Palmar erythema

Palmar erythema also called ‘liver palms‘ is reddening of the hands affecting the thenar and hypothenar eminence often seen in patients with chronic liver disease. It may be a normal finding, especially in women and pregnancy. Raised estrogen level was thought to be the main reason for increased vascularity, as the estrogen level is raised in both pregnancy and chronic liver disease. More recent studies show the role of Nitric oxide.


Palmar erythema is a sign of different physiological and pathological conditions. It disappears once the conditions causing it, are treated. Other causes of palmar erythema are the following:

  • Chronic liver disease
  • Chronic febrile illnesses
  • Thyrotoxicosis
  • Chronic leukemia
  • Polycythemia
  • Rheumatoid Arthritis
  • Secondary syphilis
  • Kawasaki disease
  • Coxsackie A infection (hand, foot, and mouth disease)
  • Rocky Mountain spotted fever
  • Eczema and Psoriasis
  • Deep telangiectasias
  • Adverse drug reactions

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