What are the causes of liver palms in cirrhosis?

The main causes of palmar erythema in patients with cirrhosis include: 1. **Impaired liver function**: Cirrhosis leads to a decrease in the liver's ability to synthesize coagulation factors. Prothrombin precursors cannot be effectively converted into prothrombin, resulting in coagulation dysfunction, which is an important factor in the development of palmar erythema. 2. **Portal hypertension**: Cirrhosis is often accompanied by portal hypertension, which causes congestion in the gastrointestinal tract and impaired venous return, further affecting circulation and promoting the formation of palmar erythema. 3. **Abnormal hormone metabolism**: In patients with cirrhosis, the liver's ability to inactivate estrogen is reduced, leading to elevated estrogen levels in the body. Estrogen stimulates capillary dilation, resulting in palmar erythema on the thenar and hypothenar eminences of the hands. 4. **Hypoproteinemia**: Patients with cirrhosis may develop impaired protein synthesis and absorption due to liver dysfunction, leading to hypoproteinemia. This can indirectly affect circulation and capillary integrity, potentially contributing to the appearance of palmar erythema.