Carotenemia Causing Yellow Skin?
A middle-aged woman recently discovered she had type II diabetes. Though insulin injections were not needed, her doctor advised strict limitation of sugar and total energy intake and recommended eating more pumpkin. She ate at least one meal of pumpkin instead of rice daily, and her treatment proved effective—her blood sugar remained within normal range, and she gradually increased her intake. Soon afterward, she noticed yellowing of her palms, followed by yellowing of her forehead. Hospital tests ruled out jaundice caused by viral hepatitis or gallbladder disease. However, her entire skin gradually turned yellow.
Her skin appeared mildly yellow overall, particularly noticeable on the forehead and nose, yet her sclera—the white part of the eyes—remained unaffected. Upon learning she had been consuming large amounts of pumpkin, I concluded the cause was pumpkin-related. Further examination confirmed her hands and feet were also yellow, but her oral mucosa was not. These features are characteristic of “pumpkin yellow.”
Skin and mucosal yellowing is commonly associated with jaundice, often due to liver damage or biliary obstruction. However, excessive intake of carrots, pumpkins, or orange juice can increase blood carotene levels, leading to skin yellowing. This woman suffered from carotenemia, commonly known as “pumpkin yellow,” which is different from true jaundice.