Pallor

Pallor is a pale color of the skin that can be caused by illness, emotional shock or stress, stimulant use, or anemia, and is the result of a reduced amount of oxyhaemoglobin and may also be visible as pallor of the conjunctivae of the eyes on physical examination.

Pallor is more evident on the face and palms. It can develop suddenly or gradually, depending on the cause. It is not usually clinically significant unless it is accompanied by a general pallor (pale lips, tongue, palms, mouth and other regions with mucous membranes). It is distinguished from similar presentations such as hypopigmentation (lack or loss of skin pigment) or simply a lightly-melanated complexion.

In patients with dark skin, pallor is more subtle and harder to detect, often manifesting as a more grayish or ashy tone of skin in individuals with very dark brown skin, or alternatively a more yellowish tone in individuals with lighter brown skin. Assessing the palms, soles, and mucous membranes with appropriate lighting in such cases may make detection easier.[1][2]

## Causes

Effects of different skin tone on the appearance of pallor Portrait of Richard Parkes Bonington by Margaret Sarah Carpenter. Bonington was suffering from tuberculosis and the paleness of his face was noted by critics.

* migraine attack or headache[3]
* excess estradiol and/or estrone
* osteoporosis
* emotional response, due to fear, embarrassment, grief, rage[4]
* anorexia
* anemia,[5] due to blood loss, poor nutrition, or underlying disease such as sickle cell anemia
* iron deficiency
* vitamin B12 deficiency[6]
* shock, a medical emergency caused by illness or injury
* acute compartment syndrome
* frostbite
* common cold
* cancer[7]
* hypoglycaemia[8]
* bradycardia
* panic attack
* medications
* ketorolac
* amphetamines
* ethanol
* cannabis
* lead poisoning
* motion sickness[9]
* heart disease
* Peripheral vascular disease
* hypothyroidism
* hypopituitarism
* scurvy
* tuberculosis
* sleep deprivation
* pheochromocytoma
* squeamishness
* visceral larva migrans
* Orthostatic hypotension
* methyldopa
* loss of appetite
* Space adaptation syndrome
* fibromyalgia
* Buerger's disease
* Hypovolemia
* death

## References

1. ↑ Pusey-Reid, Eleonor; Quinn, Lisa; Samost, Mary E.; Reidy, Patricia A. (March 2023). "Skin Assessment in Patients with Dark Skin Tone" (in en). American Journal of Nursing 123 (3): 36–43. doi:10.1097/01.NAJ.0000921800.61980.7e. ISSN 0002-936X. PMID 36815818.
2. ↑ "Identifying AEFI in diverse skin colour" (in en-AU). Murdoch Children's Research Institute. https://mvec.mcri.edu.au/references/identifying-aefi-in-diverse-skin-colour/.
3. ↑ Gupta, V. K. (19 August 2004). "Conceptual divide between adaptive and pathogenetic phenomena in migraine: nausea and vomiting". Brain 127 (11): E18. doi:10.1093/brain/awh279. PMID 15492109. https://academic.oup.com/brain/article/127/11/E18/342657. Retrieved 14 October 2022.
4. ↑ Drummond, Peter D. (October 1997). "Correlates of facial flushing and pallor in anger-provoking situations". Personality and Individual Differences 23 (4): 575–582. doi:10.1016/S0191-8869(97)00077-9.
5. ↑ Kalantri, Ashwini; Karambelkar, Mandar; Joshi, Rajnish; Kalantri, Shriprakash; Jajoo, Ulhas (1 January 2010). "Accuracy and Reliability of Pallor for Detecting Anaemia: A Hospital-Based Diagnostic Accuracy Study" (in en). PLOS ONE 5 (1). doi:10.1371/journal.pone.0008545. ISSN 1932-6203. PMID 20049324. Bibcode: 2010PLoSO...5.8545K.
6. ↑ Mishra, Vikas A.; Harbada, Rishit; Sharma, Akhilesh (2015). "Vitamin B12 and Vitamin D Deficiencies: An Unusual Cause of Fever, Severe Hemolytic Anemia and Thrombocytopenia". Journal of Family Medicine and Primary Care 4 (1): 145–148. doi:10.4103/2249-4863.152276. ISSN 2249-4863. PMID 25811010.
7. ↑ Fragkandrea, Ioanna; Nixon, John Alexander; Panagopoulou, Paraskevi (1 August 2013). "Signs and Symptoms of Childhood Cancer: A Guide for Early Recognition". American Family Physician 88 (3): 185–192. PMID 23939697. https://www.aafp.org/pubs/afp/issues/2013/0801/p185.html. Retrieved 14 October 2022.
8. ↑ Poterucha, Joseph T.; Bos, J. Martijn; Cannon, Bryan C.; Ackerman, Michael J. (1 August 2015). "Frequency and severity of hypoglycemia in children with beta-blocker–treated long QT syndrome" (in English). Heart Rhythm 12 (8): 1815–1819. doi:10.1016/j.hrthm.2015.04.034. ISSN 1547-5271. PMID 25929701.
9. ↑ Holmes, Sharon; King, Stuart; Scott, J. R. Rollin; Clemes, Stacy (2002). "Facial Skin Pallor Increases During Motion Sickness" (in en). Journal of Psychophysiology 16 (3): 150–157. doi:10.1027//0269-8803.16.3.150. https://psycnet.apa.org/fulltext/2002-06470-002.html. Retrieved 14 October 2022.

## External links

Classification|

* ICD-10: R23.1
* ICD-9-CM: 782.61
* MeSH: D010167

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External resources|

* MedlinePlus: 003244

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Symptoms and signs: skin and subcutaneous tissue (R20–R23, 782)

Disturbances of
skin sensation|

* Hypoesthesia
* Paresthesia
* Formication
* Hyperesthesia

* Hypoalgesia
* Hyperalgesia

Circulation|

* Cyanosis
* Pallor/Livedo
* Livedo reticularis
* Flushing
* Petechia

Edema|

* Peripheral edema
* Anasarca

Other|

* Rash
* Desquamation
* Induration
* Diaphoresis
* Mass
* Neck mass

Skin|

* Asboe-Hansen sign
* Auspitz's sign
* Borsari's sign
* Braverman's sign
* Crowe sign
* Dennie–Morgan fold
* Darier's sign
* Fitzpatrick's sign
* Florid cutaneous papillomatosis

* Gottron's sign
* Hutchinson's sign
* Janeway lesion
* Kerr's sign
* Koebner's phenomenon
* Koplik's spots
* Leser-Trelat sign
* Nikolsky's sign
* Pastia's sign
* Russell's sign
* Wickham striae
* Wolf's isotopic response
* Munro's microabscess

Nails|

* Aldrich-Mees' lines
* Beau's lines
* Muehrcke's lines
* Terry's nails

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