this discoloration was noted particularly in the naso - labial folds , on the palms of the hands and the soles of the feet . the frequency of this phenomenon is unknown and the relationship between skin color and blood carotenoid level is controversial . frequently the suspicion of diabetes arising from inspection of the skin color is in fact confirmed by the usual laboratory tests . carotenemia is a clinical condition characterized by yellow pigmentation of the skin ( xanthoderma ) and increased beta - carotene levels in the blood . in most cases , the condition follows prolonged and excessive consumption of carotene - rich foods , such as carrots , squash , and sweet potatoes . many individuals with diabetes have elevated serum carotene levels , but only 10% of these individuals exhibit yellowing of the skin . carotenemia may be related to restricted dietary habits , hyperlipidemia , or a deficiency in the conversion of carotene into vitamin a by the liver . a 41-year - old male presented to the outpatient department with a 1-month history of yellow discoloration of both palms and soles [ figure 1 ] . he was a known case of diabetes for the last 18 years on oral hypoglycemic agents . his lab investigation reveals fbs 187 mg / dl ; glycocylated hemoglobin value was 10.6% . he did not report ingesting excessive amounts of carotene - rich fruits or vegetables , such as carrots , squash , and green beans . the patient was treated with insulin and metformin medication , and followed up after 2 months . the yellow discoloration of his palms and soles has improved after 2 months [ figure 2 ] . yellow discoloration of left palm in comparison with the right palm of examiner on first visit normal palms after 2 months of insulin therapy yellow discoloration of the skin may be associated with carotenemia , hypothyroidism , liver disease , and renal disease . traditionally , it is considered to be related to carotenemia , but it may also be associated with end - products of advanced glycation .
carotenemia with its yellowish - red tint is found in diabetes . 
 the frequency of this phenomenon is unknown and the relationship between skin color and blood carotenoid level is controversial . 
 frequently the suspicion of diabetes arising from inspection of the skin color is in fact confirmed by the usual laboratory tests . as it is known that increased intake of carotenoid - rich fruit and vegetables leads to the yellowish - red skin discoloration , in the present case the patient was a known diabetic with uncontrolled blood sugar and showed the yellowish skin discoloration in spite of not taking any carotenoid - rich foods . after controlling his blood sugar level 
 the patient showed improvement in his skin discoloration .