Aquagenic syringeal acrokeratoderma: Report of two teenage cases

MacCormack, Mollie A.; Wiss, K; Malhotra, Ritu

doi:10.1067/mjd.2001.114586

Cited by 74 publications

(103 citation statements)

References 3 publications

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“…Yan et al [3]emphasized the ‘hand-in-the-bucket’ sign, referring to the fact that the skin changes are not or barely visible until the hand is submerged in water. Two additional cases were again described in 2001 in teenage patients with painful pruritic white papules on the palms with accentuation of the signs and symptoms after sweating or wetting of hands (table 1) [4]. Those authors suggested the name ‘aquagenic syringeal acrokeratoderma’ which seems to be more appropriate than the older designations.…”

Section: Introductionmentioning

confidence: 99%

Aquagenic Syringeal Acrokeratoderma (Transient Reactive Papulotranslucent Acrokeratoderma)

Itin

Lautenschlager

2002

Dermatology

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In 1996, English and McCollough described an unusual entity in 2 sisters characterized by a transient and recurrent keratoderma exclusively on the palms after water exposure. The condition developed 3–5 min after exposure to water and resolved within a short time after drying. This finding was associated with a tightening sensation. Yan et al. coined the term ‘aquagenic palmoplantar keratoderma’, and the designation ‘aquagenic syringeal acrokeratoderma’ was suggested by MacCormack et al. Until now, a total of 8 cases have been reported. We documented 2 new cases with acquired aquagenic syringeal acrokeratoderma. A 25-year-old female had observed within the last 3 months a burning sensation on the palms after some minutes of water contact. Physical examination revealed a perfectly normal skin on the palms. Three minutes after water immersion of 20°C, a whitish discoloration appeared on the palms and a thickening of the palmar skin was visible. In addition, the eccrine pores were much more prominent. Few minutes after drying the skin, the situation returned to a normal state. The second patient, a 33-year-old female noticed a painful whitish discoloration of the skin on the palms after a short period of water immersion. Sometimes the white skin could be peeled off. In the last year, hyperhidrosis developed, and a more reddish aspect of the palms appeared. In our office after rinsing the hands with water at room temperature, a whitish discoloration in the center of the palms appeared which was associated with a painful sensation. After drying, the whitish lesions disappeared almost completely within 30 min. Aquagenic palmar keratoderma describes an acquired and transient condition which occurs after brief exposure to water and disappears after drying within minutes to an hour. Only rarely may a slight hyperkeratosis remain for a longer time. The possible pathophysiology and treatment options are discussed.

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Section: Introductionmentioning

confidence: 99%

Aquagenic Syringeal Acrokeratoderma (Transient Reactive Papulotranslucent Acrokeratoderma)

Itin

Lautenschlager

2002

Dermatology

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“…To describe this phenomenon which may be easily distinguished from physiologic water-induced skin wrinkling, several terms have been used in the literature, e.g. aquagenic papulotranslucent or syringeal acrokeratoderma, hand-in-the-bucket sign, and others [1,2,3,4,5]. While the exact pathophysiologic mechanism of TAPH is currently unknown, increased water absorption due to an abnormal quantity and/or composition of sweat and the decreased barrier function of the epidermis seem to be important factors [4].…”

Section: Introductionmentioning

confidence: 99%

Painful Wrinkles in the Bathtub: Association with Hyperhidrosis and Cystic Fibrosis

et al. 2008

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Transient aquagenic palmar hyperwrinkling (TAPH) is a rarely reported cutaneous condition clinically characterized by swelling and hyperwrinkling of the palms, and associated with burning sensations after briefly immersing the hands in water. Upon the withdrawal of water, the symptoms rapidly disappear. We report on a 10-year-old boy with type I diabetes, who developed the typical symptoms of TAPH concomitantly with the onset of palmar hyperhidrosis. Determination of the sodium chloride concentration of the sweat revealed elevated levels. Subsequent screening for the most common mutations of the gene responsible for cystic fibrosis (CF) was negative. Review of the literature shows that TAPH may develop in conditions of increased water absorption due to an increased sweat quantity, such as hyperhidrosis, or an increased sweat electrolyte concentration, such as CF. In the majority of reported cases TAPH has been associated with CF; therefore, it is a cutaneous sign, which should be recognized by dermatologists, and patients should be referred for evaluation of the sodium chloride concentration of the sweat.

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“…ASA genellikle palmar nadiren de plantar bölgede suyla temastan birkaç dakika sonra hipopigmentasyon, sulkuslarda belirginleşme, çok sayıda, simetrik, düz-yuvarlak, şeffaf-beyaz renkli, 1 mm çaplı papül ve plakların gelişimi ile karakterizedir. Yanma, kaşıntı, ağrı ve hiperhidrozun eşlik edebildiği bu klinik tablonun diğer önemli özelliği ise deri kuruduktan sonra lezyonların kendiliğinden düzelmesidir (3,4).…”

Section: Discussionunclassified