Symmetrical lividity of the palms or soles is a common condition resulting from prolonged maceration of occluded volar skin in individuals with hyperhidrosis. Most patients are healthy adolescents or young adults who present with complaints of hyperhidrosis, bromhidrosis, and occasional tenderness or itching of the palms or soles.

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

The natural course is unpredictable. While some cases are self-limited and resolve within days, others may have a chronic course of varying intensity. However, with treatment, both the eruption and hyperhidrosis can be controlled.