Palmar Erythema

What is Palmar Erythema?

Palmar Erythema is a skin condition on the palm portion of the hands that is reddened, especially at the thumb and base part of the little fingers. Frequently, it also affects the sole region of the feet. Palmar erythema is a type of skin problem that is only limited at the palms but this incident can also mean that there might be other underlying conditions that need a thorough evaluation to ascertain the primary cause.

palmar erythema image

The skin of a human being is the largest organ of the body where changes in the essential quality of the skin might be important to a condition that has already been present. This condition is usually found in people with rheumatoid arthritis, cirrhosis, acquired genetically, or in pregnant women of about 30%.

The oral contraceptive pills taken by women results to a positive finding with palmar erythema, which is in turn, affects estrogen to become increased in the body. Palma erythema can be an alarming issue but usually it is considered a harmless condition.

What Causes Palmar Erythema?

It is a type of disease limited only at the palm of the hands and the beginning of this problem is not a condition itself but might be correlated with other disorders and diseases. Palmar erythema is an outcome of increased perfusion level of the palms despite the main cause.

Palmar erythema happens in two forms:


This is the type where the cause is not connected to the condition itself since the cause is quite uncertain and cannot be linked to anything that is already present. Causes of primary palmar erythema include:

  • Even if it does not happen frequently, the person with palmar erythema can possibly acquire the condition by genetic transmission
  • Pregnancy can also be the cause that happens more frequently and it is also connected to increased levels of estrogen and the alteration of the skin
  • Idiopathic – This is when palmar erythema is present without any trigger or the cause is not precisely known


This palmar erythema problem is affected by a primary disease. Causes include:

  • Hyperthyroidism can cause palmar erythema since individuals who have this condition have high levels of estradiol-17 beta
  • Chronic liver disease like liver cirrhosis affects the occurrence among individuals as well as an abnormality in the function in the arteriovenous anastomoses
  • Neoplasm can be a factor particularly if it includes the liver
  • Rheumatoid arthritis – Most patients usually has this as well

What are the Symptoms of Palmar Erythema?

The first symptom of palmar erythema is the reddening observed with the palm of the hands and might extend somewhere else in the palm, but is frequently found at the thenar and hypothenar areas. This may mean general tarnishing with the palm portion of the hands. It is not itchy nor is it painful but swelling can be found in other body parts.

A sign of palmar erythema might include molting and blanching of the skin when pressure is applied; blanching usually returns to normal with the release of pressure. The reddening differs from each person since it can be in red or vivid pink color.

Although the main symptom for palmar erythema is the reddening color of the palms, it does not always mean that it should be a concern. Otherwise, some causes with it can mean that another condition is present and should be checked by a physician.

How is Palmar Erythema Diagnosed?

The primary cause of the condition is first identified by the physician before any treatments are given since other conditions may be linked together with palmar erythema.

The physician evaluates the condition by getting some liver function tests done and let the physician rule out other possible conditions present. It is quite hard to have an accurate diagnosis without the right investigations and examinations. For exact diagnosis, a dermatologist may also be consulted.

How is Palmar Erythema Treated?

No primary treatments had been found for palmar erythemas since it is a type of condition which is not quite specific and can occur to individuals with other conditions, while healthy individuals can possibly acquire it as well without prior medical history.

For people who have an underlying medical condition, then the matched primary treatment should be given. If the cause of this skin problem is the medications taken, the drug should be discontinued if possible.

For healthy individuals, the disease usually settles on its own without any treatment but by being positive with the condition, a physician should still be consulted.

Treatments will be much needed for people who have a medical condition that is present where palmar erythema cannot resolve on its own without proper and immediate treatment applied to its prime cause.


palmar erythema photo

palmar erythema pic

palmar erythema pictures


Le T, Bhushan V, Vasan N (2010), First Aid for the USMLE Step 1, p. 156, mhid: 0-07-163340.

James, William; Berger, Timothy; Elston, Dirk (2005). Andrews’ Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.

Saario R, Kalliomaki JL (Dec 1985), “Palmar erythema in rheumatoid arthritis”, Clin Rheumatol. 4 (4): 449–51.

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