Yellow nail syndrome is an uncommon disorder of unknown aetiology, characterized by
the triad of yellow nails, lymphoedema and respiratory tract involvement. Vitamin E at
dosages ranging from 600 to 1200 IU daily can induce a complete clearing of the nail
changes. Although the mechanism of action of vitamin E in yellow nail syndrome is still
unknown, antioxidant properties of alpha-tocopherol may account for its efficacy. A 5%
solution of vitamin E in dimethyl sulphoxide produced marked clinical improvement in a
double-blind controlled study. The efficacy of topical vitamin E, however, still needs
confirmation. Oral itraconazole, 400 mg daily one week a month for several months, or
oral flucouazole, may be beneficial in some cases.