Metabolic carotenemia and carotenoderma in a child

We describe a 3-year-old girl with long-standing yellow discoloration of her skin and a 3-fold increase in the plasma carotenoid concentration compared to normal, but no history of excessive carotene intake or familial carotenemia. When put on a carotene-deficient diet for 8 months she still had some remaining yellow discoloration in the nasolabial folds and on the palms and soles. The results of an oral loading with beta-carotene (1 mg/kg) provide indirect evidence that the girl's carotenemia is due to a probably genetic defect in the metabolism of carotenoids.