carotenoderma

Carotenoderma is a benign skin condition characterized by yellow-orange discoloration of the skin due to excessive accumulation of dietary carotenoids, especially beta-carotene, in the outer skin layers. It is distinguished from jaundice by the absence of scleral icterus and by normal liver function tests.

Causes of carotenoderma include high intake of carotene-rich foods such as carrots, sweet potatoes, pumpkin, and leafy greens, as well as use of beta-carotene supplements. It can also occur in infants who are fed formulas or foods fortified with beta-carotene. In rare cases, metabolic variations affecting carotenoid processing, such as beta-carotene oxygenase deficiency, may contribute.

Pathophysiology involves the absorption and deposition of carotenoids in the stratum corneum. The pigment tends to accumulate in the skin more readily than in other tissues, producing the characteristic yellow-orange hue, with pigmentation often most evident on the palms, soles, and face. The condition does not reflect hepatic dysfunction and does not cause systemic illness.

Clinical features and diagnosis: The key finding is diffuse yellow-orange skin coloration, more pronounced on the hands and feet, with normal sclera and mucous membranes. Patients typically have no pruritus and no signs of liver disease. Diagnosis is clinical and supported by history; liver function tests and other evaluations are used to exclude jaundice and related conditions if there is any doubt.

Management and prognosis: The primary approach is to reduce dietary intake of carotene-rich foods or stop supplements. Skin color usually fades within several weeks to a couple of months after intake is decreased. Prognosis is excellent with persistent dietary modification and no associated health risk when liver function is normal.