|THROUGH THE LENS
|Year : 2021 | Volume
| Issue : 3 | Page : 484-485
Yellow palms with underlying type II diabetes mellitus
Ankur Guliani1, Sheetanshu Kumar2, Anuradha Bishnoi2
1 Department of Dermatology, Venereology and Leprology, Civil Hospital, Baddi, Himachal Pradesh, India
2 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
|Date of Submission||15-Mar-2020|
|Date of Decision||30-May-2020|
|Date of Acceptance||08-Jul-2020|
|Date of Web Publication||12-May-2021|
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh - 160 012
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Guliani A, Kumar S, Bishnoi A. Yellow palms with underlying type II diabetes mellitus. Indian Dermatol Online J 2021;12:484-5
|How to cite this URL:|
Guliani A, Kumar S, Bishnoi A. Yellow palms with underlying type II diabetes mellitus. Indian Dermatol Online J [serial online] 2021 [cited 2022 Jan 25];12:484-5. Available from: https://www.idoj.in/text.asp?2021/12/3/484/308901
A 39-year-old apparently healthy female presented with a 3-month-history of yellowish discoloration of her palms. She denied an excessive intake of carotene-rich vegetables and fruits such as carrots, squash, sweet potatoes, oranges, pumpkins, green beans and so on. There was no history of any medication intake including nutritional supplements prior to the onset of yellow palms. There were neither personal complaints suggesting hypothyroidism was nor a family history of the same.
Physical examination revealed stark diffuse yellow pigmentation of her palms [Figure 1]a and [Figure 1]b. There was no associated icterus. Soles were normal. Interestingly a screening for diabetes revealed her fasting blood sugar levels to be 196 mg/dl and glycosylated hemoglobin level was 7.9%. Based on the history, clinical examination and investigations, we reached the diagnosis of yellow palms (caratonemia) with type II diabetes mellitus. Treatment was initiated with oral hypoglycemic drugs, and a marked improvement was observed in discoloration at follow-up after 2 months [Figure 2].
|Figure 1: (a) Yellowish pigmentation of both the palms. (b) Yellow palm of the patient as compared with non-pigmented palm of the bystander|
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|Figure 2: Marked improvement in discoloration at follow-up after 2 months|
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Yellowish palms and soles (carotenemia) can be seen either due to excessive ingestion of carotene-rich foods, or reduced clearance of carotenes resulting from liver disease, renal disease, hypothyroidism and hyperlipidemia and rarely in patients with diabetes mellitus. It is speculated that the conversion of carotenes to vitamin A in the liver and duodenum is deficient in diabetes. The resultant excess carotene being more lipid soluble gets accumulated in stratum corneum owing to its high lipid content, imparting yellowish color to the skin. To conclude, yellow palms and soles can be associated with underlying metabolic derangements, and an adequate screening for undiagnosed diabetes should be carried out in such patients.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Lin JN. Images in clinical medicine. Yellow palms and soles in diabetes mellitus. N Engl J Med 2006;355:1486.
Hoerer E, Dreyfuss F, Herzberg M. Carotenemic, skin colour and diabetes mellitus. Acta Diabetol Lat 1975;12:202-7.
[Figure 1], [Figure 2], [Figure 1], [Figure 2]