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Vazquez T, Zarei M, Herskovitz I, Price A, Villada G, Keri J. Atypical familial aquagenic syringeal acrokeratoderma. J Cutan Pathol 2021; 47:991-996. [PMID: 33464626 DOI: 10.1111/cup.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/22/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Vazquez
- Florida International University Wertheim College of Medicine, Miami, Florida, USA.,Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mina Zarei
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ingrid Herskovitz
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Alexandra Price
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Gabriel Villada
- Pathology & Laboratory Medicine Service, Miami Veterans Affairs Healthcare System, Miami, Florida
| | - Jonette Keri
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Atzori L, Ferreli C, Rongioletti F. Aquagenic (pseudo) keratoderma (aquagenic palmoplantar keratoderma, aquagenic wrinkling of palms). Clin Dermatol 2020; 39:256-260. [PMID: 34272019 DOI: 10.1016/j.clindermatol.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aquagenic palmoplantar keratoderma (APK) is an uncommon hereditary or sporadic condition that is characterized by edematous flat-topped papules appearing on palmar skin with wrinkling after brief water exposure. APK has been associated with cystic fibrosis (CF), presenting with the same mutations found in CF (usually ΔF508 of the CFTR gene), either homozygous or heterozygous. APK may be idiopathic or drug-induced. The diagnosis is easily made if one is aware of this entity. Topical aluminum hydroxide and botulinum toxin injections are the most commonly used treatments. The sporadic form may have a shorter course compared with the hereditary one, resolving spontaneously after a few years. The condition should no longer be considered a true keratoderma but rather a pseudo keratoderma, and in spite of the many different names found in the literature, the term "aquagenic (pseudo) keratoderma" seems to be the most appropriate one.
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Affiliation(s)
- Laura Atzori
- Dermatology Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.
| | - Caterina Ferreli
- Dermatology Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Franco Rongioletti
- Dermatology Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
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Cutaneous Manifestations of Cystic Fibrosis. JOURNAL OF INTERDISCIPLINARY MEDICINE 2018. [DOI: 10.2478/jim-2018-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Cystic fibrosis (CF) is an autosomal recessive affliction triggered by genetic mutations in the cystic fibrosis transmembrane conductance regulator. The lung and pancreas are the most frequently affected organs in cystic fibrosis, cutaneous involvement is undervalued and underdiag-nosed. Skin lesions observed in patients diagnosed with cystic fibrosis are not well known and can create confusions with other dermatological diseases. The diagnosis of cutaneous lesions as signs of cystic fibrosis by pediatricians or dermatologists, despite their overlapping with different nutritional deficiencies, would allow earlier diagnosis and proper treatment and could improve quality of life and outcomes.
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From Classical to Unusual: Report on 5 Cases of Transient Reactive Aquagenic Pseudokeratoderma and Review of the Literature. Am J Dermatopathol 2017; 39:935-942. [DOI: 10.1097/dad.0000000000000815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Kutlubay Z, Engin B, Baglam S, Khatib R, Demirkesen C, Aydemir EH. Case report: Treatment failure in a case of aquagenic syringeal acrokeratoderma. J COSMET LASER THER 2015; 17:224-6. [DOI: 10.3109/14764172.2014.1003240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
There are four different areas to consider: palms, back of the hands, fingers, periungual folds (and nails). Palmoplantar keratodermas are a group of inherited or acquired disorders. Dysidrosis is a peculiar form of eczema on the palms and lateral aspects of the fingers. SAPHO syndrome (Synovitis - Acne - Pustulosis - Hyperostosis - Osteomyelitis) presents pustules on palms. Photo-ageing is frequently noticed on the back of the hands. Paraneoplastic acrokeratosis (Bazex syndrome) affects the nose, ears, and periungual folds of fingers and toes. Spontaneous blue finger syndrome can be a benign process that resolves rapidly.
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Affiliation(s)
- Gérard Lorette
- UMR 1352, université François-Rabelais, INRA, infectiologie et santé publique, CHRU de Tours, service de dermatologie, 37044 Tours cedex, France.
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Acroqueratodermia aquagénica associada a uma mutação do gene da fibrose quística. REVISTA PORTUGUESA DE PNEUMOLOGIA 2013; 19:125-8. [DOI: 10.1016/j.rppneu.2012.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 10/30/2012] [Accepted: 10/31/2012] [Indexed: 11/17/2022] Open
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Baquerizo K, Amini S, Keri JE, Badiavas EV, Elgart GW. Atypical form of transient reactive papulotranslucent acrokeratoderma in a cystic fibrosis carrier. J Cutan Pathol 2013; 40:413-8. [DOI: 10.1111/cup.12087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 10/09/2012] [Accepted: 11/18/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Katherine Baquerizo
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Sadegh Amini
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Jonette E. Keri
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Evangelos V. Badiavas
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - George W. Elgart
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
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Arkin LM, Flory JH, Shin DB, Gelfand JM, Treat JR, Allen J, Rubenstein RC, Yan AC. High prevalence of aquagenic wrinkling of the palms in patients with cystic fibrosis and association with measurable increases in transepidermal water loss. Pediatr Dermatol 2012; 29:560-6. [PMID: 22471628 DOI: 10.1111/j.1525-1470.2011.01708.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Aquagenic wrinkling of the palms (AWP) is a cutaneous phenomenon marked by the transient formation of edematous, translucent papules and plaques on the palms and fingertips within minutes of water exposure. AWP is anecdotally reported in patients with cystic fibrosis (CF) and several studies have recently confirmed this association. The primary aim of this study was to determine the prevalence of aquagenic wrinkling of the palms in subjects with cystic fibrosis (CF) compared to controls, and secondarily to evaluate for genotype-phenotype correlations among CF subjects found to have AWP. Fifty-one children with CF and 25 control children who were being treated for asthma underwent a 5-minute hand immersion in lukewarm water. The test for AWP was positive if subjects demonstrated >30% wrinkling over the palm. Secondary analyses explored associations with genotype, pancreatic and pulmonary function, body mass index (BMI), and sweat chloride levels. Palmar transepidermal water loss (TEWL) was also measured for all subjects with and without AWP. Forty-three of the subjects (84%) with CF demonstrated aquagenic wrinkling, in contrast to none (0%) of the controls. These results remained statistically significant when stratified for by age and race. TEWL was significantly higher in CF subjects with AWP compared to CF subjects without AWP and controls. No genotype-phenotype correlations were detected in patients with AWP, nor were there associations of AWP with other phenotypic features of CF, although these analyses were likely underpowered. Aquagenic wrinkling of the palms is prevalent in children with CF and is associated with increased TEWL.
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Affiliation(s)
- Lisa M Arkin
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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Rongioletti F, Tomasini C, Crovato F, Marchesi L. Aquagenic (pseudo) keratoderma: a clinical series with new pathological insights. Br J Dermatol 2012; 167:575-82. [DOI: 10.1111/j.1365-2133.2012.11003.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Houle MC, Al Dhaybi R, Benohanian A. Unilateral aquagenic keratoderma treated with botulinum toxin A. J Dermatol Case Rep 2011; 4:1-5. [PMID: 21886737 DOI: 10.3315/jdcr.2010.1045] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 04/02/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND Aquagenic keratoderma is a rare transient disease that occurs after water immersion and disappears shortly after drying. Most cases involve the palms and fingers bilaterally but it can also affect the soles. Few cases have been associated with drugs but its pathogenesis remains unclear. MAIN OBSERVATION We report a 60-year-old man with a 30-year-history of aquagenic keratoderma of the right palm without associated hyperhidrosis or history of drug intake. After unsuccessful treatment with 15% aluminium chloride hexahydrate gel, botulinum toxin A injections led to significant improvement within 2 weeks. CONCLUSIONS To our knowledge, this case is the first report of idiopathic unilateral aquagenic keratoderma in the medical literature. It is the third report of successful treatment with botulinum toxin A which is in favor of a role of sweat glands in the pathogenesis of aquagenic keratoderma.
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Affiliation(s)
- Marie-Claude Houle
- Department of Dermatology, University of Montreal, Montreal, Quebec, Canada
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Tan C, Zhu W. Atypical form of transient reactive papulotranslucent acrokeratoderma: a case report and review of the literature. Int J Dermatol 2010; 49:937-40. [DOI: 10.1111/j.1365-4632.2009.04364.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Garçon-Michel N, Roguedas-Contios AM, Rault G, Le Bihan J, Ramel S, Revert K, Dirou A, Misery L. Frequency of aquagenic palmoplantar keratoderma in cystic fibrosis: a new sign of cystic fibrosis? Br J Dermatol 2010; 163:162-6. [DOI: 10.1111/j.1365-2133.2010.09764.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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BAGAZGOITIA LOREA, PÉREZ-CARMONA LUCÍA, SALGÜERO IRENE, HARTO ANTONIO, JAÉN PEDRO. Letter: Aquagenic Keratoderma: Successful Treatment with Botulinum Toxin. Dermatol Surg 2010; 36:434-6. [DOI: 10.1111/j.1524-4725.2009.01467.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ludgate MW, Patel D, Lamb S. Tobramycin-induced aquagenic wrinkling of the palms in a patient with cystic fibrosis. Clin Exp Dermatol 2009; 34:e75-7. [DOI: 10.1111/j.1365-2230.2009.03223.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Falcón CS, Ortega SS. Aquagenic syringeal acrokeratoderma. J Am Acad Dermatol 2008; 59:S112-3. [DOI: 10.1016/j.jaad.2008.04.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 04/17/2008] [Accepted: 04/28/2008] [Indexed: 11/26/2022]
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Kabashima K, Shimauchi T, Kobayashi M, Fukamachi S, Kawakami C, Ogata M, Kabashima R, Mori T, Ota T, Fukushima S, Hara-Chikuma M, Tokura Y. Aberrant aquaporin 5 expression in the sweat gland in aquagenic wrinkling of the palms. J Am Acad Dermatol 2008; 59:S28-32. [DOI: 10.1016/j.jaad.2008.04.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Revised: 04/17/2008] [Accepted: 04/25/2008] [Indexed: 11/26/2022]
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Yoon T, Kim K, Lee J, Kim M. Aquagenic syringeal acrokeratoderma: unusual prominence on the dorsal aspect of fingers? Br J Dermatol 2008; 159:486-8. [DOI: 10.1111/j.1365-2133.2008.08633.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pastor M, González L, Kilmurray L, Bautista P, López A, Puig A. Queratodermia acuagénica. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s0001-7310(08)74700-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
Cystic fibrosis is an autosomal recessive disease reported in 1 in 2500 live births in Northern American and Northern European Caucasian populations. Classic disease findings include chronic bacterial infection of airways and sinuses, malabsorption of fat, infertility in men, and elevated concentrations of chloride in sweat. Less well-recognized findings associated with cystic fibrosis include cutaneous findings, which can be primary or secondary manifestations of the disease process. Patients demonstrate more atopic and drug hypersensitivity reactions than the general population, but have similar rates of urticaria compared with the general population. In atypical presentations of cystic fibrosis, the nutrient deficiency dermatitis of the disease may aid with diagnosis, and notably can be the presenting sign. Other dermatologic manifestations of cystic fibrosis include early aquagenic skin wrinkling and cutaneous vasculitis, which can be associated with arthralgias. Familiarity with the nutrient deficiency dermatitis of this entity may play a role in the timely diagnosis of the disease, and the other cutaneous findings add to our understanding of the protean nature of its manifestations.
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Affiliation(s)
- Megan L Bernstein
- Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Garçon N, Roguedas A, Misery L, Audrezet M, Ferec C. Kératodermie palmoplantaire aquagénique chez un sujet hétérozygote pour la mutation ΔF 508 de la mucoviscidose. Ann Dermatol Venereol 2008; 135:232-4. [DOI: 10.1016/j.annder.2007.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Accepted: 08/14/2007] [Indexed: 11/25/2022]
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Seitz CS, Gaigl Z, Bröcker EB, Trautmann A. Painful Wrinkles in the Bathtub: Association with Hyperhidrosis and Cystic Fibrosis. Dermatology 2008; 216:222-6. [DOI: 10.1159/000112929] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Accepted: 07/21/2007] [Indexed: 11/19/2022] Open
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Polat M, Gür G, Pelitli A, Yalçin B, Tamer E, Oztaş P, Alli N. Acquired aquagenic papulotranslucent acrokeratoderma: report of two cases. Am J Clin Dermatol 2008; 9:263-5. [PMID: 18572977 DOI: 10.2165/00128071-200809040-00006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Aquagenic papulotranslucent acrokeratoderma (APA) is an acquired, unusual condition characterized by bilateral, symmetric, translucent-to-white papules located on the hands and feet. These lesions are accentuated following a short period of water exposure. Since its first description in 1973 as hereditary papulotranslucent acrokeratoderma, only a few cases of APA have been reported. We report two cases of teenage girls with APA. Both patients responded well to 5% salicylic acid ointment but recurrence of lesions still occurred. The close temporal proximity of presentation of these two cases may indicate that APA is not as rare as previously thought.
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Affiliation(s)
- Muhterem Polat
- 1st Dermatology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Aquagenic Keratodermia: 3 New Cases and a Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Transient reactive papulotranslucent acrokeratoderma is a rare, acquired, reactive, and episodic disorder of the palmar skin. Herein I report on a 6-year-old child with unilateral involvement and associated with ipsilateral hyperhidrosis and pruritus. Further observations are required for unraveling the etiopathogenesis of this disorder and its accurate classification.
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Affiliation(s)
- Emel Erkek
- Department of Dermatology, Kirikkale University School of Medicine, Kirikkale, Turkey.
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Lim KS, Ng SK. Aquagenic wrinkling of the palms in a boy with a congenital cardiac anomaly. J Eur Acad Dermatol Venereol 2007; 21:985-6. [PMID: 17659016 DOI: 10.1111/j.1468-3083.2006.02061.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
A 21-year-old woman presented with a 1-month history of whitish bubbling of the palms after brief exposure to water. The symptoms arose within 3-5 min after immersion in water, as a white sponge-like appearance, and resolved after a variable drying period. She was otherwise healthy and did not complain of hyperhidrosis. There was no family history of similar lesions. Physical examination revealed a healthy appearance of the palms; however, 5 min after immersion of the hands in warm water, the central part of the left palm became swollen and tiny white papules with dilated puncta appeared. The right palm also showed similar changes. These asymptomatic papules with a tendency to coalesce became more prominent with prolonged exposure (Figs 1 and 2). The lesions resolved completely approximately 30 min after removal of the hands from water. A biopsy taken from the lesional skin revealed dilatation of intraepidermal eccrine ducts and a spongy appearance in the corneal layer (Fig. 3). A diagnosis of aquagenic syringeal palmar keratoderma was made on the basis of these clinical and histopathologic findings. A short course of treatment with topical aluminum chloride resulted in a remarkable response in 1 week. She had no recurrence after 1 year.
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Affiliation(s)
- Emek Kocatürk
- Department of Dermatology, SB Göztepe Educational Hospital, Istanbul University Faculty of Medicine, Istanbul, Turkey.
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Abstract
Palmoplantar keratodermas (PPKs) are a diverse entity of disorders that are characterized by abnormal thickening of the skin on the palms and soles. Traditionally they have been classified as either hereditary or acquired and are distinguished from each other on the basis of mode of inheritance, presence of transgrediens (defined as contiguous extension of hyperkeratosis beyond the palmar and/or plantar skin), co-morbidities with other symptoms, and extent of epidermal involvement, namely diffuse, focal, and punctate. As the terms hyperkeratosis and keratoderma have been used interchangeably throughout the literature, we define acquired keratoderma as a non-hereditary, non-frictional hyperkeratosis of the palms and/or soles that involves >/=50% of the surface of involved acral areas and that may or may not be associated with clinical and histologic inflammation. Given the numerous possible underlying causes for acquired PPKs, evaluation of patients presenting with acquired PPK can be a perplexing task. To facilitate such evaluations, this review categorizes the acquired PPKs as: keratoderma climactericum, drug related, malnutrition associated, chemically induced, systemic disease related, malignancy associated, dermatoses related, infectious, and idiopathic. In order to avoid the possibility of overlooking an underlying etiology and to eliminate excessive testing, we present an algorithm for assessing patients presenting with acquired PPK. The first step should include a comprehensive history and a physical examination, including a complete skin examination. If findings are consistent with a hereditary keratoderma, then a genetics consultation should be considered. Any findings suggestive of underlying conditions should be aggressively evaluated and treated. If no pertinent findings are identified after a history and a physical examination, laboratory and radiology studies should be undertaken in a systematic, logical fashion. In terms of treatment, the most successful results occur when the underlying etiology is diagnosed and treated. If no such etiology is evident, then conservative treatment options include topical keratolytics (urea, salicylic acid, lactic acid), repeated physical debridement, topical retinoids, topical psoralen plus UVA, and topical corticosteroids. Etretinate and acitretin have also shown some success as alternative treatments in recalcitrant cases.
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Affiliation(s)
- Shaily Patel
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Affiliation(s)
- R Suchak
- Dermatology Department, Newham University Hospital NHS Trust, St Andrew's Hospital, London, UK.
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Sais G, Bigatà X, Admella C. Aquagenic Syringeal Acrokeratoderma. ACTAS DERMO-SIFILIOGRAFICAS 2007. [DOI: 10.1016/s1578-2190(07)70397-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Baldwin BT, Prakash A, Fenske NA, Messina JL. Aquagenic syringeal acrokeratoderma: Report of a case with histologic findings. J Am Acad Dermatol 2006; 54:899-902. [PMID: 16635679 DOI: 10.1016/j.jaad.2005.09.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Revised: 08/19/2005] [Accepted: 09/13/2005] [Indexed: 11/25/2022]
Abstract
Aquagenic syringeal acrokeratoderma is a rare acquired condition characterized by painful symmetric swelling and hypopigmentation of the palms and lateral fingers, which develops after brief exposure to water. Histopathologic examination suggests that an aberration in the eccrine sweat gland apparatus may be the underlying cause of this condition. The "hand-in-the-bucket sign," in which patients arrive in their physician's office with their hand in a bucket of water to more readily demonstrate their lesions, is such a common presentation that it almost can be regarded as pathognomonic. All 12 cases reported to date have been in young females. We report a case of aquagenic syringeal acrokeratoderma in a male with unique histologic findings.
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Affiliation(s)
- Brooke T Baldwin
- Division of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida 33612, USA
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Abstract
Transient reactive papulotranslucent acrokeratoderma is a rare palmoplantar keratoderma seen predominantly in adolescent and young adult women. Clinically it is characterized by translucent white papules generally involving the palmar surfaces after exposure to water. The typical "hands-in-the-bucket" sign, which is not clearly visible until the hand is submerged in water, is indispensable for the diagnosis. Histologic examination shows a mild orthokeratotic hyperkeratosis and dilated eccrine ducts. We propose the term "transient aquagenic palmar hyperwrinkling" to describe this condition. Until now, a total of 12 patients have been reported in the literature, all female, with an age of onset from 9 to 33 years. We present the first reported instance of this condition in a young boy.
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Affiliation(s)
- Iria Neri
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of the Study of Bologna, Italy
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Affiliation(s)
- Yasemin Saray
- Basskent University Faculty of Medicine, Department of Dermatology, Ankara, Turkey.
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