Jaundice
- Means yellowing of the skin from elevated bilirubin, either from the destruction of red blood cells in hemolysis or more commonly from liver disease or obstruction of bile ducts.
- Not seen until the bilirubin level is about twice the upper limit of normal (2.5-3 mg/dL).
- Best seen in natural light, it’s often better seen in the sclera (whites) of the eyes, where it is known as scleral icterus
- Can be seen early under the tongue.
Patient 1:
This is a young woman with Laennec’s cirrhosis.
This patient also has spider angiomas and palmar erythema.
Patient 2:
This is a young woman with severe alcoholic hepatitis.
