Your palm is the underside of your hand. Conditions that can affect the palm include Dupuytren’s contracture and palmar erythema
Your palm is the underside of your hand, also called the metacarpus. Bones in the palm are called metacarpals, and there are five in each palm. Unlike other areas of the body, your palm is hairless and can’t be tanned.
The palm has several important functions:
- Allows you to grip objects, with the fascia (layer of connective fibrous tissue) between the skin and metacarpals allowing the hand to grasp objects without sliding the skin out of position
- Helps with precise movements such as sewing and writing
- Plays a role in your ability to appreciate various textures and finer touch sensations
Conditions that can affect the palm include Dupuytren’s contracture and palmar erythema.
What is Dupuytren’s contracture?
Dupuytren’s contracture is a gradually developing deformity of the palms caused by the contraction of the fingers. Over the years, knots of connective fibrous tissue under the skin of the palm create a thick cord that pulls two or more fingers toward the palm. Affected fingers cannot be straightened completely, which causes difficulty in performing daily activities.
While the exact cause of Dupuytren’s contracture is unknown, certain factors can increase your risk of this condition, including:
- Age: Usually starts in people over 50 years of age
- Sex: More prevalent among men than women
- Race: More common in people of Northern European descent
- Family history: Often runs in families
- Smoking and alcohol abuse: Linked to microscopic changes in the blood vessels caused by smoking and alcohol
- Diabetes: Risk is greater if you have diabetes
Your doctor can diagnose Dupuytren's contracture by performing a physical examination of your hand, checking for toughened knots or cords of tissue. They will also assess your ability to fully flatten the fingers.
Treatment of Dupuytren's contracture involves removal or breaking of the knots or cords that cause the condition through:
- Needling: A needle is used to puncture or break the problem-causing cords of tissue. While the procedure doesn’t require an incision, it carries a risk of damage to the nerves or tendons.
- Enzyme injection: An FDA-approved enzyme collagenase clostridium histolyticum (Xiaflex) is injected into the cords to soften and weaken them. Later, your doctor will try to straighten your fingers by manipulating them.
- Surgery: Surgery can remove the fascia from your palms affected by Dupuytren’s contracture. While surgery is a more complete and longer-lasting treatment option, it requires physical therapy afterwards and it may take a long time to recover.
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What is palmar erythema?
Palmar erythema is characterized by reddening of your palms. It may be hereditary, but it’s also relatively more common during pregnancy.
Palmar erythema may also be caused by:
- Liver diseases (such as liver cirrhosis)
- Autoimmune diseases (such as rheumatoid arthritis)
- Thyroid disease
- Brain tumor
- Human immunodeficiency virus (HIV)
- Certain medications
Currently, there is no specific treatment available for palmar erythema, and management of the condition usually involves treating the underlying health condition. If palmar erythema is a side effect of a certain medication, your doctor may ask you to discontinue and replace it with another medication.