Yellow Nail Syndrome In Diabetics
Diabetics have a tendency to yellow nails. It is seen occasionally in elderly controls, and in some patients with onychomycosis. Although this may occur on all the nails, it is often found on the distal aspect of the nail of the hallux.
Clinically the coloration is not usually the result of underlying dermatophytosis. Similar to the yellow color observed in diabetic skin, yellowing of the nails probably represents glycosylation end products. Whereas keratin of the epidermis is only present for one month before being shed, that of the nail plate may be present for greater than a year. The protein- glucose reaction presumably continues to evolve in the aging nail resulting in the most yellow pigment at the distal aspect of the slowest growing nail. The presence of the yellow glycosylation end products in the nail plate has not been confirmed to date, but one study of fingernails has demonstrated that diabetics have high levels of fructose-lysine, another indicator of nonenzymatic glycosylation.
Most diabetic patients have some aspect of this yellowing. It is best examined on toes. Minimal involvement consists of distal yellow or yellow-brown discoloration of the hallux nail plate. Marked involvement consists of canary yellow discoloration of all toe- and fingernails. It is not a specific finding in diabetes mellitus since it can be occasionally observed with normal aging. Like the yellow hue appreciated generally in the skin of persons with diabetes, the significance of this observation is undetermined. The obvious question is whether or not yellow nails and yellow skin can be used as an quantifiable indicator of the degree of nonenzymatic glycosylation for other tissues of the body
| Source : Huntley & Drugge’s Diabetes in skin disease |
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Modified : Apr 8, 2003. |
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