History and clinical findings: In a 58-year-old man progressive yellowing of all nails was associated with the diagnosis of chronic rhinosinusitis and COPD, later the COPD exacerbated with pneumonias.
Investigations: Repeated fungal cultures and polymerase chain reactions to detect fungal DNA in order to exclude Onychomycosis, chest X-ray, computed tomography of the lung, extended pulmonary function tests, ECG, echocardiography and abdominal ultrasonography were performed and had normal results.
Treatment and course: Normal fingernails regrew after a 6 month-course of vitamin E intake, most of the toenails remained coloured and thickened. After the initial presentation at the dermatological outpatient department the pulmonary situation remained stable, there was no need for additional pulmonary interventions.
Conclusion: Yellowing of all nails is a diagnostic sign of the Yellow-nail-Syndrome, which is associated with respiratory diseases, the treatment is often difficult and also an interdisciplinary approach is needed.
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