一名80岁的妇女因肺炎和鼻窦支气管综合征(SBS)恶化而入院。她所有手指和脚趾的甲床都呈黄色变色,她的指甲被认为生长缓慢。胸部X线示:双侧下叶支气管扩张,双侧胸腔积液。我们诊断她患有黄色指甲综合症(YNS),基于黄色指甲的三合会,淋巴水肿,和肺部疾病。抗生素[氨苄西林/舒巴坦和克拉霉素(CAM)]治疗肺炎和SBS后,她的一般情况有所改善,黄色的指甲消失在一些手指上。当她之前用200毫克CAM治疗SBS时,她的黄色指甲没有改善。这一次,用400mgCAM治疗后,她的黄色指甲有所改善。文献报道维生素E,锌,和局部皮质类固醇加活性维生素D3是有效的治疗黄指甲。两项研究报道了使用CAM治疗YNS,尽管他们发现缺乏功效。因此,目前的情况下是第一个报告改善黄色指甲单独使用CAM。我们得出的结论是,使用400mgCAM治疗不仅改善了SBS和肺部疾病,而且改善了YNS。
An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS). She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS), based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM)] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature
reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present
case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.