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July 1991, Vol 127, No. 7 >
Article | July 1991

Successful Use of Topical Vitamin E Solution in the Treatment of Nail Changes in Yellow Nail Syndrome

Hywel C. Williams, BSc, MRCP; Robin Buffham, BPharm, MRPharmS; Anthony du Vivier, MD, FRCP
[+] Author Affiliations

Accepted for publication February 14, 1991.

Presented as a preliminary communication at the spring meeting of the St John's Hospital Dermatological Society, London, England, March 6, 1989.

Reprints not available.


From the Departments of Dermatology (Drs Williams and du Vivier) and Analytical Pharmacy (Ms Buffham), King's College Hospital, Denmark Hill, London, England. Dr Williams is now with St John's Hospital Dermatology Centre, London, England.


Arch Dermatol. 1991;127(7):1023-1028. doi:10.1001/archderm.1991.01680060097012
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• A double-blind controlled study was performed on a patient with long-standing yellow nail syndrome to investigate the potential beneficial role of topical vitamin E solution for the nail changes seen in this disorder. Three nails received active solution containing DL-α-tocopherol in dimethyl sulfoxide; three nails received dimethyl sulfoxide only; and the remainder were untreated. After 6 months of therapy, the three nails treated with active solution showed marked clinical improvement and a corresponding increase in nail growth rates. Dimethyl sulfoxide alone produced a small increase in nail growth rate and slight clinical improvement. Active solution was then applied to all of the nails for a further 6 months, resulting in clinical improvement and increased nail growth rates in the remaining nails. These beneficial effects require further study.

(Arch Dermatol. 1991;127:1023-1028)

REFERENCES

1 +
Samman PD, White WF.  The yellow nail syndrome . Br J Dermatol. 1964;;76:153-157.
2 +
Venencie PY, Dicken CH.  Yellow nail syndrome: report of five cases . J Am Acad Dermatol. 1984;;10:187-192.
3 +
Samman PD.  Nail disorders attributed to or associated with other general medical conditions . In: The Nails in Disease . 3rd ed. North Pomfret, Vt: William Heinemann; 1978;:111-125.
4 +
Norton L.  Further observations on the yellow nail syndrome with therapeutic effects of oral alpha-tocopherol . Cutis. 1985;;36:457-462.
5 +
Samman PD, Abell E.  Intradermal triamcinolone acetonide injection in the yellow nail syndrome . Trans St Johns Hosp Dermatol Soc. 1973;;59:114-117.
6 +
Ayres S Jr, Mihan R.  Yellow nail syndrome: response to vitamin E . Arch Dermatol. 1973;;108:267-268.
7 +
Rommel A, Havet M, Ball M, Geniaux M, Texier L.  Syndrome des ongles jaunes: response a la vitamine E . Ann Dermatol Venereol. 1985;;112:625-627.
8 +
Ayres S Jr.  Yellow nail syndrome controlled by vitamin E therapy . J Am Acad Dermatol. 1986;;15:714-716.
9 +
Scher RK.  Yellow nail syndrome and half-and-half nail . Arch Dermatol. 1987;;123:710-711.
10 +
Roberts HJ.  Perspective on vitamin E as therapy . JAMA. 1991;;246:129-131.
11 +
Dawber RPR.  Fingernail growth in normal and psoriatic subjects . Br J Dermatol. 1970;;82:454-457.
12 +
Le Gros Clark WE, Buxton LHD.  Studies in nail growth . Br J Dermatol. 1938;;50:221-235.
13 +
Gupta AK, Davies GM, Haberman HF.  Yellow nail syndrome . Cutis. 1986;;37:371-374.
14 +
De Coste SD, Imber MJ, Baden HP.  Yellow nail syndrome . J Am Acad Dermatol. 1990;;22:608-611.
15 +
Dawber RPR, Baran R.  Nail disorders associated with general disease . In: Rook A, Wilkinson DS, Ebling FGJ, Champion RH, Burton JL, eds. Textbook of Dermatology. 4th ed. Boston, Mass: Blackwell Scientific Publications Inc; 1986;:2039-2073.
16 +
Marks R, Ellis JP.  Yellow nails: a report of six cases . Arch Dermatol. 1970;;102:619-623.
17 +
Knowsley-Sibley W.  Ungues flavi . Br J Dermatol. 1911;;23:288-291.
18 +
Chernosky ME, Finley VK.  Yellow nail syndrome in patients with associated immunodeficiency disease . J Am Acad Dermatol. 1985;;13:731-736.
19 +
Ilchyshyn A, Vickers CFH.  Yellow nail syndrome associated with penicillamine therapy . Acta Derm Venereol (Stockh). 1983;;63:554-555.
20 +
Ohkuma M.  Studies on yellow nail syndrome . In: Kukita A, Seiji M, eds. Proceedings of the XVIth International Congress on Dermatology . Tokyo, Japan: Tokyo University Press; 1982;.
21 +
Siakatos AN, Munkres KD.  Recent developments in the isolation and properties of autofluorescent lipopigments . In: Armstrong D, Koppang N, Rider JA, eds. Ceroid Lipofuscinosis (Batten's Disease) . Amsterdam, the Netherlands: Elsevier Science Publishers; 1982;:165-187.
22 +
Sinclair AJ, Barnett AH, Lumec J.  Free radicals and antioxidant systems in health and disease . Br J Hosp Med. 1990;;43:334-344.
23 +
Finnen MJ, Lawrence CM, Shuster S.  Inhibition of dithranol inflammation by free radical scavengers . Lancet. 1984;;2:1129-1130.
24 +
Nobbs P, Barr RD.  Soft tissue injury caused by antineoplastic drugs is inhibited by topical dimethylsulphoxide and alpha-tocopherol . Br J Cancer. 1983;;48:873-876.
25 +
Ludwig CU, Stoll HR, Obrist R, Obrecht JP.  Prevention of cytotoxic induced skin ulcers with dimethylsulfoxide (DMSO) and alpha-tocopherol . Eur J Cancer Clin Oncol. 1987;;23:327-329.
26 +
Machlin LJ. Vitamin E: A Comprehensive Treatise . New York, NY: Marcel Dekker Inc; 1980;:420.
27 +
Rice D, Kennedy S.  Vitamin E: function and effects of deficiency . Br Vet J. 1988;;144:482-496.
28 +
Biaglo JE.  Oxygen, hydrogen donors and radiation response . Adv Exp Med Biol. 1982;;157:147-175.
29 +
Goldman MP, Rapoport M.  Contact dermatitis to vitamin E oil . J Am Acad Dermatol. 1986;;14:133-134.
30 +
Saperstein H, Rapoport M, Rietschel RL.  Topical vitamin E as a cause of erythema multiforme—like eruption . Arch Dermatol. 1984;;120:906-908.
31 +
Ayres S Jr, Mihan R.  Vitamin E as a useful therapeutic agent . J Am Acad Dermatol. 1983;;8:133-134.
32 +
Goldsmith S.  Vitamin E and ocychomycosis . J Am Acad Dermatol. 1983;;8:910-911.

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1 +
Samman PD, White WF.  The yellow nail syndrome . Br J Dermatol. 1964;;76:153-157.
2 +
Venencie PY, Dicken CH.  Yellow nail syndrome: report of five cases . J Am Acad Dermatol. 1984;;10:187-192.
3 +
Samman PD.  Nail disorders attributed to or associated with other general medical conditions . In: The Nails in Disease . 3rd ed. North Pomfret, Vt: William Heinemann; 1978;:111-125.
4 +
Norton L.  Further observations on the yellow nail syndrome with therapeutic effects of oral alpha-tocopherol . Cutis. 1985;;36:457-462.
5 +
Samman PD, Abell E.  Intradermal triamcinolone acetonide injection in the yellow nail syndrome . Trans St Johns Hosp Dermatol Soc. 1973;;59:114-117.
6 +
Ayres S Jr, Mihan R.  Yellow nail syndrome: response to vitamin E . Arch Dermatol. 1973;;108:267-268.
7 +
Rommel A, Havet M, Ball M, Geniaux M, Texier L.  Syndrome des ongles jaunes: response a la vitamine E . Ann Dermatol Venereol. 1985;;112:625-627.
8 +
Ayres S Jr.  Yellow nail syndrome controlled by vitamin E therapy . J Am Acad Dermatol. 1986;;15:714-716.
9 +
Scher RK.  Yellow nail syndrome and half-and-half nail . Arch Dermatol. 1987;;123:710-711.
10 +
Roberts HJ.  Perspective on vitamin E as therapy . JAMA. 1991;;246:129-131.
11 +
Dawber RPR.  Fingernail growth in normal and psoriatic subjects . Br J Dermatol. 1970;;82:454-457.
12 +
Le Gros Clark WE, Buxton LHD.  Studies in nail growth . Br J Dermatol. 1938;;50:221-235.
13 +
Gupta AK, Davies GM, Haberman HF.  Yellow nail syndrome . Cutis. 1986;;37:371-374.
14 +
De Coste SD, Imber MJ, Baden HP.  Yellow nail syndrome . J Am Acad Dermatol. 1990;;22:608-611.
15 +
Dawber RPR, Baran R.  Nail disorders associated with general disease . In: Rook A, Wilkinson DS, Ebling FGJ, Champion RH, Burton JL, eds. Textbook of Dermatology. 4th ed. Boston, Mass: Blackwell Scientific Publications Inc; 1986;:2039-2073.
16 +
Marks R, Ellis JP.  Yellow nails: a report of six cases . Arch Dermatol. 1970;;102:619-623.
17 +
Knowsley-Sibley W.  Ungues flavi . Br J Dermatol. 1911;;23:288-291.
18 +
Chernosky ME, Finley VK.  Yellow nail syndrome in patients with associated immunodeficiency disease . J Am Acad Dermatol. 1985;;13:731-736.
19 +
Ilchyshyn A, Vickers CFH.  Yellow nail syndrome associated with penicillamine therapy . Acta Derm Venereol (Stockh). 1983;;63:554-555.
20 +
Ohkuma M.  Studies on yellow nail syndrome . In: Kukita A, Seiji M, eds. Proceedings of the XVIth International Congress on Dermatology . Tokyo, Japan: Tokyo University Press; 1982;.
21 +
Siakatos AN, Munkres KD.  Recent developments in the isolation and properties of autofluorescent lipopigments . In: Armstrong D, Koppang N, Rider JA, eds. Ceroid Lipofuscinosis (Batten's Disease) . Amsterdam, the Netherlands: Elsevier Science Publishers; 1982;:165-187.
22 +
Sinclair AJ, Barnett AH, Lumec J.  Free radicals and antioxidant systems in health and disease . Br J Hosp Med. 1990;;43:334-344.
23 +
Finnen MJ, Lawrence CM, Shuster S.  Inhibition of dithranol inflammation by free radical scavengers . Lancet. 1984;;2:1129-1130.
24 +
Nobbs P, Barr RD.  Soft tissue injury caused by antineoplastic drugs is inhibited by topical dimethylsulphoxide and alpha-tocopherol . Br J Cancer. 1983;;48:873-876.
25 +
Ludwig CU, Stoll HR, Obrist R, Obrecht JP.  Prevention of cytotoxic induced skin ulcers with dimethylsulfoxide (DMSO) and alpha-tocopherol . Eur J Cancer Clin Oncol. 1987;;23:327-329.
26 +
Machlin LJ. Vitamin E: A Comprehensive Treatise . New York, NY: Marcel Dekker Inc; 1980;:420.
27 +
Rice D, Kennedy S.  Vitamin E: function and effects of deficiency . Br Vet J. 1988;;144:482-496.
28 +
Biaglo JE.  Oxygen, hydrogen donors and radiation response . Adv Exp Med Biol. 1982;;157:147-175.
29 +
Goldman MP, Rapoport M.  Contact dermatitis to vitamin E oil . J Am Acad Dermatol. 1986;;14:133-134.
30 +
Saperstein H, Rapoport M, Rietschel RL.  Topical vitamin E as a cause of erythema multiforme—like eruption . Arch Dermatol. 1984;;120:906-908.
31 +
Ayres S Jr, Mihan R.  Vitamin E as a useful therapeutic agent . J Am Acad Dermatol. 1983;;8:133-134.
32 +
Goldsmith S.  Vitamin E and ocychomycosis . J Am Acad Dermatol. 1983;;8:910-911.

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