• Users Online: 1053
  • Print this page
  • Email this page


 
  Table of Contents  
THROUGH THE LENS
Year : 2021  |  Volume : 12  |  Issue : 3  |  Page : 484-485  

Yellow palms with underlying type II diabetes mellitus


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 Submission15-Mar-2020
Date of Decision30-May-2020
Date of Acceptance08-Jul-2020
Date of Web Publication12-May-2021

Correspondence Address:
Anuradha Bishnoi
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh - 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_129_20

Rights and Permissions

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 2021 Jun 24];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

Click here to view
Figure 2: Marked improvement in discoloration at follow-up after 2 months

Click here to view


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.[1] 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.[2] 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

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Lin JN. Images in clinical medicine. Yellow palms and soles in diabetes mellitus. N Engl J Med 2006;355:1486.  Back to cited text no. 1
    
2.
Hoerer E, Dreyfuss F, Herzberg M. Carotenemic, skin colour and diabetes mellitus. Acta Diabetol Lat 1975;12:202-7.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2], [Figure 1], [Figure 2]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed246    
    Printed0    
    Emailed0    
    PDF Downloaded24    
    Comments [Add]    

Recommend this journal