Cutaneous Signs and Syndromes Associated With Internal Malignancies

Claudia C. Ramirez, MD; Brian Berman, MD, PhD


Skinmed. 2005;4(2):84-92. 

In This Article

Xanthomas and Yellow Nail Syndrome

Diffuse normolipemic plane xanthoma is characterized by large, yellow-brown flat, xanthomatous skin lesions usually involving the eyelids, sides of the neck, upper trunk, buttocks, and the flexural folds in normolipemic persons. Histologically, the lesions contain clusters of perivascular giant cells with foamy cytoplasm in the dermis.[45]

Diffuse normolipemic plane xanthoma has been associated with monoclonal gammopathy, multiple myeloma, and lymphoproliferative and myeloproliferative disorders such as leukemia, lymphoma, and Castleman's disease.

Yellow Nail Syndrome (YNS) is a rare disorder characterized by nail changes, lymphedema, pleural effusion, and chronic respiratory tract infections such as bronchitis and sinusitis. Affected nails have yellow discoloration, are thickened, and grow slowly. Sometimes, nails present loss of cuticula, and erythema and edema of the proximal nail folds. The nail changes may be the initial manifestation, preceding other symptoms by years.

YNS has been associated with autoimmune diseases such as thyroiditis and rheumatoid arthritis, acquired immunodeficiency syndrome, as well as to certain medications. YNS has been related to malignancies, including mycosis fungoides, laryngeal carcinoma, carcinoma of the gallbladder, bronchial carcinoma, breast cancer, non-Hodgkin lymphoma, and endometrial cancer. In several reported cases, the nail deformity resolved after successful treatment of the neoplasm.[45,46,47]