1
|
da Costa RPH, Dos Santos PC, Cossi AGAP, Bertanha L, Bertanha F, Rosado AL. Aquagenic keratoderma: three case reports. Int J Dermatol 2023; 62:e629-e631. [PMID: 37670726 DOI: 10.1111/ijd.16829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 07/14/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Affiliation(s)
| | - Paola C Dos Santos
- Hospital de Força Aérea de São Paulo (HFASP), São Paulo, São Paulo, Brazil
| | - André G A P Cossi
- Hospital de Força Aérea de São Paulo (HFASP), São Paulo, São Paulo, Brazil
| | - Laura Bertanha
- Hospital de Força Aérea de São Paulo (HFASP), São Paulo, São Paulo, Brazil
| | - Fernanda Bertanha
- Hospital de Força Aérea de São Paulo (HFASP), São Paulo, São Paulo, Brazil
| | - André L Rosado
- Hospital de Força Aérea de São Paulo (HFASP), São Paulo, São Paulo, Brazil
| |
Collapse
|
2
|
Mohan M, Mannil A, Chandrasekaran V, Gulati R, Ganapathy S, Nair S. Normative data for aquagenic wrinkling of palms in children 1-15 years of age: A cross-sectional study. Pediatr Pulmonol 2023; 58:3133-3138. [PMID: 37539857 DOI: 10.1002/ppul.26633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/24/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Aquagenic wrinkling of palms (AWP) is emerging as a screening test for cystic fibrosis (CF). There is lack of normative data for the same in our population. OBJECTIVES To generate normative data for AWP in children 1-15 years of age and to describe the factors associated with it. METHODS Children aged 1-15 years were enrolled after obtaining informed consent and assent of the parent and child based on age. Information regarding age, gender, anthropometry, indications for visiting hospital and drug intake were noted down. Wrinkling test was done using distilled water maintained in room temperature. Sweat chloride analysis was done using Nano duct sweat analysis system for children having AWP within 3 min. The mean/median time to wrinkle was noted and presented as centile curves after smoothing. RESULTS The mean (SD) and median (interquartile range [IQR]) aquagenic wrinkling time in children 1-15 years of age was 4.88 (1.066) and 5 (4-5.75) minutes respectively. The mean (SD) and median (IQR) time for AWP was 4.78 (1.076) and 5 (4-5) minutes respectively for boys and 4.98 (1.048) and 5 (4-6) minutes, respectively for girls. The time taken to wrinkle was observed to increase with age. Males have earlier AWP than females. There was no association between AWP and anthropometry or sweat chloride levels. CONCLUSION We have estimated the normative data for AWP in children 1-15 years of age which can be used for CF screening in children with typical clinical features from resource limited settings.
Collapse
Affiliation(s)
- Minnaladevi Mohan
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Aruna Mannil
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Venkatesh Chandrasekaran
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Reena Gulati
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sachit Ganapathy
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sreekumaran Nair
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
3
|
Yang K, Zhou C, Luke J. Aquagenic wrinkling of the palms: review of the literature. Clin Exp Dermatol 2022; 47:1910-1915. [PMID: 35796149 PMCID: PMC9826168 DOI: 10.1111/ced.15323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2022] [Indexed: 01/11/2023]
Abstract
Aquagenic wrinkling of the palms (AWP) is a rare dermatological disease characterized by development of rapid and excessive wrinkling and oedema of the palms and transient whitish or yellowish papules without erythema on the palmar surfaces after immersion in water. This phenomenon can be accompanied by pain and/or pruritus. The most common treatment of AWP involves aluminium-based topicals. This article discusses the associations, pathological mechanisms and treatment options of AWP.
Collapse
Affiliation(s)
- Karen Yang
- School of MedicineUniversity of CaliforniaRiversideCAUSA
| | - Cici Zhou
- Department of DermatologyLoma Linda UniversityLoma LindaCAUSA
| | - Janiene Luke
- Department of DermatologyLoma Linda UniversityLoma LindaCAUSA
| |
Collapse
|
4
|
Carbonell Pradas M, Grimalt Santacana R. [Translated article] Aquagenic Keratoderma: Treatment Update. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
5
|
Vazquez T, Zarei M, Herskovitz I, Price A, Villada G, Keri J. Atypical familial aquagenic syringeal acrokeratoderma. J Cutan Pathol 2021; 47:991-996. [PMID: 33464626 DOI: 10.1111/cup.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/22/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Vazquez
- Florida International University Wertheim College of Medicine, Miami, Florida, USA.,Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mina Zarei
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ingrid Herskovitz
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Alexandra Price
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Gabriel Villada
- Pathology & Laboratory Medicine Service, Miami Veterans Affairs Healthcare System, Miami, Florida
| | - Jonette Keri
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
6
|
Carbonell Pradas M, Grimalt Santacana R. Aquagenic Keratoma: Treatment Update. ACTAS DERMO-SIFILIOGRAFICAS 2021; 113:254-260. [PMID: 34126071 DOI: 10.1016/j.ad.2021.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 11/19/2022] Open
Abstract
{0>La Queratodermia Acuagénica (QA) es una afectación dermatológica adquirida poco frecuente que se caracteriza por la aparición de edema y pápulas blanquecinas-translúcidas desencadenado por la inmersión o contacto con agua.<}100{>Aquagenic keratoderma is an uncommon acquired dermatosis characterized by edema and whitish-translucent papules triggered by immersion or contact with water.<0} {0>Se han descrito casos asociados a fármacos, hiperhidrosis y a fibrosis quística.<}100{>Cases have been described in association with certain medications, hyperhidrosis, and cystic fibrosis.<0} {0>Los objetivos del estudio son evaluar la efectividad de los distintos tratamientos existentes para la QA.<}0{>The aim of this review is to evaluate the effectiveness of different treatments for aquagenic keratoderma.<0} {0>Realizamos una revisión de la literatura existente al respecto hasta el momento, incluyendo series de casos y reportes de caso.<}94{>We reviewed the literature and analyzed treatments for aquagenic keratoderma described in case series and reports.<0} {0>El tratamiento de la QA es efectivo en las formas asociadas a hiperhidrosis.<}100{>Aquagenic keratoderma associated with hyperhidrosis can be treated effectively.<0} {0>La iontoforesis de agua del grifo, la simpatectomía torácica endoscópica, las inyecciones de toxina botulínica y la oxibutinina son efectivas en las formas refractarias.<}100{>Tap water iontophoresis, endoscopic thoracic sympathectomy, botulinum toxin injections, and oxybutynin are effective against refractory forms.<0} {0>La aplicación tópica de ácido salicílico o sales de aluminio es efectiva pero resulta poco eficaz como tratamiento de mantenimiento.<}0{>Topical salicylic acid and aluminum salts are effective, but of little value as maintenance therapy.<0} {0>Probablemente la mejor alternativa para el tratamiento de la QA sea la Oxibutinina 5mg/día v.o.<}100{>Oral oxybutynin 5 mg/d is probably the best option for treating aquagenic keratoderma.<0} {0>Se ha observado que los efectos fisiopatológicos de los antiinflamatorios no esteroideos en la QA podrían justificar el uso de las prostaglandinas como un tratamiento dirigido de la enfermedad.<}100{>The reported pathophysiological effects of nonsteroidal anti-inflammatory drugs in this setting suggest that the use of prostaglandins might be justified.<0} {0>Se necesitan estudios adicionales para fortalecer estas deducciones y abordar las incertidumbres restantes.<}100{>Additional studies are needed to investigate these hypotheses and resolve other questions.<0}.
Collapse
Affiliation(s)
- M Carbonell Pradas
- Facultat de Medicina i Ciències de la Salut, UIC-Barcelona, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España
| | - R Grimalt Santacana
- Facultat de Medicina i Ciències de la Salut, UIC-Barcelona, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
| |
Collapse
|
7
|
Shirshakova M, Morozova E, Sokolova D, Pervykh S, Smirnova L. The effectiveness of botulinum toxin type A (BTX-A) in the treatment of facial skin oily seborrhea, enlarged pores, and symptom complex of post-acne. Int J Dermatol 2021; 60:1232-1241. [PMID: 33937981 DOI: 10.1111/ijd.15574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/19/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND This study aimed to examine the effectiveness of botulinum toxin type A (BTX-A) in the treatment of acne. METHODS The study was conducted in 2018 on 12 patients, 10 females and two males, aged 35 years on average. The injections with BTX-A were given during 2 weeks into the face skin in a dosage of 0.125-0.250 units. RESULTS Skin moisture indexes increased during the therapy by 4% (P ≤ 0.05), and porosity decreased by 7% (P ≤ 0.01). Maximal changes were recorded for the sulci and pigmentation of the skin, namely, its values decreased by 10 and 9%, respectively (P ≤ 0.01). BTX-A is recommended for an application not only in plastic surgeries but also for local correction of acne on the patient's skin. CONCLUSION A positive correlation was revealed between the duration of treatment and reduction of skin oiliness (0.87), pigmentation (0.78), skin sulci (0.84), and skin porosity (0.88), and negative correlation was established with increased skin moisture (-0.64). The obtained dependencies apply for the therapy period of up to 2 weeks. Pharmacological properties of BTX-A allow recommending it as a drug used in post-acne therapy.
Collapse
Affiliation(s)
| | - Elena Morozova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Daria Sokolova
- Clinic: Centre of Medical Practice, Moscow, Russian Federation
| | | | - Lyudmila Smirnova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| |
Collapse
|
8
|
Alexopoulos A, Chouliaras G, Kakourou T, Dakoutrou M, Nasi L, Petrocheilou A, Siahanidou S, Kanaka-Gantenbein C, Chrousos G, Loukou I, Michos A. Aquagenic wrinkling of the palms after brief immersion to water test as a screening tool for cystic fibrosis diagnosis. J Eur Acad Dermatol Venereol 2021; 35:1717-1724. [PMID: 33914973 DOI: 10.1111/jdv.17312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aquagenic wrinkling of the palms (AWP) is an excessive and early palmar wrinkling occurring after Brief Immersion to Water (BIW), and has been reported as a frequent finding among cystic fibrosis (CF) patients. OBJECTIVES To evaluate and assess the diagnostic performance of BIW test as an initial screening tool for CF diagnosis. METHODS We measured AWP in CF patients, CF-heterozygotes (CF-het) and normal controls. The AWP parameters of palmar wrinkling, oedema, papules, pruritus and pain were assessed at 3, 7 and 11 min after a BIW test was performed for all the participants. Statistical analyses explored the progression of AWP in time for the three groups and assessed the diagnostic performance of BIW test as a diagnostic screening tool for CF. RESULTS A total of 250 individuals (100 CF patients, their 50 CF-het parents, 100 healthy controls) were included in the analysis. The average age in years (mean ± SD) was 10.4 ± 4.0 for CF, 35.9 ± 6.1 for CF-het and 10.5 ± 4.0 for controls. The rate of positives for AWP at 3 min among CF patients, CF-het and controls was 68%, 8% and 0%, respectively (P < 0.01). Kaplan-Meier analysis showed a clear trend towards earlier appearance of all five parameters in the direction controls < hetCF < CF (P values <0.01). The best diagnostic performance in detecting between CF patients and non-CF was achieved by the presence of papules and wrinkling at 7 min (sensitivity/specificity: 94.0%/98.3% and 100.0%/92.0%, respectively). CONCLUSIONS A strong association between AWP and CF was detected. AWP after BIW could be elicited easily and possibly can be used as an initial screening tool to assess if an individual with symptoms and signs that raise the likelihood of CF is a CF patient.
Collapse
Affiliation(s)
- A Alexopoulos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - G Chouliaras
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - T Kakourou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - M Dakoutrou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - L Nasi
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - A Petrocheilou
- Department of Cystic Fibrosis, 'Aghia Sofia', Children's Hospital, Athens, Greece
| | - S Siahanidou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - C Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - G Chrousos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - I Loukou
- Department of Cystic Fibrosis, 'Aghia Sofia', Children's Hospital, Athens, Greece
| | - A Michos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| |
Collapse
|
9
|
Atzori L, Ferreli C, Rongioletti F. Aquagenic (pseudo) keratoderma (aquagenic palmoplantar keratoderma, aquagenic wrinkling of palms). Clin Dermatol 2020; 39:256-260. [PMID: 34272019 DOI: 10.1016/j.clindermatol.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aquagenic palmoplantar keratoderma (APK) is an uncommon hereditary or sporadic condition that is characterized by edematous flat-topped papules appearing on palmar skin with wrinkling after brief water exposure. APK has been associated with cystic fibrosis (CF), presenting with the same mutations found in CF (usually ΔF508 of the CFTR gene), either homozygous or heterozygous. APK may be idiopathic or drug-induced. The diagnosis is easily made if one is aware of this entity. Topical aluminum hydroxide and botulinum toxin injections are the most commonly used treatments. The sporadic form may have a shorter course compared with the hereditary one, resolving spontaneously after a few years. The condition should no longer be considered a true keratoderma but rather a pseudo keratoderma, and in spite of the many different names found in the literature, the term "aquagenic (pseudo) keratoderma" seems to be the most appropriate one.
Collapse
Affiliation(s)
- Laura Atzori
- Dermatology Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.
| | - Caterina Ferreli
- Dermatology Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Franco Rongioletti
- Dermatology Clinic, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
10
|
Tognetti L, Rizzo A, Fiorani D, Cinotti E, Perrot JL, Rubegni P. New findings in non‐invasive imaging of aquagenic keratoderma: Line‐field optical coherence tomography, dermoscopy and reflectance confocal microscopy. Skin Res Technol 2020; 26:956-959. [DOI: 10.1111/srt.12882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/11/2020] [Accepted: 05/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Linda Tognetti
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| | - Arianna Rizzo
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| | - Diletta Fiorani
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| | - Elisa Cinotti
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| | - Jean Luc Perrot
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| | - Pietro Rubegni
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| |
Collapse
|
11
|
Narang I, Mohandas P, Hawari R, Nambi R. A unique 'hand in bucket' sign in a case of acquired unilateral aquagenic syringeal acrokeratoderma. Clin Exp Dermatol 2020; 45:1100-1102. [PMID: 32696516 DOI: 10.1111/ced.14338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Affiliation(s)
- I Narang
- Department of Dermatology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - P Mohandas
- Department of Dermatology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - R Hawari
- Department of Pathology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - R Nambi
- Department of Dermatology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| |
Collapse
|
12
|
Bodemer C, Steijlen P, Mazereeuw-Hautier J, O'Toole EA. Treatment of hereditary palmoplantar keratoderma: a review by analysis of the literature. Br J Dermatol 2020; 184:393-400. [PMID: 32307694 DOI: 10.1111/bjd.19144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND No specific or curative therapy exists for hereditary palmoplantar keratoderma (hPPK), which can profoundly alter patient quality of life, leading sometimes to severe functional impairment and pain. The rarity and the aetiological diversity of this group of disorders can explain the difficulty in comparing the efficacy of available treatments. OBJECTIVES To review the different treatments tried in patients with hPPK since 2008, their efficacy and safety, with an evaluation of the various therapeutic modalities that can be used to treat hPPK. METHODS We undertook a comprehensive review of the literature data published since 2008. RESULTS Only a few case series and individual case reports were identified. Topical (emollients, keratolytics, retinoids, steroids) and systemic treatments (mostly different retinoids), often combined, are used to relieve symptoms. Oral retinoids appear to be the most efficient treatment, but not in all PPK forms, and with variable tolerance. New targeted treatments, according to the specific mechanisms of hPPK, appear promising for the future. CONCLUSIONS More studies using robust methodology and involving larger cohorts of well-characterized patients (phenotype-genotype) are necessary and should be prioritized by structured networks, such as the European Network for Rare Skin Diseases (ERN-Skin), with the aim of better management of patients with rare skin diseases.
Collapse
Affiliation(s)
- C Bodemer
- Department of Dermatology, Reference Centre for Genodermatoses, MAGEC Necker Enfants Malades, Paris-centre University, APHP5, ERN-Skin, France
| | - P Steijlen
- Department of Dermatology, Maastricht University Medical Centre and the GROW School for Oncology and Developmental Biology, Maastricht, ERN-Skin, the Netherlands
| | - J Mazereeuw-Hautier
- Department of Dermatology, Centre de référence des maladies rares de la peau, Larrey Hospital, Paul Sabatier University, Toulouse, ERN-Skin, France
| | - E A O'Toole
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, ERN-Skin, UK
| |
Collapse
|
13
|
|
14
|
Kim BJ, Kim J, Oh SH. Hereditary Papulotranslucent Acrokeratoderma: Prominent Clinical Presentation after Water Exposure. Ann Dermatol 2019; 31:S52-S53. [PMID: 33911696 PMCID: PMC7997055 DOI: 10.5021/ad.2019.31.s.s52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/26/2019] [Accepted: 03/26/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Beom Jun Kim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jihee Kim
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Ho Oh
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
15
|
Dermatosis inducida por el agua: queratodermia acuagénica, a propósito de un caso. ACTA ACUST UNITED AC 2019; 39:247-251. [DOI: 10.7705/biomedica.v39i2.4524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Indexed: 11/21/2022]
Abstract
La queratodermia acuagénica es una entidad benigna, caracterizada por producir pápulas blanquecinas o traslúcidas pocos segundos después del contacto con el agua.Se presenta el caso de una paciente de 16 años de edad con aparición de múltiples pápulas confluentes y asintomáticas en ambas palmas al contacto con el agua, que desaparecían luego del secado. En el estudio de histopatología se observó dilatación de los conductos ecrinos y cambios en el estrato córneo.Esta rara condición de etiología desconocida se ha relacionado con disfunción neuronal, alteraciones de las glándulas ecrinas y, más recientemente, con alteraciones en las acuaporinas. Se puede diagnosticar con una prueba semiológica sencilla llamada ‘la mano en el balde’; la sospecha clínica es fundamental para hacer el diagnóstico, ya que los hallazgos histopatológicos pueden ser sutiles e inespecíficos. El tratamiento tópico incluye mecanismos de barrera y la toxina botulínica.
Collapse
|
16
|
González-López G, García-Doval I, Molina-Leyva A, Descalzo-Gallego M, Taberner R, Gilaberte Y, Buendía-Eisman A, Fernández-Peñas P. Difficulties Coding Dermatological Disorders Using the ICD-10: The DIADERM Study. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
17
|
González-López G, García-Doval I, Molina-Leyva A, Descalzo-Gallego MA, Taberner R, Gilaberte Y, Buendía-Eisman A, Fernández-Peñas P. Difficulties Coding Dermatological Disorders Using the ICD-10: The DIADERM Study. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:893-899. [PMID: 30268517 DOI: 10.1016/j.ad.2018.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/10/2018] [Accepted: 06/14/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) has some shortcomings when it comes to coding certain dermatological disorders. To overcome these shortcomings, a compatible version of the ICD-10 specifically adapted to dermatology was produced in Spain in 1999. The recent DIADERM study recorded 10 999 dermatological diagnoses using a representative sample of dermatologists working at outpatient clinics in Spain. The aims of the current study were to identify diagnoses from the DIADERM study that could not be coded using the adapted ICD-10, determine why, and check if they could be coded using the draft ICD-11. MATERIAL AND METHODS We included all dermatological diagnoses from the DIADERM study that could not be assigned a code from the adapted ICD-10. We then quantified and recorded all the diagnoses that could not be coded using either the adapted ICD-10 or the draft ICD-11. RESULTS Of the 10 999 diagnoses analyzed, 41 had not been assigned a code. Of these, 19 were assigned an adapted ICD-10 code on reassessment. However, the adapted ICD-10 and the draft ICD-11 lacked specific codes for 22 and 17 diagnoses, respectively. CONCLUSIONS The adapted ICD-10 can be used to correctly code the vast majority of dermatological diagnoses seen in routine clinical practice. Nevertheless, the system does have some minor shortcomings when it comes to coding certain diseases, particularly newly discovered and emerging diseases. Some of these problems, however, were resolved with the new ICD-11. Based on our findings, we propose some modifications to the ICD-11.
Collapse
Affiliation(s)
- G González-López
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España.
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, España; Servicio de Dermatología, Complejo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - A Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | | | - R Taberner
- Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, Baleares, España
| | - Y Gilaberte
- Unidad de Dermatología, Hospital San Jorge de Huesca, Huesca, España
| | | | - P Fernández-Peñas
- The University of Sydney, Department of Dermatology, Westmead Hospital, Westmead, Sídney, New South Wales, Australia
| |
Collapse
|
18
|
Donnarumma M, Megna M, Napolitano M, Patruno C. Aquagenic wrinkling of the palms. GIORN ITAL DERMAT V 2018; 154:364-366. [PMID: 29368852 DOI: 10.23736/s0392-0488.18.05762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marianna Donnarumma
- Department of Dermatology, University of Naples Federico II, Naples, Italy -
| | - Matteo Megna
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Science "Vincenzo Tiberio, " University of Molise, Campobasso, Italy
| | - Cataldo Patruno
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| |
Collapse
|
19
|
From Classical to Unusual: Report on 5 Cases of Transient Reactive Aquagenic Pseudokeratoderma and Review of the Literature. Am J Dermatopathol 2017; 39:935-942. [DOI: 10.1097/dad.0000000000000815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Translucent whitish papules on the palms after exposure to the water - aquagenic syringeal acrokeratoderma. Postepy Dermatol Alergol 2017; 34:372-374. [PMID: 28951715 PMCID: PMC5560188 DOI: 10.5114/ada.2017.69321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 06/25/2016] [Indexed: 12/04/2022] Open
|
21
|
Campanati A, Martina E, Giuliodori K, Consales V, Bobyr I, Offidani A. Botulinum Toxin Off-Label Use in Dermatology: A Review. Skin Appendage Disord 2017; 3:39-56. [PMID: 28612001 DOI: 10.1159/000452341] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/05/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum which causes a flaccid muscle paralysis. It is currently used for aesthetic treatments and in the focal hyperhidrosis. Recently, botulinum toxin has also been used experimentally in many other dermatological conditions with good results. OBJECTIVE To review and analyze the possible botulinum toxin off-label applications published. METHODS A retrospective review of the published data was conducted. CONCLUSIONS this potent drug can lead to several off-label indications of interest for dermatologists. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and dose protocols.
Collapse
Affiliation(s)
- Anna Campanati
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Emanuela Martina
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Katia Giuliodori
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Veronica Consales
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Ivan Bobyr
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| |
Collapse
|
22
|
Angra D, Angra K, Rodney IJ. Aquagenic palmoplantar keratoderma with dorsal hand involvement in an adolescent female. JAAD Case Rep 2016; 2:239-40. [PMID: 27408931 PMCID: PMC4927638 DOI: 10.1016/j.jdcr.2016.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Divya Angra
- George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Kunal Angra
- Department of Dermatology, Howard University College of Medicine, Washington, DC
| | - Ife J Rodney
- Department of Dermatology, Howard University College of Medicine, Washington, DC
| |
Collapse
|
23
|
Nazik H, Nazik S, Çoban FG, Demir B. Sporadic and familial cases of aquagenic keratoderma. J Dermatol Case Rep 2016; 10:10-3. [PMID: 27119001 DOI: 10.3315/jdcr.2016.1223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 01/20/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Aquagenic keratoderma is a dermatosis characterized by transient whitish and transluscent hyperwrinkling after water exposure. The aim of the current report was to present a sporadic and familial cases of aquagenic keratoderma. OBSERVATION Sporadic Case: A 38-year-old female patient presented with eruption in the right hand after exposure to water. The patient was placed on systemic acitretin therapy with the diagnosis of idiopathic acquired aquagenic keratoderma. No recurrence occurred during a 6-month follow-up period. Familial Cases: A 55-year-old male patient, who was engaged in fishery, presented to the outpatient clinics of the department of dermatology due to whitish vesicles in the palms of both hands. It was realized that the father, sister, and brother of the patient had similar complaints. The cases were thought to have familial aquagenic keratoderma; however acitretin therapy could not be initiated due to elevated alanine aminotransferase and triglyceride levels. Topical application of salicylic acid 10% and 10% urea containing lotions was effective but did not prevent recurrence. CONCLUSION Systemic acitretin may be an effective agent in the treatment of aquagenic keratoderma, and topical application of 10% salicylic acid and 10% urea-containing lotion did not prevent recurrence.
Collapse
Affiliation(s)
- Hülya Nazik
- Bingöl State Hospital, Department of Dermatology, Bingöl, Turkey
| | - Selçuk Nazik
- Bingöl Maternity and Children's Hospital, Department of Infectious Diseases and Clinical Microbiology, Bingöl, Turkey
| | - Feride Gül Çoban
- Elazığ Education and Training Hospital, Department of Dermatology, Elazığ, Turkey
| | - Betül Demir
- Fırat University, Department of Dermatology, Elazığ, Turkey
| |
Collapse
|
24
|
Bielicky L, Braun-Falco M, Ruzicka T, Maier T. Aquagenic Wrinkling of the Palms: Morphological Changes in Reflectance Confocal Microscopy and High-Definition Optical Coherence Tomography. Dermatology 2015; 230:208-12. [DOI: 10.1159/000369165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 10/17/2014] [Indexed: 11/19/2022] Open
|
25
|
Abstract
Aquagenic syringeal acrokeratoderma is a newly described condition of the palms and soles characterized by hypopigmented papules and plaques, elicited after submersion in water. Symptoms include a burning pain and a tightening sensation in the palms, as well as hyperhidrosis. Initially thought to be rare, its frequent citation in the literature points to a more common entity. It is more often found in young women and has been linked to a number of medications and illnesses, including nonsteroidal anti-inflammatory drugs and cystic fibrosis. It is typically self-limiting, but certain medications such as topical aluminum chloride or salicylic acid ointment have been found to be an effective treatment option. This case details a collegiate-level coxswain who presented to the university athletic training room with a typical presentation of aquagenic syringeal acrokeratoderma. For an aquatic athlete, aquagenic syringeal acrokeratoderma can be a distressing condition that can limit training and athletic participation. As such, the sports medicine physician should be knowledgeable about aquagenic syringeal acrokeratoderma to provide effective counseling and treatment options for the athlete.
Collapse
Affiliation(s)
- Jeremy B Kent
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Siobhan M Statuta
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia ; Physical Medicine & Rehabilitation, University of Virginia Health System, Charlottesville, Virginia
| | - Kenneth E Greer
- Department of Dermatology, University of Virginia Health System, Charlottesville, Virginia
| | - John M MacKnight
- Internal Medicine and Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia
| |
Collapse
|
26
|
Li CX, Han CL, Zeng K, Zhang XB, Ma ZL. Clinical, demographic and histopathological features of symmetrical acral keratoderma. Br J Dermatol 2014; 170:948-51. [PMID: 24341804 DOI: 10.1111/bjd.12754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C.-X. Li
- Department of Dermatology; Nanfang Hospital; South Medical University; Guangzhou China
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| | - C.-L. Han
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| | - K. Zeng
- Department of Dermatology; Nanfang Hospital; South Medical University; Guangzhou China
| | - X.-B. Zhang
- Department of Dermatology; Guangzhou Institute of Dermatology; Guangzhou China
| | - Z.-L. Ma
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| |
Collapse
|
27
|
Tchernev G, Semkova K, Cardoso JC, Ananiev JJ, Wollina U. Aquagenic keratoderma. Two new case reports and a new hypothesis. Indian Dermatol Online J 2014; 5:30-3. [PMID: 24616851 PMCID: PMC3937482 DOI: 10.4103/2229-5178.126025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Aquagenic keratoderma has been described as a transient condition affecting predominantly young females and defined clinically by the appearance of palmar hyper-wrinkling accentuated after immersion in water. We present two new cases with aquagenic palmoplantar acrokeratoderma - a child and a young male. A significant clinical improvement was achieved after topical treatment with aluminum salts. Aquagenic palmar keratoderma may be a clue to cystic fibrosis in adolescents and young adults. We developed a new hypothesis on its pathogenesis.
Collapse
Affiliation(s)
- Georgi Tchernev
- Department of Dermatology and Venerology, Saint Kliment Ohridski University, University Hospital Lozenetz, Bulgaria
| | - Kristina Semkova
- Department of Dermatology and Venerology, Medical University Sofia, Sofia, Bulgaria
| | - José Carlos Cardoso
- Department of Dermatology, University Hospital of Coimbra, Coimbra, Portugal
| | - J Julian Ananiev
- Department of General and Clinical Pathology, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital, Dresden-Friedrichstadt, Dresden, Germany
| |
Collapse
|
28
|
Chinazzo C, De Alessandri A, Menoni S, Romanisio G, Rebora A, Rongioletti F. Aquagenic Wrinkling of the Palms and Cystic Fibrosis: An Italian Study with Controls and Genotype-Phenotype Correlations. Dermatology 2014; 228:60-5. [DOI: 10.1159/000355183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/15/2013] [Indexed: 11/19/2022] Open
|
29
|
Wang TS, Tsai TF. Cutaneous irritancy of water. REVIEWS ON ENVIRONMENTAL HEALTH 2014; 29:217-220. [PMID: 25274940 DOI: 10.1515/reveh-2014-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 07/10/2014] [Indexed: 06/03/2023]
Abstract
Abstract Water is an ubiquitous irritant that exerts its irritancy through different mechanisms. Water passage and optimal water content is a highly controlled process of human skin and changes in the water gradient may lead to skin diseases. The pH, osmolarity, and temperature of water can all be attributes of water irritancy. In addition, the irritancy of water is also determined by individual susceptibility.
Collapse
|
30
|
|
31
|
Acroqueratodermia aquagénica associada a uma mutação do gene da fibrose quística. REVISTA PORTUGUESA DE PNEUMOLOGIA 2013; 19:125-8. [DOI: 10.1016/j.rppneu.2012.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 10/30/2012] [Accepted: 10/31/2012] [Indexed: 11/17/2022] Open
|
32
|
Baquerizo K, Amini S, Keri JE, Badiavas EV, Elgart GW. Atypical form of transient reactive papulotranslucent acrokeratoderma in a cystic fibrosis carrier. J Cutan Pathol 2013; 40:413-8. [DOI: 10.1111/cup.12087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 10/09/2012] [Accepted: 11/18/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Katherine Baquerizo
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Sadegh Amini
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Jonette E. Keri
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Evangelos V. Badiavas
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| | - George W. Elgart
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami; FL; USA
| |
Collapse
|
33
|
|
34
|
Arkin LM, Flory JH, Shin DB, Gelfand JM, Treat JR, Allen J, Rubenstein RC, Yan AC. High prevalence of aquagenic wrinkling of the palms in patients with cystic fibrosis and association with measurable increases in transepidermal water loss. Pediatr Dermatol 2012; 29:560-6. [PMID: 22471628 DOI: 10.1111/j.1525-1470.2011.01708.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Aquagenic wrinkling of the palms (AWP) is a cutaneous phenomenon marked by the transient formation of edematous, translucent papules and plaques on the palms and fingertips within minutes of water exposure. AWP is anecdotally reported in patients with cystic fibrosis (CF) and several studies have recently confirmed this association. The primary aim of this study was to determine the prevalence of aquagenic wrinkling of the palms in subjects with cystic fibrosis (CF) compared to controls, and secondarily to evaluate for genotype-phenotype correlations among CF subjects found to have AWP. Fifty-one children with CF and 25 control children who were being treated for asthma underwent a 5-minute hand immersion in lukewarm water. The test for AWP was positive if subjects demonstrated >30% wrinkling over the palm. Secondary analyses explored associations with genotype, pancreatic and pulmonary function, body mass index (BMI), and sweat chloride levels. Palmar transepidermal water loss (TEWL) was also measured for all subjects with and without AWP. Forty-three of the subjects (84%) with CF demonstrated aquagenic wrinkling, in contrast to none (0%) of the controls. These results remained statistically significant when stratified for by age and race. TEWL was significantly higher in CF subjects with AWP compared to CF subjects without AWP and controls. No genotype-phenotype correlations were detected in patients with AWP, nor were there associations of AWP with other phenotypic features of CF, although these analyses were likely underpowered. Aquagenic wrinkling of the palms is prevalent in children with CF and is associated with increased TEWL.
Collapse
Affiliation(s)
- Lisa M Arkin
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Rongioletti F, Tomasini C, Crovato F, Marchesi L. Aquagenic (pseudo) keratoderma: a clinical series with new pathological insights. Br J Dermatol 2012; 167:575-82. [DOI: 10.1111/j.1365-2133.2012.11003.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Abstract
Aquagenic wrinkling of the palms (AWP) is a condition characterized by excessive wrinkling, palmar edema, and whitish papules accompanied by pain, pruritus, or discomfort after brief immersion of the hands in water. It is well documented to be associated with cystic fibrosis (CF), with several theories regarding the pathogenesis having been proposed. We report a case of two sisters with AWP in whom CF has not been diagnosed and review the literature on AWP and its association with CF and CF carrier status. Because diagnosis of mild forms CF or knowledge of an underlying CF genetic mutation is frequently unknown, identification of AWP may represent the only sign of such mutations. The dermatologist plays an integral role in early detection of AWP, and the importance of genetic testing in such patients cannot be overlooked. We recommend various measures to apply in clinical practice to ensure diagnosis and decrease morbidity and mortality in patients.
Collapse
Affiliation(s)
- Ligaya Park
- University Hospitals Case Medical Center, Cleveland, Ohio, USA.
| | | | | |
Collapse
|
37
|
Houle MC, Al Dhaybi R, Benohanian A. Unilateral aquagenic keratoderma treated with botulinum toxin A. J Dermatol Case Rep 2011; 4:1-5. [PMID: 21886737 DOI: 10.3315/jdcr.2010.1045] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 04/02/2010] [Indexed: 11/11/2022]
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.
Collapse
Affiliation(s)
- Marie-Claude Houle
- Department of Dermatology, University of Montreal, Montreal, Quebec, Canada
| | | | | |
Collapse
|
38
|
|
39
|
Abstract
A 13-year-old girl sought medical care for pain in both palms that consistently occurred after brief exposure to water and resolved spontaneously 20 to 30 minutes after immersion. The pain was not associated with wrinkling of the palms. After excluding other causes of acrodynia and water-induced discomfort, we diagnosed the patient as having idiopathic localized aquadynia. Treatment with systemic clonidine led to a substantial improvement in her symptoms. To our knowledge, this patient represents the only fifth reported case of aquadynia and the first child affected by this enigmatic condition.
Collapse
Affiliation(s)
- Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | | | | |
Collapse
|
40
|
Aquagenic acrokeratoderma: A case with family history and unusual involvements of the palms and soles, and the dorsum of fingers and toes. J Dermatol 2010; 38:612-5. [DOI: 10.1111/j.1346-8138.2010.01011.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
41
|
Fan YM, Li SF, Yang YP, Chen QX, Li W. Is acquired symmetrical acrokeratoderma a new dermatosis? Two case reports and Chinese literature review. Int J Dermatol 2010; 49:647-52. [PMID: 20618469 DOI: 10.1111/j.1365-4632.2009.04301.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A series of cases characterized by symmetrical acral hyperkeratosis, mainly involving the dorsal surface of the hands, feet, and wrists, but sparing the palmoplantar areas, as well as rapid immersion upon exposure to water have been recently described in China, but similar disorders have not been reported in the English literature. METHODS The clinicopathologic features of two cases of acquired symmetrical acrokeratoderma were reported and 27 Chinese patients were reviewed. RESULTS The disorder typically occurred in young or middle aged men. Brown to black hyperkeratotic patches were symmetrically distributed particularly on the wrists and dorsum of hands, fingers, and feet, but without involvement of palms and soles. The lesions became whitish with mild swelling immediately after contact with water and improved generally in winter. Histopathologic examination revealed epidermal hyperkeratosis, acanthosis, and papillomatous hyperplasia, as well as superficial perivascular lymphohistiocytic infiltrate. Main ultrastructural features of the immersed lesion were epidermal hyperkeratosis and spongiosis with partial split of the desmosomes. CONCLUSION This disorder may be a new dermatosis, and the term "acquired symmetrical acrokeratoderma" could exactly reflect its clinicopathologic characteristics.
Collapse
Affiliation(s)
- Yi-Ming Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, China.
| | | | | | | | | |
Collapse
|
42
|
|
43
|
Garçon-Michel N, Roguedas-Contios AM, Rault G, Le Bihan J, Ramel S, Revert K, Dirou A, Misery L. Frequency of aquagenic palmoplantar keratoderma in cystic fibrosis: a new sign of cystic fibrosis? Br J Dermatol 2010; 163:162-6. [DOI: 10.1111/j.1365-2133.2010.09764.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
44
|
|
45
|
Luo DQ, Li Y, Huang YB, Wu LC, He DY. Aquagenic syringeal acrokeratoderma in an adult man: case report and review of the literature. Clin Exp Dermatol 2009; 34:e907-9. [DOI: 10.1111/j.1365-2230.2009.03680.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
46
|
Stewart LC, Doe SJ, Bourke SJ, Leech S. Aquagenic palmar wrinkling as a presenting feature of cystic fibrosis gene dysfunction. Clin Exp Dermatol 2009; 34:e647-9. [DOI: 10.1111/j.1365-2230.2009.03357.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
47
|
La toxine botulique dans les maladies dermatologiques invalidantes. Ann Dermatol Venereol 2009; 136 Suppl 4:S129-36. [DOI: 10.1016/s0151-9638(09)74540-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
48
|
Falcón CS, Ortega SS. Aquagenic syringeal acrokeratoderma. J Am Acad Dermatol 2008; 59:S112-3. [DOI: 10.1016/j.jaad.2008.04.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 04/17/2008] [Accepted: 04/28/2008] [Indexed: 11/26/2022]
|
49
|
Kabashima K, Shimauchi T, Kobayashi M, Fukamachi S, Kawakami C, Ogata M, Kabashima R, Mori T, Ota T, Fukushima S, Hara-Chikuma M, Tokura Y. Aberrant aquaporin 5 expression in the sweat gland in aquagenic wrinkling of the palms. J Am Acad Dermatol 2008; 59:S28-32. [DOI: 10.1016/j.jaad.2008.04.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Revised: 04/17/2008] [Accepted: 04/25/2008] [Indexed: 11/26/2022]
|
50
|
Yoon T, Kim K, Lee J, Kim M. Aquagenic syringeal acrokeratoderma: unusual prominence on the dorsal aspect of fingers? Br J Dermatol 2008; 159:486-8. [DOI: 10.1111/j.1365-2133.2008.08633.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|