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What causes mottled palms?

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Posted on Sat, 28 Nov 2015
Question: Dear Doctor,

Im concerned about how my palms are very mottled/splotchy. I will attach pictures for you.

These splotches fade when pressure is applied, but comes back after. They are not raised and do not itch.

I saw a few practitioners for it (but not derms). I was put on a few days of prednisone which did not help with the symptoms, and antihistamines like zyrtec, pepcid, and levocetrizine did not help either.

I was also scared of syphilis and therefore has had an RPR done, which was negative. I also got tested for other stds which were neg as well. Does this look like a syphilis rash?

What do you think the spots are from? Do you think it is just caused by anxiety? Any way to alleviate it?

Thanks doc!
doctor
Answered by Dr. Asmeet Kaur Sawhney (53 minutes later)
Brief Answer:
No the rash doesn't look like syphilis at all

Detailed Answer:
Hi
Thanks for being at healthcaremagic
I have gone through your history and reviewed the attached photographs.
You need not worry about syphilis as rash of syphilis never manifests like this. It occurs at around 8 weeks, mostly concentrated on the trunk, shoulders, upper arms, palms and soles and either disappears or evolved into a bumpy rash.
As far as mottled appearance of your palms is concerned it can be due to disturbance in blood circulation or due to exposure to cold in some sensitive individuals.
If the rash is asymptomatic and not associated with pain, burning, ulceration, tingling and numbness of the skin you don't have to take stress about it. Otherwise you need to consult a vascular surgeon and get yourself properly evaluated to rule out any underlying cause of this blotchy pigmentation.
I hope to have answered your query.
I would be happy to clarify any further doubts.
Regards
Dr Asmeet
Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Asmeet Kaur Sawhney

Dermatologist

Practicing since :2007

Answered : 5014 Questions

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What causes mottled palms?

Brief Answer: No the rash doesn't look like syphilis at all Detailed Answer: Hi Thanks for being at healthcaremagic I have gone through your history and reviewed the attached photographs. You need not worry about syphilis as rash of syphilis never manifests like this. It occurs at around 8 weeks, mostly concentrated on the trunk, shoulders, upper arms, palms and soles and either disappears or evolved into a bumpy rash. As far as mottled appearance of your palms is concerned it can be due to disturbance in blood circulation or due to exposure to cold in some sensitive individuals. If the rash is asymptomatic and not associated with pain, burning, ulceration, tingling and numbness of the skin you don't have to take stress about it. Otherwise you need to consult a vascular surgeon and get yourself properly evaluated to rule out any underlying cause of this blotchy pigmentation. I hope to have answered your query. I would be happy to clarify any further doubts. Regards Dr Asmeet