Palmar Glabrous Skin

I have a new word: glabrous. It just means smooth, not hairy or fuzzy. So the skin on the palm of your hand is glabrous. Before I was so rudely interrupted by my left ear, I was reading about a study Albrecht et al (see library) has performed looking at arteriole-venule shunts in the palms of the hands of fibromyalgia patients compared to healthy control subjects. It seems so random, doesn’t it?

Essentially, they biopsied the palm of patients’ hands to look at innervation – how the nerves work in that area. Really, from what I can tell (until I go to medical school), they used the palm of the hand as a microcosm of the rest of the body, assuming the rest of the body is set up sort of the same way. The palm is a “major site of convergence for dense sympathetic and sensory innervation,” and thus could reflect what happens elsewhere. It’s not much of a surprise, but fibromyalgia patients showed excessive sensory innervation in the palm of their hands. The researchers think perhaps this could be a cause of severe pain and tenderness in the hands of fibro patients. Taking it one step further then, maybe the skin on the heels of the feet (also glabrous) has the same thing going on and thus my feet hurt so much all the time. Elbow skin is glabrous, I think, they could check it out there too. My elbows hurt all the time.

There’s more too it, however, when you look at what functions the skin actually has, and the article by Albrecht et al is pretty complex. I was surprised to see a mention of substance P in this context. Substance P is a mysterious…thing…which levels are elevated in people with fibro, and it is partly regulated in the skin. Just boiling down because there are a lot of Greek symbols, “mechanoreceptive, metaboreceptive, thermoreceptive, and various nociceptive capabilities” are connected in this whole system, which they looked at from the palm of the hand. That is, muscles, metabolism, temperature regulation, and pain stemming from nerve cells are affected by how these little shunts that go between arterioles and venules work, how many they are, etc.

That sounds pretty significant. Perhaps more significant is: “Conceivably, the neuropathology of the AVS could result in insufficient blood flow and ischemia in deep tissues like skeletal muscles, which may contribute to the widespread deep pain and fatigue of FM, and cause compromised circadian blood flow regulation thereby impacting sleep and cognition.” In other words, if what’s happening in the palms of your hands is messed up it can affect blood flow to vital organs like the heart and brain and break the natural 24-hour cycle – which accounts for sleep difficulties.

So in the palms of our hands we have muscle pain, weight gain (metabolism), body temperature, generalized pain from nerve cells, sleep disruption, and brain fog. In addition, some of (not sure how many) the imbalances in chemicals and hormones can be tracked right back to how the skin functions.

The good news is while this research was published in 2013, it is ongoing. There is more to read, and new developments.

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