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Stillman AE.


In: Walker HK, Hall WD, Hurst JW, editors.


Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 87.


Jaundice is the yellow color of skin and mucous membranes due to accumulation of bile pigments in blood and their deposition in body tissues. Jaundice should be distinguished from cholestasis, which refers to a decreased rate of bile flow. Depending on the clinical situation, jaundice and cholestasis may coexist or each may exist without the other. Although many sources confidently say that jaundice can be recognized when the serum bilirubin rises to 2 to 2.5 mg/dl, experienced clinicians often cannot see a yellow skin coloration until the serum bilirubin is at least 7 to 8 mg/dl. Jaundice must be distinguished from yellow or green skin color resulting from carotenemia or quinacrine ingestion. Eating large quantities of green and yellow vegetables, tomatoes, or yellow corn may result in excess carotene intake. The resultant yellow skin color is differentiated from jaundice by the absence of yellow color in mucous membranes and sclerae, the normal urine color, and the accentuation of yellow-brown carotenoid pigment in the palms, soles, and nasolabial folds. Quinacrine, commonly used for treatment of giardiasis, may produce a yellow skin color, but the urine remains normal. Serum bilirubin levels are normal in patients with yellow skin caused by carotenemia or quinacrine.

Copyright © 1990, Butterworth Publishers, a division of Reed Publishing.

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