A 60-year old man presenting with yellow nail syndrome.

Yellow nail syndrome is a rare disorder of unclear etiology. Since its original description by Samman and White,1 many other reports and associations have been described. Current evidence suggests that its pathologic mechanism is based on lymphatic dysfunction, which is thought to be acquired rather than congenital. However, our understanding of its pathogenesis is still speculative, as it relies on anecdotal observations. We report a case of a man who presented with dry cough, shortness of breath, bilateral lower-extremity edema, and pleural effusion. Yellow nail syndrome was diagnosed.