Dear Editor,The clinical trials for the Moderna and Pfizer COVID-19 vaccines reported local injection site cutaneous reactions 1,2 ; however, varied cutaneous reactions have been noted including delayed large local cutaneous reaction called 'COVID arm' and rashes characterized by their dermatologic morphological equivalents including urticarial, morbilliform, pernio/chilblains-like and pityriasis rosea-like reactions. [3][4][5]

Aquagenic wrinkling of the palms (AWP) is a rare dermatological disease characterized by development of rapid and excessive wrinkling and oedema of the palms and transient whitish or yellowish papules without erythema on the palmar surfaces after immersion in water. This phenomenon can be accompanied by pain and/or pruritus. The most common treatment of AWP involves aluminium-based topicals. This article discusses the associations, pathological mechanisms and treatment options of AWP.

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