Symmetrical lividity of the palms and soles

Symmetrical lividity (SL) was the term coined by Pernet in 1925 for symmetrical, bluish-red plaques on the soles of the feet, accompanied by hyperhidrosis and not corresponding to areas of pressure or patterns of innervation. We report two patients with a persistent eruption of the palms analogous to that described by Pernet on the feet. Unlike most reported cases of SL, our patients did not respond to topical drying treatments, but one patient partially responded to tretinoin. There appear to be two forms of SL: transient, which responds to drying; and persistent which does not respond to drying. The hyperhidrosis studied in one of our two patients was significantly greater within the plaques of SL than the normal palm. While we could suppress the hyperhidrosis with topical therapy, this failed to clear his hyperkeratosis or eliminate the livid color.