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Polascik BW, Karklins SP, Johnson MC, Hammert WC, McMichael AJ. Acquired Aquagenic Syringeal Keratoderma Following COVID-19 Infection. Hand (N Y) 2024:15589447241233371. [PMID: 38439631 DOI: 10.1177/15589447241233371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
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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Affiliation(s)
- Bryce W Polascik
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Matthew C Johnson
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Warren C Hammert
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Amy J McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Park BG, Jeong JY, Seul TW, Ryu HJ. A Case of Idiopathic Aquagenic Wrinkling of the Palms Successfully Treated with 20% Aluminum Chloride Hexahydrate. Ann Dermatol 2023; 35:S371-S372. [PMID: 38061749 PMCID: PMC10727871 DOI: 10.5021/ad.21.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/11/2022] [Accepted: 02/20/2022] [Indexed: 12/20/2023] Open
Affiliation(s)
- Byeong Geun Park
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Jae Yeong Jeong
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Tae Woong Seul
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea.
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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.
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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
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Lin ZT, Jiang-Wei Cheng, Hao Guo, Jiu-Hong Li. Symmetrical White Transparent Papules: A Quiz. Acta Derm Venereol 2022; 102:adv00720. [DOI: 10.2340/actadv.v102.2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missng (Quiz)
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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
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Pande P, Poonia K, Kaur J. Isolated aquagenic acrokeratoderma of dorsal hands. J Postgrad Med 2021; 67:184-185. [PMID: 33707399 PMCID: PMC8445118 DOI: 10.4103/jpgm.jpgm_779_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- P Pande
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Chandigarh, India
| | - K Poonia
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Chandigarh, India
| | - J Kaur
- Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Chandigarh, India
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Rodríguez-Villa Lario A, Vega-Díez D, González-Cañete M, Gómez-Zubiaur A, Vélez-Velázquez MD, Polo-Rodríguez I, Medina-Montalvo S, Trasobares-Marugán L. Aquagenic keratoderma with dorsal involvement treated with botulinum toxin. Case report and review of literature. Dermatol Ther 2020; 33:e14347. [PMID: 32986261 DOI: 10.1111/dth.14347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/07/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - David Vega-Díez
- Department of Dermatology, Príncipe de Asturias University Hospital, Madrid, Spain
| | | | - Alba Gómez-Zubiaur
- Department of Dermatology, Príncipe de Asturias University Hospital, Madrid, Spain
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Choi H, Bae IH, Kim MS, Na CH, Shin BS. Two Cases of Aquagenic Wrinkling of the Palms in Korean Healthy Women: Easily Overlooked Disease. Ann Dermatol 2020; 32:151-154. [PMID: 33911727 PMCID: PMC7992540 DOI: 10.5021/ad.2020.32.2.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/10/2018] [Accepted: 01/02/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Hoon Choi
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - In Ho Bae
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Min Sung Kim
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Chan Ho Na
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
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Hamie L, Abou-Rahal J. Water-related dermatoses. Int J Dermatol 2018; 58:515-529. [PMID: 30506676 DOI: 10.1111/ijd.14316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/27/2018] [Accepted: 10/31/2018] [Indexed: 01/22/2023]
Abstract
Water-related dermatoses are a spectrum of diseases that are associated with water exposure. They result either from the direct influence of water or after injury from water inhabitants. In this review, clinical entities that manifest after water exposure (aquagenic pruritus, aquagenic urticaria, and aquagenic wrinkling of the palms) will be discussed with particular focus on the reported pathogenesis. Aquatic organisms and activities can be linked to cutaneous injuries that require identification and distinct management. Marine and freshwater dermatoses were summarized to provide physicians with easy access to the causative organism, method of injury, and appropriate management.
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Affiliation(s)
- Lamiaa Hamie
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jihane Abou-Rahal
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
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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]
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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
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Kim DW, Woo SH, Kim JI, Oh YJ, Yun SK, Kim HU, Park J. Idiopathic Aquagenic Wrinkling of the Palms in Korean Patients. Ann Dermatol 2015; 27:776-7. [PMID: 26719656 PMCID: PMC4695439 DOI: 10.5021/ad.2015.27.6.776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/08/2015] [Accepted: 02/18/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
- Dae-Woo Kim
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Soo-Han Woo
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Joo-Ik Kim
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Yu-Jeong Oh
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Seok-Kweon Yun
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Han-Uk Kim
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Jin Park
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Bonhomme A, Barbaud A, Schmutz JL, Bursztejn AC. [Aquagenic palmoplantar keratoderma during treatment of Langerhans cell histiocytosis]. Ann Dermatol Venereol 2015; 142:197-200. [PMID: 25683007 DOI: 10.1016/j.annder.2015.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/26/2014] [Accepted: 01/06/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Aquagenic palmoplantar keratoderma (APPK) is characterised by whitish oedematous papules, sometimes itchy or painful of rapid onset following immersion of the palms and/or soles in water. We report a case that was atypical in terms of the secondary appearance of persistent fine desquamation. PATIENTS AND METHODS A 6-year-old girl presented with typical APPK, present for three months and characterised by swelling, skin wrinkling, hyperhidrosis and secondary desquamation of the palms and soles, and which occurred after bathing. The patient had been treated with vinblastine, mercaptopurine and oral corticosteroids for Langerhans cell histiocytosis ongoing for six months. Physical examination revealed persistent fine desquamation of the palms and soles, occurring some time after immersion in water. There was no mutation of the CFTR gene. No similar cases could be found in the pharmacovigilance database. Topical therapy with an emollient provided some relief. Symptoms had partially resolved two months after discontinuation of chemotherapy and oral corticosteroids. DISCUSSION Cases of unilateral palmar damage involving unusual sites have been reported. Neither secondary desquamation nor association with Langerhans cell histiocytosis have been described. Hyperhidrosis and association with 1 or 2 CFTR mutations appear to constitute predisposing factors. There are cases of APPK related to anti-inflammatory intake. In view of the clinical course, an iatrogenic origin cannot be excluded in this case. CONCLUSION Persistent fine palmoplantar desquamation may be a manifestation of APPK.
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Affiliation(s)
- A Bonhomme
- Service de dermatologie, CHU de Nancy, 6, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
| | - A Barbaud
- Service de dermatologie, CHU de Nancy, 6, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - J-L Schmutz
- Service de dermatologie, CHU de Nancy, 6, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - A-C Bursztejn
- Service de dermatologie, CHU de Nancy, 6, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
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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.
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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
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Ertürk-Özdemir E, Özcan D, Seçkin D. Acquired aquagenic syringeal acrokeratoderma: A case series of 10 patients. Australas J Dermatol 2013; 56:e43-5. [DOI: 10.1111/ajd.12122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 08/20/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Emel Ertürk-Özdemir
- Department of Dermatology; Faculty of Medicine; Başkent University; Ankara Turkey
| | - Deren Özcan
- Department of Dermatology; Faculty of Medicine; Başkent University; Ankara Turkey
| | - Deniz Seçkin
- Department of Dermatology; Faculty of Medicine; Başkent University; Ankara Turkey
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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]
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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.
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Affiliation(s)
- Marie-Claude Houle
- Department of Dermatology, University of Montreal, Montreal, Quebec, Canada
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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]
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