What is Palmar Erythema?

Palmar erythema is a reddening of the palms, especially around the base of the little finger and thumb. A number of medical conditions can cause this clinical sign, and some people also experience such reddening when they are in normal health. When this condition is identified in a patient, a doctor may recommend some follow up tests to determine the cause if the patient has no known medical condition which could cause reddening of the palms.

High blood pressure is a common cause for palmar erythema. It is also associated with liver disease, including liver cancers, cirrhosis, and hepatitis. Pregnant women have also be been known to experience this clinical sign. Some studies have suggested that elevated estrogen levels may also lead to reddened palms. However, it is important to remember that natural color variations in the hand are common in humans, and that redness in the palms is not necessarily a sign of disease or a cause for concern.

The reddened skin is not actually inflamed, although it may be caused by an inflammatory process elsewhere in the body. The skin should not feel tender or hot, and it may blanch when touched. In this case, applying pressure to the reddened areas will cause them to turn white for a moment before the red hue emerges.

Identifying this condition can be complicated. Many people have some reddening and mottling in their hands which makes it challenging to determine whether discoloration is normal or abnormal. The hue of the red can also vary, from a vivid pink to a more subdued red, and the redness may occur in areas beyond the base of the thumb and the little finger. For a patient with a regular primary care provider, the doctor may be familiar with cyclical reddening of the hands which appears normally in the patient, and thus able to differentiate between palmar erythema and perfectly normal palms. Patients who lack regular medical providers and are concerned about color changes in the hands may want to stress that the redness is new, and has not been experienced before.

In patients with conditions associated with palmar erythema, the appearance of reddening on the palms may not be a cause for concern. The doctor may suggest follow up tests to confirm that the patient isn’t experiencing problems or changes. If the condition occurs in a patient with no history of problem such as high blood pressure, testing and examination can be used to explore what is causing the redness. If a cause is determined, a treatment plan can be developed and the redness should resolve as the condition is brought under control. If no cause can be found, the patient may simply have naturally red hands.