case_images: PMC5617082_01
case_images: Preoperative fingernails and sinus computed tomographic scans are observed on both hands. (A) Yellowing and thickening of the fingernails are observed on both hands. (B) Homogenous soft tissue densities are seen around the maxillary and ethmoid sinuses on both sides. No clear bone loss or destruction is observed.
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case_images: Physical findings comprised yellowing and thickening of the fingernails on both hands (Figure 1A). Sinus CT showed soft tissue densities around maxillary and ethmoid sinuses on both sides, confirming CRS (Figure 1B).
case_images: Histopathologic findings in the nasal polyps (hematoxylin-eosin, original magnification x200). No abnormalities are observed in the mucosal epithelium of the resected sinus mucosa, and there is very mild inflammatory cell infiltration.
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case_images: No findings indicating malignancy were observed (Figure 2).
case_images: Nail findings observed 8 months after endoscopic sinus surgery. Nail yellowing and thickening are dramatically improved compared with the findings before surgery.
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case_images: Dramatic improvement in nail manifestations was observed from 1 month postoperatively (Figure 3), and the pulmonary symptoms, such as cough and sputum frequency, also decreased.
case_images: Sinus computed tomographic scan 90 days after surgery. A mucosal retention cyst is observed in the right maxillary sinus; however, no clear residual or exacerbated chronic rhinosinusitis is present.
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case_images: A sinus CT scan taken at 90 days postoperatively is shown in Figure 4.