Carotenemia is the common article title for carotenaemia, a yellow-orange discolouration of the skin caused by raised carotene levels in the blood. It is most often linked with high intake of beta-carotene from foods such as carrots, sweet potato, pumpkin, squash, mango, spinach, and kale.
The condition is usually harmless, but it matters because it can be mistaken for jaundice. In carotenaemia the palms, soles, and folds around the nose can become orange-yellow, while the whites of the eyes usually stay white. Jaundice more often affects the sclera as well as the skin.
Cause
Carotenoids are plant pigments found in many yellow, orange, red, and dark green foods. Beta-carotene can be converted into vitamin A, but conversion is controlled. Extra carotenoids can circulate in blood and collect in the outer skin and fatty tissue.
Common triggers include:
- Large amounts of carrot, sweet potato, pumpkin, squash, mango, or similar foods.
- Infant diets with frequent pureed orange vegetables.
- Supplements containing carotenoids.
- Restricted diets where a small group of carotenoid-rich foods is eaten very often.
Carotenaemia can also be associated with conditions that alter carotene handling, including hypothyroidism, diabetes mellitus, liver disease, kidney disease, and some eating disorders. In those cases the diet may not be the only factor.
Appearance
The colour change is usually gradual and painless. It is often most visible on:
- Palms.
- Soles.
- Nasolabial folds.
- Areas with thicker skin or more underlying fat.
The skin may look more orange than yellow. The person is usually otherwise well if diet is the main cause.
Difference from Jaundice
The main practical distinction is the sclera. In carotenaemia the sclera usually remains white. In jaundice the sclera often turns yellow because bilirubin is raised.
Jaundice can point to liver, gallbladder, blood, or pancreatic disease, so it is not something to dismiss as a diet effect without proper assessment when the signs do not fit simple carotenaemia.
Diagnosis
Diagnosis is usually based on history and examination. A recent diet high in carotenoid-rich food supports the diagnosis. Blood tests may be used when jaundice, liver disease, thyroid disease, diabetes, or another cause is possible.
The condition is usually reversible. When dietary carotene intake is reduced, the colour fades gradually as stored carotenoids are cleared.
Nutrition Context
Carotenoid-rich vegetables and fruit are normal parts of a healthy diet. The problem is not ordinary intake, but very high or repetitive intake, sometimes combined with supplements or an underlying condition.
Preformed vitamin A from animal foods and some supplements can cause toxicity when taken in excess. Beta-carotene from food is handled differently, but high-dose beta-carotene supplements have separate safety concerns in some groups, including smokers.
See Also
References
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