Palmar erythema

Erythema

Erythema is redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or inflammation...

is reddening of the palm

Hand

A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...

s at the thenar and hypothenar eminences.

Causes

It is associated with various physiological as well as pathological changes, the principal one of which is portal hypertension

Portal hypertension

In medicine, portal hypertension is hypertension in the portal vein and its tributaries.It is often defined as a portal pressure gradient of 10 mmHg or greater.-Causes:Causes can be divided into prehepatic, intrahepatic, and posthepatic...

. It is also seen in patients with liver dysfunction, such as chronic liver disease (chronic hepatitis  ), and also in pregnant women. Palmar erythema may also be the result of thyrotoxicosis and dermatoses such as eczema or psoriasis, and is related to deep telangiectasias. It may also be a normal finding.

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

Palmar erythema occurs in about 30% of patients with rheumatoid arthritis

Rheumatoid arthritis

Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...

especially those with elevated hemoglobin levels .

Palmar erythema can also be seen in Coxsackievirus A infection (hand, foot and mouth disease), Rocky Mountain Spotted Fever, and secondary Syphilis.
.