The common causes of two erythematous spots on palms include allergic skin diseases, liver diseases, systemic lupus erythematosus, and allergic purpura. 1. Contact dermatitis: when the palms come into contact with exogenous substances such as pollen, animal dander, chemicals, etc., it may lead to erythema and red papules on the palms, which are mostly accompanied by itching. 2. Liver diseases: patients with liver diseases such as cirrhosis and hepatitis may develop erythema on the palms of their hands, commonly known as “liver palms”. 3. Systemic lupus erythematosus (SLE): it is an autoimmune disease, which will invade many organs, and patients may show symptoms such as annular erythema, mental changes, anemia, etc. Erythema may appear on the palms of the hands and the palms of the feet. 4. Anaphylactic purpura: due to the body’s allergic reaction to certain sensitizing substances, resulting in petechiae and ecchymoses on the skin and mucous membranes, which are commonly found on the limbs, and may be accompanied by symptoms such as arthritic swelling and pain, abdominal pain, blood in the stool, hematuria, and so on. Two red spots on the palm of the hand may also be due to other reasons, it is recommended that the patient seek medical attention in a timely manner, and actively cooperate with the relevant examination, in order to clarify the cause of the symptomatic treatment.