Symmetrical lividity of the palms or soles
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Synopsis

In addition, patients often have a history of occlusive glove or footwear use. Further predisposing factors include pressure and friction from ill-fitting shoes or thin soles. Many patients have a history of psychoneurosis. In a subset of patients, there may be a family history of symmetrical lividity.
This condition has been subdivided into 2 forms:
- Transient symmetrical lividity – induced by various forms of physical or psychological stress along with the use of occlusive footwear; can be successfully treated with drying agents
- Persistent (chronic) symmetrical lividity – possibly familial; unresponsive to drying agents but with partial response to tretinoin cream
Codes
ICD10CM:L98.8 – Other specified disorders of the skin and subcutaneous tissue
SNOMEDCT:
238760005 – Symmetrical lividities of soles
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Eczema
- Urticaria
- Juvenile plantar dermatosis
- Recurrent palmoplantar hidradenitis
- Psoriatic keratoderma – skin biopsy shows histopathologic findings of psoriasis
- Contact dermatitis – no hyperhidrosis noted
- Erythromelalgia – no hyperhidrosis noted
- Raynaud disease – no hyperhidrosis noted
- Pernio
- Immersion foot
- Pseudomonas hot-foot syndrome
- Tinea pedis
- COVID toes (see COVID-19)
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Management Pearls
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Therapy
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References
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Last Reviewed:10/20/2020
Last Updated:11/22/2020
Last Updated:11/22/2020