Aquagenic keratoderma has been described as a transitory condition involving young females and defined clinically by the appearance of palmar lesions accentuated after immersion in water. According to previous case reports, these lesions are characterized histologically by hyperkeratosis and dilated eccrine ducts. Some aberration in the eccrine ducts has been suggested as a possible pathogenic mechanism. We report a new case in a female adolescent. With regard to the normal aspect of the epidermis in our case, the clinical changes should be ascribed to a structural alteration of the horny layer without any visible microscopy change or functional alteration of the stratum corneum involving the organism in the adolescence period.
Juvenile acute pityriasis rubra pilaris (JAPRP) is a form of pityriasis rubra pilaris (PRP) with particular clinical characteristics and course. It is usually preceded by an infectious condition. We report a boy, initially thought to have Kawasaki disease, and subsequently diagnosed as having JAPRP, who made a satisfactory recovery. In this case, prior antibiotic treatment made it impossible to show the presence of any microorganism. However, the clinical characteristics of these patients and the similarities with other disorders involving the skin that are mediated by superantigens led us to think that these antigens may be involved in the development of this disease. Also, in view of the obvious differences between JAPRP and the other PRP, we suggest that, in the future this disorder may be considered a separate entity as a reactive exanthem.
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