Carotenosis

Carotenosis
Other namesCarotenaemia, xanthaemia, carotenoderma, carotenodermia
Carotenoderma visible on the nose
SpecialtyDermatology

Carotenosis is a benign and reversible medical condition where an excess of dietary carotenoids results in orange discoloration of the outermost skin layer. The discoloration is most easily observed in light-skinned people and may be mistaken for jaundice.[1][2]: 540 [3]: 681  Carotenoids are lipid-soluble compounds that include alpha- and beta-carotene, beta-cryptoxanthin, lycopene, lutein, and zeaxanthin. The primary serum carotenoids are beta-carotene, lycopene, and lutein. Serum levels of carotenoids vary between region, ethnicity, and sex in the healthy population. All are absorbed by passive diffusion from the gastrointestinal tract and are then partially metabolized in the intestinal mucosa and liver to vitamin A. From there they are transported in the plasma into the peripheral tissues. Carotenoids are eliminated via sweat, sebum, urine, and gastrointestinal secretions.[citation needed] Carotenoids contribute to normal-appearing human skin color, and are a significant component of physiologic ultraviolet photoprotection.[4]

Carotenemia most commonly occurs in vegetarians and young children with light skin.[5] Carotenemia is more easily appreciated in light-complexioned people, and it may present chiefly as an orange discolouration of the palms and the soles in more darkly pigmented persons.[6] Carotenemia does not cause selective orange discoloration of the conjunctival membranes over the sclerae (whites of the eyes), and thus is usually easy to distinguish from the yellowing of the skin and conjunctiva caused by bile pigments in states of jaundice.

Carotenoderma is deliberately caused by beta-carotenoid treatment of certain photo-sensitive dermatitis diseases such as erythropoietic protoporphyria, where beta carotene is prescribed in quantities which discolor the skin. These high doses of beta carotene have been found to be harmless in studies, though cosmetically displeasing to some. In a recent meta analysis of these treatments, however, the effectiveness of the treatment has been called into question.[7]

  1. ^ Haught JM, Patel S, English JC (2007). "Xanthoderma: a clinical review". J. Am. Acad. Dermatol. 57 (6): 1051–8. doi:10.1016/j.jaad.2007.06.011. PMID 17637481.
  2. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  3. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  4. ^ Stahl W; Sies H (2012). "β-Carotene and other carotenoids in protection from sunlight". The American Journal of Clinical Nutrition. 96 (5): 1179S–84S. doi:10.3945/ajcn.112.034819. PMID 23053552.
  5. ^ Brian J. Hall; John C. Hall (28 March 2012). Sauer's Manual of Skin Diseases. Lippincott Williams & Wilkins. pp. 1219–. ISBN 978-1-4511-4868-8.
  6. ^ eMedicine – Carotenemia : Article by Robert A Schwartz
  7. ^ Minder EI, Schneider-Yin X, Steurer J, Bachmann LM (2009). "A systematic review of treatment options for dermal photosensitivity in erythropoietic protoporphyria". Cellular and Molecular Biology (Noisy-le-Grand, France). 55 (1): 84–97. PMID 19268006.