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What Causes Reddish Purple Discoloration On The Hands?
Question: I was hoping to get a hepatologist opinion on my hands. I have hands that are pink/reddish and slightly purple (maybe)?They can be a pale pink or bright red especially after washing my hands in hot water...They get really red. Usually they are a pink color that is definitely different from my wrist up. I am pale and my legs can get red as well at times. With my hand they are the same color through the whole hand and on the top of my hand too from the knuckles up, not just the palm. I went back through pictures almost 10 years back and my hands are pinker/redder than most then too. It looks like the palm side too but hard to say in pictures.
A year and a half ago I had an abdominal ultrasound. They said fatty liver and bounderline splenemiglia at 13.9. No indication of portal hypertension, aorta, ivr all normal. Bloodwork cameback normal as wellback. ALT was slightly high at 57. All other metabalic panels were within normal limits with platelets at 280000, though down from 299000. I remember creatinine was 1.1 and albium was 4.7. Cbc/diff, iron, feritin, and lipids all good except triglycerides were at 179. My gastro also looked at my hands and did not say anythings or seem concerned. Per the pictures attached and the information provided could this be palmar erythemia and livzetr cirrohsis. Jusht concerned since I looked up red hands and it says cirrohsis.
A year and a half ago I had an abdominal ultrasound. They said fatty liver and bounderline splenemiglia at 13.9. No indication of portal hypertension, aorta, ivr all normal. Bloodwork cameback normal as wellback. ALT was slightly high at 57. All other metabalic panels were within normal limits with platelets at 280000, though down from 299000. I remember creatinine was 1.1 and albium was 4.7. Cbc/diff, iron, feritin, and lipids all good except triglycerides were at 179. My gastro also looked at my hands and did not say anythings or seem concerned. Per the pictures attached and the information provided could this be palmar erythemia and livzetr cirrohsis. Jusht concerned since I looked up red hands and it says cirrohsis.
Brief Answer:
Most likely Idiopathic Palmar erythemia!
Detailed Answer:
Hi,
Thanks for choosing HCM for query!
As per your question, No it can't be liver Cirrhosis. Cirrhosis represents a late stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules.
It is generally considered to be irreversible in its advanced stages, at which point the only treatment option may be liver transplantation.In patient of cirrhosis the liver function tests will be grossly deranged,Ultra souncd will be clearly indicative of cirrhosis.Most of the test in your case are absolutely normal with some of them just mildly deranged,On top of that you are totally asymptomatic hence it can't be cirrhosis of liver neither clinically nor diagnostically. Though palmar arrythmia is closely associated with cirrhosis of liver in 23% of cases yet its not your case.
On the other hand yes it can be palmar erythemia. Palmar erythemia is defined as "reddening of the skin on the palmar aspect of the hands, usually over the hypothenar eminence. It may also involve the thenar eminence and fingers. It can also be found on the soles of the feet, when it is termed plantar erythema." All features defined above can be seen in your case.
Palmar erythema can be caused by numerous conditions and is more commonly being associated with high blood pressure. It is a skin condition that is rather difficult to distinguish and diagnose owing to its similarity with other skin conditions that have the same clinical presentation. Identification of palmar erythema is significant in determining an underlying condition particularly when the erythema occurred without prior medical condition.The onset is not always inflammatory yet the inflammation could be elsewhere which makes itself present through the manifestation of palmar erythema.
Palmar erythema exist without the presence of itchiness, scaling and pain although inflammation may be present.The manifestation of palmar erythema may have molting and may blanch when pressed or when put on with a pressure.Blanching of the skin in palmar erythema will momentarily return to its reddening hue after the pressure has been released. Palmar erythema occurs in two forms.
Primary palmar erythema is the form where the cause is not related.As almost all your tests are normal.It can be in your case hereditary or Idiopathic (cause unknown).
Secondary palmar erythema is the form that exists as secondary to an existing underlying condition or that which is influenced by a primary disease.
It can be associated with almost 70% cases of rheumatoid arthritis and is also seen in liver neoplasm.
I would suggest you get your serum estrogen levels checked. As estrogen levels are highly increased in palmar erythemia.
Apart from that a consultation should be done with a dermatologist also for his opinion.
Let me know if you've any further queries.
Thank you!
Most likely Idiopathic Palmar erythemia!
Detailed Answer:
Hi,
Thanks for choosing HCM for query!
As per your question, No it can't be liver Cirrhosis. Cirrhosis represents a late stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules.
It is generally considered to be irreversible in its advanced stages, at which point the only treatment option may be liver transplantation.In patient of cirrhosis the liver function tests will be grossly deranged,Ultra souncd will be clearly indicative of cirrhosis.Most of the test in your case are absolutely normal with some of them just mildly deranged,On top of that you are totally asymptomatic hence it can't be cirrhosis of liver neither clinically nor diagnostically. Though palmar arrythmia is closely associated with cirrhosis of liver in 23% of cases yet its not your case.
On the other hand yes it can be palmar erythemia. Palmar erythemia is defined as "reddening of the skin on the palmar aspect of the hands, usually over the hypothenar eminence. It may also involve the thenar eminence and fingers. It can also be found on the soles of the feet, when it is termed plantar erythema." All features defined above can be seen in your case.
Palmar erythema can be caused by numerous conditions and is more commonly being associated with high blood pressure. It is a skin condition that is rather difficult to distinguish and diagnose owing to its similarity with other skin conditions that have the same clinical presentation. Identification of palmar erythema is significant in determining an underlying condition particularly when the erythema occurred without prior medical condition.The onset is not always inflammatory yet the inflammation could be elsewhere which makes itself present through the manifestation of palmar erythema.
Palmar erythema exist without the presence of itchiness, scaling and pain although inflammation may be present.The manifestation of palmar erythema may have molting and may blanch when pressed or when put on with a pressure.Blanching of the skin in palmar erythema will momentarily return to its reddening hue after the pressure has been released. Palmar erythema occurs in two forms.
Primary palmar erythema is the form where the cause is not related.As almost all your tests are normal.It can be in your case hereditary or Idiopathic (cause unknown).
Secondary palmar erythema is the form that exists as secondary to an existing underlying condition or that which is influenced by a primary disease.
It can be associated with almost 70% cases of rheumatoid arthritis and is also seen in liver neoplasm.
I would suggest you get your serum estrogen levels checked. As estrogen levels are highly increased in palmar erythemia.
Apart from that a consultation should be done with a dermatologist also for his opinion.
Let me know if you've any further queries.
Thank you!
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you Doctor? That is a big relief. Is it typical for platelets to fluctuate? Also what would cause me to have high estrogen levels if not a bad liver? I am 260 pounds at 5'10. Can being fat raise them?
Brief Answer:
Details below'!
Detailed Answer:
Hi dear,
Normal range of platelts is 1.5-4.5 lakhs but 299900 is not that bad its not going to give you symptoms.Slight variation of platelets can be there always but your platelet range is not that low to give you symptoms.
Initially i would suggest you to check the level of estrogen in you,its not always likely that estrogen is always high but many time patients with palmar erythema have high estrogen which increase the vascularity
.Nops estrogen has no relation with fats as i already told you that most of the case of erythema are idiopathic hence we try to rule out every possibility before labelling it idiopathic.
Thanks!
Details below'!
Detailed Answer:
Hi dear,
Normal range of platelts is 1.5-4.5 lakhs but 299900 is not that bad its not going to give you symptoms.Slight variation of platelets can be there always but your platelet range is not that low to give you symptoms.
Initially i would suggest you to check the level of estrogen in you,its not always likely that estrogen is always high but many time patients with palmar erythema have high estrogen which increase the vascularity
.Nops estrogen has no relation with fats as i already told you that most of the case of erythema are idiopathic hence we try to rule out every possibility before labelling it idiopathic.
Thanks!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you Doctor.
Brief Answer:
welcome!
Detailed Answer:
Your welcome dear,
Get well soon.
welcome!
Detailed Answer:
Your welcome dear,
Get well soon.
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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