Palmar erythema

Palmar erythema is reddening of the palms at the thenar and hypothenar eminences.

Causes

It is associated with various physiological as well as pathological changes, or may be a normal finding:

Portal hypertension
Chronic liver disease
Pregnancy
Polycythemia
Thyrotoxicosis
Rheumatoid arthritis
Eczema and psoriasis
Deep telangiectasias
Coxsackievirus A infection
Rocky Mountain spotted fever
Secondary syphilis
Kawasaki disease
Adverse drug reaction: palmoplantar erythrodysesthesia

Because circulating levels of estrogen increase in both cirrhosis and pregnancy, estrogen was thought to be the main cause for the increased vascularity. More recently, nitric oxide has also been implicated in the pathogenesis of palmar erythema.

Treatment

Palmar erythema has no specific treatment. Management is based on the underlying cause. When its cause is treated then patients get relief. If it is attributable to a particular drug then the drug should be withdrawn.