Yellow Nail Syndrome (YNS) is a rare clinical condition affecting multiple districts. Distinctive signs include nail abnormalities, pulmonary manifestations, and lymphedema. The aetiology is unknown; usually presents isolated or as a paraneoplasticsyndrome.

There is no established treatment and resolution is limited. Low dose azithromycin with mucolytics and long-acting muscarinic antagonist could improve the respiratory component of the YNS when present. Here we describe a case of paraneoplastic YNS presenting with cough, sputum, rhinosinusitis, and nail discoloration appearing after a recent history of breast cancer.

In a patient with an oncological history, nail abnormalities associated with pulmonary manifestations and/or lower limbs lymphedema, the diagnosis of paraneoplastic YNS should be considered.