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December 6, 1976

Carotenemia vs Jaundice

Author Affiliations

Castro Valley, Calif

JAMA. 1976;236(23):2603. doi:10.1001/jama.1976.03270240013007

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To the Editor.—  Included in the differential diagnosis of jaundice is the yellow tint of the skin caused by carotene. A recent clinical observation differentiated these entities.The patient was a 28-year-old woman who was referred for evaluation of a yellow color to her skin. She had felt well except for some loss of visual acuity. In addition to oral contraceptives, she ingested many vitamins and food supplements including multivitamin tablets (Theragran M); vitamins C, E, D, and A; wheat germ oil; desiccated liver; brewer's yeast; zinc; bone meal and kelp tablets; and lecithin capsules. Her diet contained ample yellow, carotene-containing vegetables. Abnormal physical findings were limited to the skin, which showed a striking yellow color, most notable on the palms of the hands, the knees, and the soles of the feet. This was clearly evident when viewed under artificial light but barely discernible when viewed in natural light. The