Answer to Medical Challenge-Yellow Nail Syndrome

Yesterday's Medical Challenge answer was clear to some readers and a mystery to others.  The answer was:
#4  Yellow Nail Syndrome.  Although nails can become discolored from nail polish, the medical Yellow Nail Syndrome is a sign of a serious disorder and not well understood.  It is believed to be associated with  restrictive lung disease or  (rarely) problems with lymphatic drainage channels. (good memory, Grady Doc!)

nail fungus-onchomycosis

Because these nails stop growing and become thicker, they are susceptible to fungal infections too.  Those who guessed Onchomycosis were not far off.   Onchomycosis is very common and the fungus infection causes lifting of the nail from the nail bed.

Psoriatic nail

Psoriasis of the nail can also cause changes that can be confused with Yellow Nail Syndrome.   Ninety-five% of these patients have cutaneous psoriasis also.

Thanks for your diagnosis in this challenging case!