Aquagenic syringeal acrokeratoderma in an adolescent female with COVID-19

Alay, Handan; Bilen, Handan

doi:10.1590/0037-8682-0152-2021

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…The condition relieves spontaneously by water escaping, hence it is vital for ASA to avoid contact with water in unnecessary situations. The COVID-19 pandemic outbreak has brought changes in lifestyle, including long-term glove wearing and frequent hand washing, causing longer duration of water contact . So dermatologists should be more aware of the prevalence of ASA and help to prevent and diagnose this condition during the pandemic period.…”

Section: Discussionmentioning

confidence: 99%

Excessive Wrinkling on the Dorsum of the Hands and Wrists

Zhang

2022

JAMA Dermatol

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An otherwise healthy man in his 20s presented to the dermatology department with thickening and swelling of hands after immersion in water, accompanied by burning pruritus for 3 years. The lesions occurred as symmetrical white and transparent papules, white keratosis, excessive wrinkling on the dorsum of hands after water immersion and worsened in summer, and remitted in winter. He was treated with topical tretinoin ointment intermittently per a diagnosis of chronic eczema at the local clinic with little improvement. The lesions gradually aggravated, and the affected area dispersed to wrists and elbows during past the 1.5 years. He attributed these changes to the need for washing hands frequently in the period of the COVID-19 epidemic. He had no family history of similar skin problems and did not have a history of hyperhidrosis, cystic fibrosis, atopy, or trauma to the hands.Physical examination showed some changes emerged on both hands after water immersion contrasting with any other condition (Figure , A and B). We took a skin biopsy specimen from white papules on the right hand, and representative histopathologic features are shown in the Figure, C and D.

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Section: Discussionmentioning

confidence: 99%

Excessive Wrinkling on the Dorsum of the Hands and Wrists

Zhang

2022

JAMA Dermatol

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Section: Figurementioning

confidence: 99%

“…Up till now, reports of ASA during the COVID‐19 pandemic have all been associated with an increase in the frequency of daily handwashing. 2 , 3 However, although increased handwashing may be a probable trigger for ASA, this factor by itself does not explain the fading of ASA symptoms after COVID‐19 resolution. Several histopathological studies of COVID‐19 patients have reported the presence of an abnormal perieccrine lymphocytic infiltrate in chilblain‐like lesions.…”

Section: Figurementioning

confidence: 99%

“…Data available on request from the authors. P. Burgos-Blasco, 1,2 * M. Gonz alez-Cañete, 3 A. Melian-Olivera, 1,2 D. Vega-Diez, 3 I. Aldanondo-Fernandez de la Mora, 1,2 B. Perez-Garcia, 1,2 D. De Perosanz-Lobo 1,2…”

Section: Conflicts Of Interestmentioning

confidence: 99%

“…1 We have since identified an increase in the diagnosis of aquagenic syringeal acrokeratoderma (ASA), in consonance with other reports of ASA following excessive exposure to water and disinfectants. 2,3 However, an association between SARS-CoV-2 and ASA has not previously been reported. The objective of this study was to describe cases of ASA presenting during the COVID-19 outbreak and its possible association with SARS-CoV-2 infection.We retrospectively reviewed patients with a diagnosis of ASA consulting either to the emergency department or to the dermatology outpatient clinic in two third-level referral hospitals from March 2020 to March 2021, including virtual consultations.…”

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confidence: 99%

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Transient aquagenic syringeal acrokeratoderma during COVID‐19 outbreak: a retrospective case series of eight patients

Burgos-Blasco

González‐Cañete

Melián-Olivera

et al. 2022

Acad Dermatol Venereol

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diverse skin manifestations have been reported to be associated with the disease, most of them concerning skin rashes. 1 We have since identified an increase in the diagnosis of aquagenic syringeal acrokeratoderma (ASA), in consonance with other reports of ASA following excessive exposure to water and disinfectants. 2,3 However, an association between SARS-CoV-2 and ASA has not previously been reported. The objective of this study was to describe cases of ASA presenting during the COVID-19 outbreak and its possible association with SARS-CoV-2 infection.We retrospectively reviewed patients with a diagnosis of ASA consulting either to the emergency department or to the dermatology outpatient clinic in two third-level referral hospitals from March 2020 to March 2021, including virtual consultations. Diagnosis was established by a board-certified dermatologist through symptoms and a water immersion test, where patients were exposed to warm water for 2 min. Patients with a history of ASA or symptoms beginning previous to March 2020 were excluded. The clinical pattern of ASA was documented regarding both palmar and plantar involvement as well as the presence or absence of symptoms (Fig. 1). Known associated risk factors such as hyperhidrosis, cystic fibrosis or atopic dermatitis were recorded. All patients were asked about COVID-19 symptoms such as fever, cough or dyspnoea. When available, RT-PCR nasopharyngeal swabs for SARS-CoV-2 results were registered. No skin biopsies were performed due to virtual consultation and lack of patients' consent.The study population comprised 8 patients (3 men and 5 women), with ages ranging from 5 to 34. Demographic and clinical data of the patients are depicted in Table 1. All patients presented with bilateral palmar ASA, while none reported the involvement of the soles. Out of 8 patients, 5 tested positive for SARS-CoV-2 while one reported symptoms compatible with COVID-19 pneumonia, with no PCR available. The former reported onset of ASA days after the diagnosis of COVID-19 infection, while the latter described the beginning of ASA immediately after the first pneumonia symptoms. All of these patients

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Acquired Aquagenic Syringeal Keratoderma Following COVID-19 Infection

Polascik,

Karklins,

Johnson

et al. 2024

Hand (New York, N,Y.)

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Aquagenic syringeal keratoderma (ASK), rare in males, is characterized by the rapid onset of edematous palmar wrinkling with small white papules after brief contact with water or sweat. A 24-year-old atopic male presented with a 2-week subacute history of bilateral palmar edema with whitish-colored papules after exposure to water, 3 months after having had COVID-19 infection treated with a full course of ritonavir-boosted nirmatrelvir (PAXLOVIDTM). He had received 3 COVID-19 vaccines (Pfizer, New York, NY) about 12 months prior. Workup was negative. Initial spontaneous near-resolution 2 months after onset was temporary, with recurrence 1 month later. Treatment with 12% topical aluminum chloride was ineffective. Botulinum toxin injection to both palms led to resolution of symptoms that has been sustained for 7 months. The association between atopy and ASK remains weak. We present a case of new-onset ASK in an adult male 3 months following COVID-19 infection without a history of excessive handwashing. Our patient may have had a predisposition to recurrent ASK due to his history of atopy including atopic dermatitis and food allergy anaphylaxis combined with prior COVID-19 infection. It is possible that ASK is a novel manifestation of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC) infection or long COVID.

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Aquagenic syringeal acrokeratoderma in an adolescent female with COVID-19

Cited by 3 publications

References 2 publications

Excessive Wrinkling on the Dorsum of the Hands and Wrists

Excessive Wrinkling on the Dorsum of the Hands and Wrists

Transient aquagenic syringeal acrokeratoderma during COVID‐19 outbreak: a retrospective case series of eight patients

Acquired Aquagenic Syringeal Keratoderma Following COVID-19 Infection

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