Aquagenic syringeal acrokeratoderma (ASA) is a rare, acquired disease affecting predominantly young women. It is characterised by the development of hypopigmented, translucent, flat-topped, oedematous papules and plaques that form hyperwrinkling or keratoderma. 1 It occurs after 3-5 minutes of contact with water and resolves when the hand dries. 1 Although its aetiology is not known