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Dermatology (Expert Forum)
everyone is stumped by yellow nails with black spots
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.
everyone is stumped by yellow nails with black spots
by ohiorph, Mar 15, 2006 12:00AM
I am a clinical pharmacist and have been searching for a possible cause to a medical problem of a family friend...so far no luck on medline and the pt has been evaluated at Clevland Clinic and was told they can't diagnose the cause either (they are hoping to have her evaluated at a derm conference in May).
Derm sx: yellowed nails (all finger nails and all toe nails) with black spots about the size of a pin head.
Systemic sx: 1 "spot on her lungs" - a culture was attempetd by the clev. clinic using a saline wash- but nothing grew after 6 wks- so they ruled out TB (the tissue was never biopsied b/c they don't think it is cancer) also has chronic productive cough, and fatigue
Timeframe: Jan 05 she traveled to Florida and returned with a severe cold/sinus infxn. Sx failed to improve with several courses of antibiotics and she was eventually diagnosed with pneumonia. After the pneumonia resolved the cough remained, and still continues after 1 yr. Cleve. Clinic doctors tell her the spot on her lungs could be scar tissue from the pneumonia. Coincedentally, her trip to Florida was during a really bad red tide and she noticed some asthma (never had asthma prior to this trip) like sx while there. The yellow nails with black spots developed 1-2 months later.
PMH: ulcerative colitis
SH: non smoker, moved to new home May 05 (after sx already developed) and has woked at same job >15yrs (her family owns a lawnmower repair shop and she works there--doesn't come into contact with any chemicals/fertilizers)
Meds: She has been on most of her meds >10yrs, with the exception of
Fosamax- tried for 1 month then quit just b/c not feeling well
Advair- tried to alleviate asthma like sx, was on for 2-4 months but now d/c'd
singulair- same as advair
Any ideas for the cause or potential treatments??
Derm sx: yellowed nails (all finger nails and all toe nails) with black spots about the size of a pin head.
Systemic sx: 1 "spot on her lungs" - a culture was attempetd by the clev. clinic using a saline wash- but nothing grew after 6 wks- so they ruled out TB (the tissue was never biopsied b/c they don't think it is cancer) also has chronic productive cough, and fatigue
Timeframe: Jan 05 she traveled to Florida and returned with a severe cold/sinus infxn. Sx failed to improve with several courses of antibiotics and she was eventually diagnosed with pneumonia. After the pneumonia resolved the cough remained, and still continues after 1 yr. Cleve. Clinic doctors tell her the spot on her lungs could be scar tissue from the pneumonia. Coincedentally, her trip to Florida was during a really bad red tide and she noticed some asthma (never had asthma prior to this trip) like sx while there. The yellow nails with black spots developed 1-2 months later.
PMH: ulcerative colitis
SH: non smoker, moved to new home May 05 (after sx already developed) and has woked at same job >15yrs (her family owns a lawnmower repair shop and she works there--doesn't come into contact with any chemicals/fertilizers)
Meds: She has been on most of her meds >10yrs, with the exception of
Fosamax- tried for 1 month then quit just b/c not feeling well
Advair- tried to alleviate asthma like sx, was on for 2-4 months but now d/c'd
singulair- same as advair
Any ideas for the cause or potential treatments??
Doctor's Answer
by Alan Rockoff, MD, Mar 16, 2006 12:00AM
, Mar 16, 2006 12:00AM
I apologize, but yellow nails with black spots does not bring any diagnosis to mind. Perhaps the dermatology conference at the Cleveland Clinic will yield some suggestions.
Dr. Rockoff
Dr. Rockoff
psalmsong