A toddler with a yellow nose and excessive intake of sweet potato.

1 of 2 DESCRIPTION A 30-month-old boy presented with yellowish discolouration of the nose ( fi gure 1 ), for 4 months. He was born prematurely at 32 weeks gestation with atrial and ventricular septal defects; both repaired in March 2009. Also has asthma and gastro-oesophageal refl ux. He is on erythromycin 16 mg four times a day, omeprazole 5 mg once daily, fl exitide 50 2 puffs twice daily, pharmaton 7.5 mls once daily and fortini milk 500 mls a day. On examination, he looks well, sclera is white and the soles of the feet were slightly yellow. He eats a regular diet of sweet potato 75 mg once or twice daily as estimated by dietician. This contains at least 3000–6000 IU of β carotene depending on the colour of sweet potato. The Fortini milk and squash also contains β carotene but to a lesser extent. Blood investigations revealed high serum β carotene levels and slightly raised aspartate aminotransferase (AST) and alanine transaminase (ALT) levels but blood sugar, rest of liver function test, vitamin A level and thyroid function test were normal. The mother received dietary advice to avoid excessive intake of carotene. Whether the slightly raised AST and ALT is related to the high βcarotemia or his medication is not known but the liver function test will be repeated after resolution of β carotenemia. β carotenemia is a benign condition which presents with yellow discolouration of the skin due to increased intake of β carotene. 1