Aquagenic wrinkling: A unique facial presentation

Frequent handwashing and disinfection: a potential new trigger for aquagenic wrinkling of the palms caused by COVID‐19 outbreak

“…Dear Editor, Aquagenic wrinkling of the palms (AWP) is an uncommon reaction causing transient, oedematous, whitish papules and plaques to form on the palms after brief exposure to water. [1][2][3] This condition has been reported under various names, including syringeal acrokeratoderma, aquagenic palmoplantar keratoderma, transient reactive papulotranslucent acrokeratoderma, aquagenic keratoderma and aquagenic papulotranslucent acrokeratoderma. Patients with AWP often experience a burning sensation, pain or pruritus.…”

Water‐related dermatoses

“…AWP usually occurs on the palms, but uncommon presentations have been described. For example, unilateral palmar eruption and facial involvement have been separately reported after brief water exposure . It has also been noted that AWP can occur with the sparing of palms, involving only the lateral margin and the volar aspects of the 10 fingers, or even with complete sparing of the palmar aspect of the hand and involvement of the dorsal side only …”

“…For example, to reduce AWP in patients with hyperhidrosis, topical aluminum hydroxide (most commonly used) or botulinum toxin injections (in refractory cases) or even tap water iontophoresis (as a last resort) have been tried with good results . Nonetheless, antihistamines, 5% salicylic acid ointment, topical corticosteroids, retinoids, acitretin, and 20% urea‐containing lotion were used with various results …”

“…For example, unilateral palmar eruption and facial involvement have been separately reported after brief water exposure. 26,27 It has also been noted that AWP can occur with the sparing of palms, involving only the lateral margin and the volar aspects of the 10 fingers, or even with complete sparing of the palmar aspect of the hand and involvement of the dorsal side only. 28,29 The pathogenesis of AWP is not fully understood, but there have been attempts on understanding the cause based on associated disorders.…”

“…39 Nonetheless, antihistamines, 5% salicylic acid ointment, topical corticosteroids, retinoids, acitretin, and 20% urea-containing lotion were used with various results. 26,27 Aquatic Dermatology…”