SYMPTOMS

What does liver palm look like?

Liver palm, also known as palmar erythema, refers to the appearance of red patches on the base of the thumb and little finger (i.e., the thenar and hypothenar eminences). Sometimes, these red patches may spread to a larger area, such as the entire palm or even the back of the hand. When pressure is applied to these red patches, the redness may fade, and the skin may turn pale, returning to its original state after the pressure is released. Small red patches may also appear on the soles of the feet.

Palmar erythema may present with no symptoms other than redness, but sometimes it can be accompanied by itching or excessive sweating.

Where does the name "liver palm" come from?

We call palmar erythema "liver palm" because many chronic liver diseases can cause this change in the palms due to altered sex hormone metabolism. Statistics show that approximately 23% of patients with cirrhosis develop palmar erythema. Hence, we also refer to palmar erythema as liver palm.

Does liver palm always indicate liver disease?

Although liver disease can easily cause liver palm, it is incorrect to assume that liver palm is always caused by liver disease. Liver palm is not exclusive to liver diseases, as many physiological conditions and other diseases can also lead to liver palm (palmar erythema).

For example, physiological conditions such as nervousness, excitement, raising the hands, or pregnancy can cause redness in the palms. As for diseases, there are even more possibilities, which we will discuss later. In short, the appearance of palmar erythema does not necessarily mean one has liver disease, so there is no need to worry excessively.

TREATMENT

How can palmar erythema be relieved?

Relieving palmar erythema is actually a false proposition. There is no way to alleviate the palmar erythema itself.

• Redness of the palms due to physiological conditions will gradually recover on its own.
• If palmar erythema is caused by disease, then treating the disease itself is the only way to potentially reduce this redness.

DIAGNOSIS

When should you seek medical attention for palmar erythema?

If you develop newly noticeable palmar redness that persists after ruling out physiological causes (such as nervous excitement, pressing your palms forcefully, or raising your hands), it's advisable to visit a hospital promptly for evaluation to exclude potential underlying conditions.

Similarly, if you already have known disease-related palmar redness but observe significant progression—such as increasingly prominent redness or expanding affected areas—you should remain vigilant and seek medical care without delay.

POTENTIAL DISEASES

What are the possible causes of palmar erythema?

The primary cause of palmar erythema is liver disease. Conditions such as cirrhosis, Wilson's disease, or various acute or chronic hepatitis can impair the liver's ability to metabolize estrogen, leading to elevated estrogen levels. This stimulates capillary dilation and congestion, resulting in palmar erythema.

Other diseases associated with palmar erythema include diabetes, rheumatoid arthritis, hyperthyroidism, eczema, and psoriasis. Additionally, certain medications like salbutamol and amiodarone may also cause erythema of the palms.

Palmar erythema does not always indicate liver disease, as some healthy individuals may also exhibit this condition. Many cases observed over years show normal liver function without any liver pathology. Therefore, a thorough evaluation combining medical history and multiple tests is necessary for an accurate diagnosis. Avoid hastily labeling it as liver disease.