Palmar Erythema

The significant palmar erythema seen on the hands of a 60-year-old man with alcoholic cirrhosis is a sign of underlying chronic liver failure, write Drs Sonia Arunabh and Terence M. Brady of Flushing, NY. Such erythema generally involves the entire palm but is usually more apparent on the hypothenar eminence. The erythema blanches on pressure, and it may regress following treatment of the liver disease. The soles of the feet may show similar changes.

Palmar erythema may also be seen in association with such conditions as rheumatoid arthritis, pregnancy, mitral stenosis, and thyrotoxicosis. In liver disease and pregnancy, this erythema may be caused by hyperestrogenemia; it has also been seen in young women who take oral contraceptives that have a high estrogen content.