The skin is inexplicably yellow? Beware of "caroteneemia"

One day, when it was raining, an aunt dressed in fashionable clothes came in from the clinic, sat down and said, "Doctor, I suspect that I have a liver problem, you help me take a good look at it, draw a blood test." ”

It turned out that this Aunt Li was the backbone of the dance team of the neighborhood committee, and her age of more than 60 years was nothing to her, and she was indispensable to large and small activities.

I carefully inquired about the medical history, Aunt Li has always had a regular schedule, and there has been no special discomfort in recent days. Except for having hypertension under medication control, there is no remaining chronic history and family history of malignancy. Examination revealed that the palms of his hands were markedly yellow, his face was slightly yellow, his sclera was not yellowed, and his abdomen was tender.

When asked about eating habits, Aunt Li told me: A week ago, the people from the countryside brought a lot of big pumpkins they planted themselves, and they were afraid that they would be bad if they didn't have time to eat them, so they burned pumpkins all at once. Pumpkin porridge in the morning, fried pumpkin in spring onion oil at noon, steamed pumpkin as a staple food in the evening, the family is almost unable to eat.

In fact, Aunt Li's yellow skin is the curse of pumpkins. Because pumpkin is rich in "carotene", after eating a lot, it will appear a distinct yellow on the skin, which is called "caroteneemia". This skin yellowing gradually subsides within 2 to 6 weeks after stopping the intake of large amounts of carotene and does not require special treatment.

I explained the situation to Aunt Lee, and she went home happily.

About "Caroteneemia"

Why: Eat plenty of carotene and carotenoids (including α-carotene, β-carotene, and lycopene-rich foods: carrots, oranges, pumpkins, sweet potatoes, mangoes, tomatoes, broccoli, bell peppers, etc.

Clinical manifestations: the typical skin color is orange-yellow, the palms, soles and other areas are more pronounced, can also occur on the face, nasolabial folds, etc., but not in the mucosal tissues and sclera. Serum bilirubin is normal and not accompanied by constitutional symptoms.

Treatment: No special treatment is required, the relevant food is stopped, and the skin yellowing subsides on its own.

Other disorders that may cause hypercaroteneemia: nephrotic syndrome, diabetes mellitus, hypothyroidism, hyperlipidemia, anorexia nervosa, etc.

What else can cause yellowing of the skin?

Hemolytic jaundice: a large number of red blood cells are destroyed, such as hemolytic anemia, neonatal hemolytic disease, hemolysis after blood transfusion of different blood types, etc.

Features: yellow staining of the mucous membranes and sclera of the skin, acute hemolysis can appear soy sauce color urine. Predominantly elevated unconjugated bilirubin.

Hepatocellular jaundice: Extensive damage to hepatocytes, such as viral hepatitis, drug-induced liver damage, and liver damage caused by systemic infectious diseases (such as sepsis, malaria, etc.).

Features: The skin and mucous membranes are light yellow to dark golden yellow, the gastrointestinal symptoms are more obvious, the combined bilirubin and non-binding bilirubin are elevated, and the liver function is abnormal.

Cholestatic jaundice: common bile duct stones or stenosis, inflammatory edema, liver cancer, pancreatic head cancer, duodenal tumors, drug-induced cholestasis, etc.

Features: the urine color is obviously yellow, and it can be clay-like color, and there may be itching throughout the body.

Neonatal jaundice: physiological: the skin is light yellow, and the palms of the hands and feet are generally not yellow.

Pathological: the skin is orange-yellow, throughout the body. It is necessary to distinguish between the time of onset, mental state, serum bilirubin, etc.

Congenital non-hemolytic jaundice: Crigler-Najjar syndrome, etc.

What am I going to do?

When you find that your skin has turned yellow, first think carefully about whether you have been unwell recently, and whether you have special diets, medications, etc. If the cause of the yellowing of the skin cannot be judged, you can come to the hospital for treatment, and a professional doctor will give the identification and diagnosis.

This article is scientifically checked by Xu Zhongqing, chief physician of the Department of General Medicine of Shanghai Tongren Hospital.

Contributed by "Da Yi Xiao Nursing"