and Editor-in-Chief, 2022.

Edited by the DermNet content department

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Background

This patient, now in her early 60s, is concerned about the appearance of her nails. Over the years she has found that they grow much more slowly than when she was younger.

Describe what you see and the likely cause?

open

The nail plates are yellow in colour, and have excessive transverse and longitudinal curvature. These features are typical of yellow nail syndrome, and patients usually describe the need to only infrequently cut their nails as the nail growth rate is substantially slower than normal.

What is this associated with?

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It is most commonly associated with lymphoedema, pleural effusions, and bronchiectasis.

What are the causes and treatment?

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The cause is unknown; there is limited evidence that it may improve with oral or topical vitamin E supplements, and the antifungal agents. Oral itraconazole and fluconazole are oral antifungal agents. It has been noted that they appear to speed up the rate of growth of nails, which may be of benefit in yellow nail syndrome even though it is not caused by fungal infection.

 

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