Yellow skin, jaundice

Alternative names:

eyes, yellow; icterus; jaundice; skin, yellow; yellow eyes

Definition:

A yellow discoloring of the skin, mucous membranes, and eyes, caused by too much bilirubin in the blood.

Considerations:

Jaundice is a condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat (the layer of fat just beneath the skin), causing a yellowish appearance of the skin and the whites of the eyes. With the exception of physiologic jaundice in the newborn (normal newborn jaundice), all other jaundice indicates overload or damage to the liver, or inability to move bilirubin from the liver through the biliary tract to the gut.

JAUNDICE IN AN INFANT, CHILD, OR ADULT SHOULD ALWAYS BE MEDICALLY EVALUATED.

Newborn jaundice is common and unless associated with an abnormal condition will clear without treatment. Another condition called Gilbert's syndrome is a hereditary condition in which mild jaundice develops during times of stress. This condition, once recognized, requires no further treatment or evaluation. All other jaundice is the result of an underlying disease, condition, or toxicity.

A yellow-to-orange color may be imparted to the skin by excessive intake of beta carotene, the orange pigment seen in carrots. People who consume large quantities of carrots or carrot juice or take beta carotene tablets may develop a distinctly yellow-orange cast to their skin. This condition is called hypercarotenemia or just carotenemia. Hypercarotenemia is easily distinguished from jaundice in that the whites of the eye (sclera) remain white, while people with true jaundice have a yellow sclera.

Common causes:

• drug-induced cholestasis (bile pools in the gallbladder because of the effects of drugs)
• drug-induced hepatitis (hepatitis triggered by medications, including erythromycin sulfa drugs, antidepressants, anti-cancer drugs, Aldomet, rifampin, steroids, chlorpropamide, tolbutamide, oral contraceptives, testosterone, propylthiouracil)
• pancreatic carcinoma (cancer of the pancreas)
• primary biliary cirrhosis
• biliary atresia
• ischemic hepatocellular jaundice (jaundice caused by inadequate oxygen or inadequate blood flow to the liver)
• Gilbert's syndrome
• Dubin-Johnson syndrome
• intrahepatic cholestasis of pregnancy (bile pools in the gallbladder because of the pressure in the abdomen with pregnancy)
• biliary stricture
• newborn jaundice
• hemolytic anemia
• congenital disorders of bilirubin metabolism
• viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E)
• chronic active hepatitis
• autoimmune hepatitis
• obstruction of the bile ducts (by infection, tumor or gallstones)
• malaria

Note: There may be other causes of jaundice. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for jaundice, occurring alone or in combination with other problems.