Diet-induced carotenoderma – a rare clinical presentation

Carotene is a lipochrome which adds a yellowish tinge to the skin. Carotenoderma is an orange yellow pigmentation of the skin, resulting from hypercarotenemia leading to carotene deposition in the skin, mainly the stratum corneum [1]. It occurs commonly due to high β-carotene intake from vegetables, fruits, eggs, and nutrient supplements. Several metabolic diseases including hypothyroidism, liver disorders, diabetes mellitus, pregnancy and anorexia nervosa have also been incriminated in carotenoderma [1]. Diet-related carotenoderma has usually been described in children but rarely in adults. In this article, we present an adult case of carotenoderma secondary to excessive ingestion of foodstuffs rich in carotene.
A 35-year-old man, gym trainer by profession, presented with the complaint of yellowish discoloration of the palms for the past 2 months. He initially noticed yellow discoloration of his palms, and later soles. He was otherwise healthy with no habits of smoking/alcohol. On questioning, he mentioned that he was a non-vegetarian and followed a mixed diet. His dietary history revealed that he eats 6–8 carrots/day, two sweet potatoes/day along with plenty of green salads; and a papaya every other day as routine. He had no history of dark urine, pain in right upper area of the abdomen, itching or fever. His family history was non-contributory. He denied any suggestive drug history. On clinical examination, he had orange-yellow discoloration of palms and soles (fig. 1) and a yellowish tinge over the mid face sparing the sclera and oral mucosa. The rest of the physical examination was unremarkable. His routine laboratory tests including lipid profile, blood glucose level, hepatitis serology and thyroid function were unremarkable. β-Carotene level in the was not measured due to non-availability. Based on a suggestive dietary history and further supported by physical examination, he was diagnosed to have diet-induced carotenoderma and was suggested to avoid β-carotene rich food stuffs. After a span of 3 months of avoidance of a carotene-rich diet, his skin color improved, which further confirmed our diagnosis.
Carotenoids are organic compounds found mainly in red, orange or yellow colored fruits, vegetables and green leafy vegetables. Foods with a high concentration of carotenoids include carrots, apricots, orange, mandarin, mangoes, sweet potatoes, kale, melon, papaya and other green leafy vegetables [2]. Other good sources include butter,...


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