What are the other Names for this Condition? (Also known as/Synonyms)

• Lane’s Disease
• Liver Palms
• Red Palms

What is Palmar Erythema? (Definition/Background Information)

• Palmar Erythema, or Lane’s Disease, is the reddening of the palms of the hands, especially in the region of hypothenar eminence - an area of the palm that is close to the wrist along the line of the little finger (and not the thumb side, which is called the thenar eminence)
• Based on the cause of the condition, Palmar Erythema is classified as primary or secondary:
  • Primary Palmar Erythema - the cause of the condition is generally unknown
  • Secondary Palmar Erythema - it occurs due to a variety of conditions such as heart abnormalities, liver cirrhosis, diabetes, and sarcoidosis, among others
• Palmar Erythema may be observed in children and adults. There are no significant signs and symptoms observed, and the condition is typically painless and non-itchy
• There is also no treatment specified for Palmar Erythema, apart from suitably managing the underlying causative condition. Typically, the prognosis depends on the type and severity of the underlying/associated condition, which may vary from one individual to another

Who gets Palmar Erythema? (Age and Sex Distribution)

• Palmar Erythema is common condition that is observed in both children and adults, depending on the underlying or associated condition
• Both males and females are affected
• Individuals of all racial and ethnic background may be affected. Worldwide, no geographical localization has been reported

What are the Risk Factors for Palmar Erythema? (Predisposing Factors)

The risk factors for Palmar Erythema may include the following:

• Primary Palmar Erythema:
  • Psychological stress
  • Pregnancy - it is reported that 1 in 3 pregnant women may develop Palmar Erythema
  • Positive family history - the condition may run in families (hereditary Palmar Erythema); these are observed in children
• Secondary Palmar Erythema:
  • Any condition resulting in chronic increase in estrogen levels in the body
  • Any condition resulting in increased blood circulation in the body
  • Chronic alcohol abuse
  • Chronic mercury poisoning
  • Congenital syphilis
  • Drug-induced (caused by a variety of medication)
  • Heart conditions resulting in increased cardiac output
  • Hemochromatosis
  • History of smoking
  • Liver cirrhosis - 1 in 4 individuals may develop Palmar Erythema
  • Kawasaki disease
  • Paraneoplastic syndromes
  • Polycythemia vera
  • Poorly-controlled diabetes
  • Rheumatoid arthritis - over 60% of the affected individuals may develop the condition
  • Sarcoidosis
  • Systemic lupus erythematosus (SLE) 
  • Thyrotoxicosis
  • Wilson disease

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Palmar Erythema? (Etiology)

• The cause of development of primary Palmar Erythema is unknown. Some experts believe that it may be due to pregnancy, stress, or it may run in families (very rarely noted)
• Secondary Palmar Erythema is caused by a host of clinical conditions, such as hormonal issues, heart conditions, medication use, and longstanding diabetes, among others

The following conditions have been associated with Palmar Erythema:

• Psoriasis
• Eczema
• Certain viral and bacterial infections

What are the Signs and Symptoms of Palmar Erythema?

The signs and symptoms of Palmar Erythema may include:

• Red palms - both palms may be involved; in some, the redness may be mild
• No pain or itching is noted
• The palms may be slightly warm
• Stress may increase severity of the condition

Additional signs and symptoms of any underlying conditions may be noted.

When the soles of the feet are affected (red soles), the condition is termed plantar erythema.

How is Palmar Erythema Diagnosed?

A diagnosis of Palmar Erythema may involve the following tests and exams:

• A thorough medical history and physical examination
• Blood tests such as complete blood count (CBC)
• Thyroid function test
• Liver function test
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Radiological testing as clinically indicated depending on the underlying cause
• Skin biopsy (if required): A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Additional testing may be needed to diagnose underlying conditions if any

Note: A biopsy may be performed to rule out other skin conditions with similar signs and symptoms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Palmar Erythema?

• No specific complications of Palmar Erythema are generally noted
• However, complications may occur from any underlying/associated conditions

How is Palmar Erythema Treated?

There is no specific treatment for Palmar Erythema.

• Treating the underlying disorder, as needed, can help improve the condition
• Palmar Erythema is known to go away after delivery in pregnant women
• Discontinuing the causative medication may help in improving drug-induced Palmar Erythema

How can Palmar Erythema be Prevented?

Currently, there are no known methods available to prevent the occurrence of primary Palmar Erythema. In some cases of secondary Palmar Erythema, the following may be considered:

• Recognize and promptly treat any health condition
• Maintain diabetes under control via food control and adequate physical activities/exercises
• Maintain a stress-free life to the extent possible
• Stop smoking or drinking 
• Having a low-fat diet and adequate physical activities/exercises to maintain optimal weight are beneficial in controlling blood lipid/cholesterol levels

What is the Prognosis of Palmar Erythema? (Outcomes/Resolutions)

The prognosis of Palmar Erythema depends on the severity of the underlying causative condition. The prognosis varies from one individual to another on a case-by-case basis.

Additional and Relevant Useful Information for Palmar Erythema:

• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse