Palmar Erythema

 

 

There are two clinical forms of palmar erythema. In the first , there is an exaggeration of normal mottling; the hands are warm and bright red, especially on the palm, the dorsae of the hands, the fingers, and the nail bases. In the second, there is well-demarcated redness of the hypothenar eminence that gradually spreads to the fingertips and then to other areas of the palm. The soles of the feet may show similar changes. The mottling blanches on pressure and flushes synchronously with the pulse rate under a glass slide. Patients may complain of throbbing or tingling. “Liver palms” occur not only in liver disease, but also in pregnancy and thyrotoxicosis. An accompanying change in those with cirrhosis is atrophy of the muscles of the thenar and hypothenar eminence. This is of myogenic rather than neurogenic origin.