
This Disease Turns You Blue… Literally
Blue skin is actually due to the blood disorder methemoglobinemia. In patients with methemoglobinemia, the body overproduces the form of hemoglobin called methemoglobin. Instead of the typical 1% methemoglobin, those with this disease can have up to 20%. Because their hemoglobin cannot distribute oxygen in the body, their skin turns blue, their lips turn purple, and their blood turns chocolate brown. Other symptoms include headache, dizziness, shortness of breath, poor coordination, seizures, and arrhythmias. People can inherit this condition, but it comes from exposure to chemicals and drugs like benzocaine, lidocaine, nitrates, or dapsone. Babies under six months have lower levels of a critical methemoglobin-reducing enzyme, so they are at significant risk for developing this disease. Doctors make the diagnosis via arterial blood gas and CO-oximetry panels. You can treat methemoglobinemia with supplemental oxygen and methylene blue.