Editing Jaundice (section)

== Signs and symptoms ==
[[File:Jaundice.jpg|thumb|A 4-year-old boy with icteric sclera due to [[G6PD deficiency]]]]
The most common signs of jaundice in adults are a yellowish discoloration of the white area of the eye ([[sclera]]) and skin,<ref>{{cite journal | vauthors = Gondal B, Aronsohn A | title = A Systematic Approach to Patients with Jaundice | journal = Seminars in Interventional Radiology | volume = 33 | issue = 4 | pages = 253–258 | date = December 2016 | pmid = 27904243 | pmc = 5088098 | doi = 10.1055/s-0036-1592331 }}</ref> with scleral icterus presence indicating a serum bilirubin of at least 3&nbsp;mg/dl.<ref name="Reuben_2012" /> Other common signs include dark urine ([[bilirubinuria]]) and pale ([[acholia]]) fatty stool ([[steatorrhea]]).<ref>{{cite book | vauthors = Goroll AH |title= Primary care medicine : office evaluation and management of the adult patient |date= 2009 |publisher= Wolters Kluwer Health/Lippincott Williams & Wilkins |location= Philadelphia |isbn= 978-0-7817-7513-7 |page= 496 |edition= 6th |url= https://books.google.com/books?id=bIZvJPcSEXMC&pg=PA496 |url-status= live |archive-url= https://web.archive.org/web/20170908204555/https://books.google.com/books?id=bIZvJPcSEXMC&pg=PA496 |archive-date= 2017-09-08 }}</ref> Because bilirubin is a skin irritant, jaundice is commonly associated with severe itchiness.<ref>{{cite book| vauthors = James WD |title=Andrews' diseases of the skin : clinical dermatology|date=2006|publisher=Saunders Elsevier|others=Berger, Timothy G.; Elston, Dirk M.; Odom, Richard B.|isbn=0-7216-2921-0|edition=10th|location=Philadelphia|oclc=62736861}}</ref><ref>{{cite journal | vauthors = Bassari R, Koea JB | title = Jaundice associated pruritis: a review of pathophysiology and treatment | journal = World Journal of Gastroenterology | volume = 21 | issue = 5 | pages = 1404–1413 | date = February 2015 | pmid = 25663760 | pmc = 4316083 | doi = 10.3748/wjg.v21.i5.1404 | doi-access = free }}</ref>

Eye [[conjunctiva]] has a particularly high affinity for bilirubin deposition due to high elastin content. Slight increases in serum bilirubin can, therefore, be detected early on by observing the yellowing of sclerae. Traditionally referred to as scleral icterus, this term is actually a misnomer, because bilirubin deposition technically occurs in the [[Conjunctiva|conjunctival membranes]] overlying the avascular sclera. Thus, the proper term for the yellowing of "white of the eyes" is conjunctival icterus.<ref>{{cite book | vauthors = McGee SR |title=Evidence-Based Physical Diagnosis |date=2018 |publisher=Elsevier |location=Philadelphia |isbn=978-0-323-39276-1 |pages=59–68 |edition=4th |chapter=Jaundice}}</ref>

In individuals with darker skin tones, jaundice may be less readily apparent on the skin and is more reliably observed in areas such as the sclera, palms, soles, and oral mucosa. Educational resources have increasingly highlighted this variation to support accurate clinical assessment across diverse populations.<ref>{{cite web |title=Mind the Gap: A handbook of clinical signs in Black and Brown skin |url=https://sgul.figshare.com/articles/online_resource/Mind_the_Gap_A_handbook_of_clinical_signs_in_Black_and_Brown_skin/12769988 |website=St George’s University of London |access-date=2025-05-19}}</ref><ref>{{cite journal |last=Ferdinand |first=Joshua |title=Recognising Clinical Signs and Symptoms on Black, Asian and Minority Ethnic (BAME) Skin Types |journal=Atomic Academia |date=2024 |url=https://doi.org/10.62594/LTHW5053 |access-date=2025-05-19 |doi=10.62594/LTHW5053}}</ref>

A rare sign of jaundice in childhood is the appearance of yellowish or greenish teeth. In developing children, hyperbilirubinemia can lead to yellow or green tooth discoloration as bilirubin deposits during tooth calcification.<ref>{{cite book| vauthors = Neville BW |title=Oral and Maxillofacial Pathology |publisher=Elsevier |year=2012 |isbn=978-981-4371-07-0 |edition=3rd |location=Singapore |pages=798 }}</ref> While this may occur in children with hyperbilirubinemia, tooth discoloration due to hyperbilirubinemia is not observed in individuals with adult-onset liver disease. Disorders associated with a rise in serum levels of conjugated bilirubin during early development can also cause [[Enamel hypoplasia|dental hypoplasia]].<ref>{{cite journal | vauthors = Amin SB, Karp JM, Benzley LP | title = Unconjugated hyperbilirubinemia and early childhood caries in a diverse group of neonates | journal = American Journal of Perinatology | volume = 27 | issue = 5 | pages = 393–397 | date = May 2010 | pmid = 20013583 | pmc = 3264945 | doi = 10.1055/s-0029-1243314 }}</ref>