How can a yellow-skinned patient with beta-carotinemia be distinguished from a jaundiced patient?

Beta-carotinemia is a condition characterized by elevated levels of beta-carotene in the blood, leading to a yellowish discoloration of the skin, particularly noticeable in areas like the palms and soles. However, unlike jaundice, which results from elevated bilirubin levels and typically causes both skin and scleral (the white part of the eye) yellowing, beta-carotinemia does not affect the sclera. Thus, a key feature that distinguishes a patient with beta-carotinemia from someone with jaundice is the lack of yellowing in the sclera.

In jaundice, the accumulation of bilirubin causes a yellow tint in both the skin and the sclera, making it an important clinical sign. In contrast, patients with beta-carotinemia retain their normal scleral color, as the yellow discoloration from beta-carotene does not penetrate the tissues that give the sclera its white appearance.

Chronic fatigue and weight loss are nonspecific symptoms and may present in various conditions, but do not provide direct differentiation between beta-carotinemia and jaundice. Therefore, the distinguishing feature lies in the scleral coloration, making the absence of yellow discoloration in the sclera the critical factor for differentiation