Combination of Fluconazole and Alpha-tocopherol in the Treatment of Yellow Nail Syndrome
March 2009 | Volume 8 | Issue 3 | Case Reports | 276 | Copyright © March 2009
Robert Baran MD, Luc Thomas MD PhD
Abstract
Yellow nail syndrome (YNS) is an uncommon disorder that is characterized by the slow nail growth, marked thickening, and yellow
to yellow-green discoloration of the fingernails or toenails. Although the etiology of YNS is unknown, a diagnosis is indicated by the
concurrent presentation of the nail changes, with lymphedema and respiratory manifestations. Although lymphedema and respiratory
manifestations are sometimes manageable with regimens of medical and surgical treatments, YNS treatment options are limited and
often unsuccessful. For the patient, YNS can also be cosmetically unacceptable and concealment with nail polish may not always be
possible. However, it is now widely accepted that the azole class of antifungals can stimulate linear nail growth. In addition, vitamin
E has also been reported in the treatment of YNS with positive results. Herein, the authors report on a promising combination treatment
of oral fluconazole pulse therapy and oral alpha-tocopherol (vitamin E) in 13 patients with YNS with clinical successes observed
in 2 individuals and clinical cures observed in 11 subjects.