Last reviewed by mvhs13 on August 13th, 2018.
What is Palmar Erythema?
Palmar erythema is defined as the reddening of the palm of the hands, particularly at the base of the little finger and the thumb. It is a skin condition that is localized only at the palm of the hand although the incidence may be significant to some underlying condition which necessitates a medical evaluation to determine the root cause.
Palmar erythema is common in people with rheumatoid arthritis while around 30% of pregnant women get to experience the same. Palmar erythema is also being associated with liver cirrhosis where about 23% of patients experience the reddening of the palm of the hands. Women taking oral contraceptive pills are also seen with palmar erythema which is being linked to the high levels of estrogen as an effect of the oral contraceptive pills.
The skin is the largest organ of the body that any changes in the characteristic of the skin may be significant to an existing underlying condition. The palm of the hand is considered a skin that changes such as that of reddening accompanied by molting could be an alarming issue although the incidence of palmar erythema in itself is generally a harmless condition.
Palmar erythema can be caused by numerous conditions and is more commonly being associated with high blood pressure. It is a skin condition that is rather difficult to distinguish and diagnose owing to its similarity with other skin conditions that have the same clinical presentation. Identification of palmar erythema is significant in determining an underlying condition particularly when the erythema occurred without prior medical condition. The incidence could be a manifestation of something more serious that series of test is recommended. The onset is not always inflammatory yet the inflammation could be elsewhere which makes itself present through the manifestation of palmar erythema.
Palmar Erythema Symptoms
Palmar erythema appears a symmetrical and slightly warm reddening of the palm of the hands particularly at the base of the little finger and the thumb. It can appear or extend elsewhere in the palm of the hand but is more common at the hypothenar and thenar eminence. It can manifest as a general discoloration of the palm of the hands although more common at its usual designation.
Palmar erythema exist without the presence of itchiness, scaling and pain although inflammation may be present which could be originating from other parts of the body which only makes the inflammation itself known through palmar erythema.
The manifestation of palmar erythema may have molting and may blanch when pressed or when put on with a pressure. Blanching of the skin in palmar erythema will momentarily return to its reddening hue after the pressure has been released. The reddening can extend or involve the fingers and the nail folds adjacent to the hypothenar and thenar eminence. Reddening in palmar erythema is not always the same and therefore varies from one person to another. The coloring hue may differ and which could be in vivid pink or in passive red color.
Reddening of the palm may not always be a cause for concern as it could occur to healthy people as well or to those without history of medical conditions. Palmar erythema may on the other hand occur significant to an underlying condition for which case the symptoms that may appear will depend on the underlying condition associated with palmar erythema.
Palmar Erythema Causes
Palmar erythema is a self-limited disease localized only at the palm of the hands and the onset is not a condition itself but may be associated with other diseases and disorders. The onset of palmar erythema is the result of increased in the perfusion of the palm of the hands regardless of the primary cause. Increased levels of estrogen are the most implicated in the incidence as the increase in the level of estrogen is believed to influence the endometrial capillary density, which in turn has a similar effect on the palm of the hands. Palmar erythema occurs in two forms.
Primary palmar erythema is the form where the cause is not related or secondary to an underlying condition. The cause is more unclear and cannot be related to an existing medical condition.
The cause of primary palmar erythema may include the following:
- Pregnancy is the most common trigger of palmar erythema and is related to increased levels of circulating estrogen and also being linked to the changes in the function of the skin and vasculature
- Heredity is also believed to play a role in the onset of palmar erythema although this seldom happens
- Idiopathic is one in where the exact cause is unknown or palmar erythema exist without any trigger
Secondary palmar erythema is the form that exists as secondary to an existing underlying condition or that which is influenced by a primary disease.
- Chronic liver disease such as liver cirrhosis influences the incidence of palmar erythema as a result of increased levels of estrogen or abnormality in the levels of oestradiol. A dysfunction in the arteriovenous anastomoses is also considered to cause palmar erythema among patient suffering from liver cirrhosis
- Rheumatoid arthritis is considered to be one of the common causes of palmar erythema. Palmar erythema incidence covers approximately 60% of patients with rheumatoid arthritis although the exact pathogenesis remains unclear
- Neoplasm is another factor considered to cause palmar erythema especially if it involves the liver. The growth of solid tumor can enhance the levels of circulating estrogen and the onset of palmar erythema may be due to the enhanced angiogenic factor
- Hyperthyroidism is one condition where patients are seen to have an increase levels of estradiol-17-beta which is most likely to cause palmar erythema
Palmar erythema has no specific treatment and treatment for which involves identification of the primary cause and the treatment indicated. Palmar erythema is a non-specific condition which can occur as significant to an underlying condition while it may also happen to healthy individuals without prior medical history.
Palmar erythema in healthy individuals may resolve on its own without treatment although it is still necessary to consult a doctor. Treatment otherwise, is necessary for those who have present medical condition where palmar erythema resolves as soon as prompt and right treatment is applied to its primary cause.