Palmar erythema

Palmar erythema is known as the reddening of the palms and soles of the feet due to increased blood flow to these areas of the body. Causes include liver disease, pregnancy, certain drugs and other physiological changes. They are seen to be red, symmetrical, non itchy and non painful.

• Vascular

  Brachial arteriovenous fistula

  Aortic aneurysm

  Hemiplegic stroke [1]

• Infection

  Bacterial endocarditis

  Lung abscess

  TB [2]

• neoplasm

  Atrial myxoma

  Lung cancer [3]

• drugs

  Laxative overuse

  Interferon alfa-2A

  Prostaglandin infusion [1]

• Iatrogenic

  Arterial graft sepsis [4]

• congenital

  Congenital heart disease [1]

• Autoimmune

  Thyroid acropachy [1]

• Trauma

  Damage to blood vessels, or injuries or deformities that block them, can reduce circulating oxygen levels and trigger clubbing

• Endocrine/metabolic

  Hyperthyroidism

  Acromegaly

  Liver cirrhosis [1]

Source: DermNetNZ.org [1]

Palmar erythema 

Redness on the palms symmetrically distributed

Palmar erythema 

Widely diffused redness on on the palms symmetrically distributed

Source: DermNetNZ.org [1]

Palmar erythema 

Widely diffused redness on on the palms symmetrically distributed

Source: Physical Diagnosis PDX [6]

Palmar erythema on darker skin 

Brown/ hyperpigmentation on the palm

References

[1] https://dermnetnz.org/topics/palmar-erythema

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325006/

[3] https://www.ccjm.org/content/84/9/666

[4] https://www.uptodate.com/contents/assessing-surgical-risk-in-patients-with-liver-disease

[5] https://ijdvl.com/a-case-series-and-literature-review-of-erythema-palmare-hereditarium-lanes-disease/

[6] https://physicaldiagnosispdx.com/gastroentereology-m/palmar-erythema/#:~:text=Erythema%20of%20the%20thenar%2Fhypothenar,imbalance%20of%20estrogens%20to%20androgens).