January 2005

Diagnosis: Pregnancy associated Palmar Erythema

Discussion: Palmar erythema is considered a benign physiologic change that can occur during pregnancy. The etiology is thought to be due to hormonal changes (increased estrogen) which are usually most pronounced during the third trimester. Palms and soles may be involved and affected areas may or may not be pruritic. Most vascular changes acquired during pregnancy such as this regress spontaneously after delivery.

Although most cases of palmar erythema associated with pregnancy are secondary to hormonal change, it is prudent to rule out other potential causes such as chronic liver disease, thyrotoxicosis, rheumatoid arthritis, or polycythaemia.

Our patient had an uneventful pregnancy and delivered a healthy baby at full term. Her palmar erythema was never symptomatic and required no treatment. It resolved spontaneously shortly after she delivered.

References:
1. Kroumpouzos G. Cohen LM. Dermatoses of pregnancy. Journal of the American Academy of Dermatology. 2001;45:1-19.

2. Sodhi VK. Sausker WF. Dermatoses of pregnancy. American Family Physician. 1988;37(1):131-8.

3. Shomick JK. Dermatoses of pregnancy. Seminars in Cutaneous Medicine and Surgery. 1998;17:172-81.

This case was presented by Dr. Stacy Tull.