Unilateral aquagenic keratoderma treated with botulinum toxin A

Abstract

Background: Aquagenic keratoderma is a rare transient disease that occurs after water immersion and disappears shortly after drying. Most cases involve the palms and fingers bilaterally but it can also affect the soles. Few cases have been associated with drugs but its pathogenesis remains unclear.Main observation: We report a 60-year-old man with a 30-year-history of aquagenic keratoderma of the right palm without associated hyperhidrosis or history of drug intake. After unsuccessful treatment with 15% aluminium chloride hexahydrate gel, botulinum toxin A injections led to significant improvement within 2 weeks.Conclusions: To our knowledge, this case is the first report of idiopathic unilateral aquagenic keratoderma in the medical literature. It is the third report of successful treatment with botulinum toxin A which is in favor of a role of sweat glands in the pathogenesis of aquagenic keratoderma.

Aquagenic (pseudo) keratoderma: a clinical series with new pathological insights

“…The dorsum of the fingers 15,27 or the medial aspect of the heel 38 are also unusual areas of involvement. Unilateral cases have also been described 37 . Warm water provokes the lesions more rapidly than does cold water 34 .…”

“…Aquagenic keratoderma is an unusual acquired condition that has been described under different terms such as transient reactive papulotranslucent acrokeratoderma, aquagenic syringeal acrokeratoderma, aquagenic palmoplantar keratoderma, (instant) aquagenic wrinkling of the palms, acquired aquagenic papulotranslucent acrokeratoderma and transient aquagenic palmar hyperwrinkling 1–41 . It is characterized by the development of hypopigmented, translucent, flat‐topped, oedematous papules and plaques with hyperwrinkling and eccrine duct prominence on the palms, fingers and, rarely, on the soles induced after a few minutes of exposure to water contact.…”

Sporadic and familial cases of aquagenic keratoderma

“…Transient lesions occur after water exposure. 1,2 The aim of the current report was to present a rare case of unilateral involvement and familial cases of AK and emphasize the efficacy of new treatment regimens.…”

Use of botulinum toxin in the treatment of aquagenic keratoderma: One case report

“…Multiple treatments have been described in the literature: 20% aluminum chloride hexahydrate, 20% urea creams, salicylic acid preparations, antihistamines, acitretine, iontophoresis, and botulinum toxin A. There are four cases of AK successfully treated with botulinum toxin in the literature (Diba, Cormack, & Burrows, ; Bagazgoitia, Pérez‐Carmona, Salgüero, Harto, & Jaén, ; Houle, Al Dhaybi, & Benohanian, ; Poletti& Muñoz‐Sandoval, ). Among them 2 were women and 2 men between 18 and 60 years old, all of them sporadic cases without family history or drug intake.…”