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Nail alterations characteristic of yellow nail syndrome. (A,B) Absence of the cuticles and nail fold swelling are key to diagnosis. (C) Head CT scan revealing type II septal deviation (Mladina classification) associated with unilateral spur compromising the airway (arrow, left) and secondary hypoplasia of the right middle nasal turbinate (arrow, right). (D,E) Improved appearance of the nails 1 year after rhinoseptoplasty and oral vitamin E supplementation.
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Notably, the cuticles were lacking (Figure 1, A and B). CT scan was performed, which detected a severe nasal septum deviation compromising the airway (Figure 1C). Chest x-ray was unrevealing. One year later, his respiratory symptoms had resolved and his nails appeared completely cured (Figure 1, D and E).