Carotenemia caused by durian
A few patients presented to my clinic here in Sipitang, Sabah complaining of yellowish discolouration of their palm and soles. One of them is a contractor, deny any exposure to chemical and paint or even plant that can cause the contamination and discoloration of palm and sole. That patient claimed his cousin, brother and sister also having the same problem. It all happen within this few days to weeks. It occur suddenly, when it occur it is so obvious that their palms and soles were yellow in colour. Otherwise their sclera is normal. There is also an old lady complain of the same thing. She also did not have yellowish discoloration of the sclera. Her palm and soles completely turn to yellow. I have ordered liver function test for all patient ehich turn out to be normal. Their bilirubin leven did not raised. Its a carotenemia from what I have learn in medical school. The first thing I ask them when I suspect this is " have you eaten a lot of carrot or tamato juice at home. O