A woman with treated breast cancer, recent neurological symptoms and xanthoderma

We describe a 69-year-old-woman with antecedent of breast cancer and recent transitory neurological symptoms. Physical examination showed yellow to orange skin pigmentation, more conspicuous on her palms and soles, while discoloration changes were absent in the eye and oral mucous membranes. Routine laboratory findings were not indicative of hemolytic anemia, liver or bile disorders, nephrotic syndrome, hypothyroidism or diabetes mellitus. We emphasize the role of her excessive ingestion of papaw and tomato. These foods are rich in carotenoids (β-carotene and lycopene), which are associated with pigmentation disorders. The skin discoloration improved in about two months after correction of the inadequate diet. Major concerns about differential diagnosis of yellow skin pigmentation are also highlighted.