Pallor Explained

Pallor
Field:	Hematology, Rheumatology, Dermatology
Differential:	Hypopigmentation

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 fair complexion.

Causes

• migraine attack or headache^[1]
• excess estradiol and/or estrone
• osteoporosis
• emotional response, due to fear, embarrassment, grief, rage^[2]
• anorexia
• anemia,^[3] due to blood loss, poor nutrition, or underlying disease such as sickle cell anemia
• iron deficiency
• vitamin B12 deficiency^[4]
• shock, a medical emergency caused by illness or injury
• acute compartment syndrome
• frostbite
• common cold
• cancer^[5]
• hypoglycaemia^[6]
• bradycardia
• panic attack
• medications
  • ketorolac
  • amphetamines
  • ethanol
  • cannabis
• lead poisoning
• motion sickness^[7]
• 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

Notes and References

1. Gupta . V. K. . Conceptual divide between adaptive and pathogenetic phenomena in migraine: nausea and vomiting . Brain . 19 August 2004 . 127 . 11 . E18 . 10.1093/brain/awh279 . 15492109 . 14 October 2022.
2. Drummond . Peter D. . Correlates of facial flushing and pallor in anger-provoking situations . Personality and Individual Differences . October 1997 . 23 . 4 . 575–582 . 10.1016/S0191-8869(97)00077-9.
3. Kalantri . Ashwini . Karambelkar . Mandar . Joshi . Rajnish . Kalantri . Shriprakash . Jajoo . Ulhas . Accuracy and Reliability of Pallor for Detecting Anaemia: A Hospital-Based Diagnostic Accuracy Study . PLOS ONE . 1 January 2010 . 5 . 1 . e8545 . 10.1371/journal.pone.0008545 . 20049324 . 2797134 . 2010PLoSO...5.8545K . en . 1932-6203. free .
4. 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 . 10.4103/2249-4863.152276 . 2249-4863 . 4366991 . 25811010 . free .
5. Fragkandrea . Ioanna . Nixon . John Alexander . Panagopoulou . Paraskevi . Signs and Symptoms of Childhood Cancer: A Guide for Early Recognition . American Family Physician . 1 August 2013 . 88 . 3 . 185–192 . 23939697 . 14 October 2022.
6. Poterucha . Joseph T. . Bos . J. Martijn . Cannon . Bryan C. . Ackerman . Michael J. . Frequency and severity of hypoglycemia in children with beta-blocker–treated long QT syndrome . Heart Rhythm . 1 August 2015 . 12 . 8 . 1815–1819 . 10.1016/j.hrthm.2015.04.034 . 25929701 . 14 October 2022 . English . 1547-5271.
7. Holmes . Sharon . King . Stuart . Scott . J. R. Rollin . Clemes . Stacy . Facial Skin Pallor Increases During Motion Sickness . Journal of Psychophysiology . 2002 . 16 . 3 . 150–157 . 10.1027//0269-8803.16.3.150 . 14 October 2022 . en.