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Cutaneous spots and blotches may be yellow because of endogenous or exogenous pigment (xanthochromia), or because of a thick layer of keratin of lipid.
For each of the twelve cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
What is the diagnosis?
Jaundice
What causes the yellow hue in the skin in this condition?
Jaundice is the result of bilirubin binding to elastin in the skin, mucous membranes and sclerae and tends to have a greenish tinge . The same colour is seen in resolving bruises. Conjugated hyperbilirubinaemia results from impaired uptake (systemic illness, drugs), reduced secretion (liver disease) or biliary obstruction. Stigmata of chronic liver disease may or may not be present. Cholestatic jaundice also results in dark urine and lightly coloured stools. It may be associated with generalised pruritus due to elevated bile acids. There is no excessive bilirubin in urine with unconjugated hyperbilirubinaemia.