Abstract

COSTA, Raquel Xavier Martins  and  LOPES, Hugo Manuel de Azevedo Lourenço. When vegetables are too much: a case of carotenodermia. Rev Port Med Geral Fam [online]. 2020, vol.36, n.1, pp.72-76. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i1.12280.

Introduction: Carotenes are a ubiquitous pigment in nature, initially identified in carrot. Ten percent of the ingested pigment is absorbed unchanged and transported to the liver. The remainder is converted, in the intestine itself, into vitamin A. The excess is excreted by the colon and epidermis. However, when its ingestion is elevated, the fat-soluble stratum corneum reabsorbs it and accumulates it, giving a yellowish color to the skin. Children, either due to the immaturity of the enzyme conversion systems or due to the diet and food preparation mode, are more likely to show high levels of carotene in the blood (carotenemia) and on the skin (carotenodermia). Case Report: G.A.F., male, is brought to the 9-month surveillance counsel. He shows a yellowish color of the palms and plants, without any other complaints or intercurrences. On examination, sclera and oral mucosa show normal staining. His mother reports excessive consumption of carrots and sweet potatoes in the soup. It is considered to be carotenodermia and parents are explained the benignity of the situation and advised to reduce the intake of those foods. Comment: Although other causes besides diet are extremely rare in children, there is an association between carotenemia and several pathologies, namely diabetes mellitus, hypothyroidism, anorexia nervosa, and biliary dyskinesia, which will have to be investigated if dietary changes do not resolve the clinical condition. Carotenes are present in food as encapsulated crystals. Crushing them breaks the cell membranes and makes them more available for absorption, making infant-based purees more prone to its development. Regardless of color, various foods (e.g. broccoli and green beans) have high levels of carotene and should be taken into account in the clinical interview. Notwithstanding the benign nature of the clinical condition, its correct identification is of extreme importance in order to avoid the not-so-rare diagnostic confusion with jaundice and subsequent unnecessary and costly investigation.

Keywords : Carotene; 15’β carotene dioxygenase.

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