A localized form of aquagenic syringeal acrokeratoderma

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

“…Plantar involvement is occasionally observed 3,13 and rarely the soles or the feet are the only affected site 21 . 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 .…”

“…Several treatments for aquagenic keratoderma have been proposed: 15–20% topical aluminium hydroxide is the most frequently prescribed with variable results, followed by botulinum toxin injections, topical corticosteroids, topical salicylic acid, formalin in alcohol, barrier agents, antihistamines and topical antibiotics 38,43 . Treatments involving the application of 12% ammonium lactate creams or petroleum jelly or the use of gloves have not been shown to be effective 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.…”

Aquagenic Palmar Wrinkling Induced by Combined Use of Salazopyrin and Indomethacin

“…Etiology of APW is unknown, but there are studies indicating an association with cystic fibrosis (CF) [1, 2] and some case reports implying various drugs as possible triggering factors [3–5]. Although called palmar wrinkling, similar lesions can be observed on other cutaneous surfaces after water exposure [6]. We describe an ankylosing spondylitis patient who manifested APW lesions four weeks after the start of salazopyrin and indomethacin combination therapy.…”

Unilateral aquagenic keratoderma treated with botulinum toxin A

“…2 The "hand-in-the bucket" sign, when patients submerge their hands in water to demonstrate the lesions, constitutes a clue to diagnosis. 3 Patients may report tightness, pruritus, mild pain, 4 Bellotch et al (1 case) 13 Katz et al (2 cases) 14 Neri et al (1 case) 15 Suchak et al (1 case) 16 Kocatürk et al (1 case) 17 Seitz et al (1 case) 9 Katz et al (1 case) 14 Baldwin et al (1 case) 18 Flann et al (1 case) 19 Kabashina et al (1 case) 20 Diba et al (1 case) 11 Bagazgoita et al (1 case) 6 Our case The last 3 cases responded to botulinum toxin injections…”