From Classical to Unusual: Report on 5 Cases of Transient Reactive Aquagenic Pseudokeratoderma and Review of the Literature

Connecting the Past and Present: An Updated Literature Review of Aquagenic Syringeal Acrokeratoderma

Aquagenic syringeal acrokeradermatoma (ASA) is a dermatological condition characterized by the transient appearance of edematous, white, translucent papules on the palms, typically triggered by water exposure. While ASA is most commonly associated with cystic fibrosis (CF) and predominantly affects young females, there has been a significant increase in ASA cases since the most recent update in 2015. The COVID-19 pandemic increased the number of patients diagnosed with ASA following exposure to the viral infection. The growing body of literature suggests a multifactorial etiology for ASA, with potential links to CF, medication use, and possibly COVID-19-related behavioral changes. Due to the recent increase in cases of ASA, an updated review seeks to quantify the existing literature that has been published on the prevalence of this condition. This review sought to find those newly diagnosed cases between the years 2014 and 2024. Through a literature review, we were able to find 57 cases of ASA since the last significant update to the total number of cases found in the literature. This review includes the prevalence of CF, a known etiology of ASA, as well as demographic information and known status of exposure to COVID-19.

Dermatosis inducida por el agua: queratodermia acuagénica, a propósito de un caso

La queratodermia acuagénica es una entidad benigna, caracterizada por producir pápulas blanquecinas o traslúcidas pocos segundos después del contacto con el agua.Se presenta el caso de una paciente de 16 años de edad con aparición de múltiples pápulas confluentes y asintomáticas en ambas palmas al contacto con el agua, que desaparecían luego del secado. En el estudio de histopatología se observó dilatación de los conductos ecrinos y cambios en el estrato córneo.Esta rara condición de etiología desconocida se ha relacionado con disfunción neuronal, alteraciones de las glándulas ecrinas y, más recientemente, con alteraciones en las acuaporinas. Se puede diagnosticar con una prueba semiológica sencilla llamada ‘la mano en el balde’; la sospecha clínica es fundamental para hacer el diagnóstico, ya que los hallazgos histopatológicos pueden ser sutiles e inespecíficos. El tratamiento tópico incluye mecanismos de barrera y la toxina botulínica.