Yellow nails, lymphoedema, and pleural effusions.

The purpose of this paper is to draw attention to a new syndrome and to describe three examples of chronic pleural effusion due to chronic lymphoedema. Before encountering these patients I had never previously considered chronic lymphoedema as a cause of chronic pleural effusion: it is certainly not described in any standard textbook, although it was tentatively referred to in one in 1963 (Robson and Emerson, 1963), and more recently Hurwitz and Pinnals (1964) have described two patients with pleural effusions and lymphoedema only. The thesis is that an otherwise unexplained pleural effusion may occur in patients with chronic lymphoedema and be due to some deficiency in the lymphatics draining the pleural space. These two conditions may be associated with yellow fingerand toe-nails, due also to impaired lymphatic drainage. CASE REPORTS