Yellow nail syndrome is an idiopathic condition characterized by a triad consisting of yellow nail, lymphedema, and pulmonary manifestations. Thiol compounds such as D-penicillamine have been reported to be the major cause of drug-induced yellow nail syndrome in patients with rheumatoid arthritis (RA). We recently experienced two Japanese cases with RA who developed yellow nail under treatment with bucillamine, a thiol-containing anti-rheumatic drug developed and approved in Japan. We reviewed the literature for similar cases and identified 36 RA cases with bucillamine-induced yellow nail, mostly in Japanese medical journals. Most of these cases (90.3%) showed improvement of yellow nail after discontinuation of bucillamine, whereas lymphedema and pulmonary manifestations improved only in 30.8 and 35.0% of the patients, respectively.
Yellow nail syndrome Bucillamine Thiol Rheumatoid arthritis Lymphedema Pleural effusion
This is a preview of subscription content, log in to check access.
Maldonado F, Tazelaar HD, Wang CW, Ryu JH (2008) Yellow nail syndrome: analysis of 41 consecutive patients. Chest 134:375–381PubMedCrossRefGoogle Scholar
Mattingly PC, Bossingham DH (1979) Yellow nail syndrome in rheumatoid arthritis: report of three cases. Ann Rheum Dis 38:475–478PubMedCrossRefGoogle Scholar
Lehuédé G, Toussirot E, Despaux J, Michel F, Wendling D (2002) Yellow nail syndrome associated with thiol compound therapy for rheumatoid arthritis. Two case reports. Joint Bone Spine 69:406–408PubMedCrossRefGoogle Scholar
Ichikawa Y, Shimizu H, Arimori S (1991) Yellow nail syndrome and rheumatoid arthritis. Tokai J Exp Clin Med 16:203–209PubMedGoogle Scholar
Ishizaki C, Sueki H, Kohsokabe S, Nishida H (1995) Yellow nail induced by bucillamine. Int J Dermatol 34:493–494PubMedCrossRefGoogle Scholar
Yamamoto T, Yokozeki H (2007) Yellow nails under bucillamine therapy for rheumatoid arthritis: a report of two cases. Rheumatol Int 27:603–604PubMedCrossRefGoogle Scholar