Aquagenic palmoplantar keratoderma - observations in a case
Aquagenic palmoplantar keratoderma is a rare acquired condition involving young females, characterized by painful symmetric swelling and hypopigmentation of the palms and lateral fingers, which develops after brief exposure to water.
Female patient aged 28 presented with edema on both hands after immersion in water, associated with apperance of white papules and burning sensation.
The lesions resolved spontaneously approximately 30-60 minutes after removal of her hands from water. A biopsy specimen performed after exposure to water revealed hyperplasia of the eccrine sweat glands with focal stratification. Treatment with hexahydrated aluminium chloride led to an improvement in her condition.
Aquagenic palmoplantar keratoderma must be differentiated from hereditary papulotranslucent acrokeratoderma that exhibits an autosomal dominant pattern of inheritance and manifests as asymptomatic yellowish-white papules and plaques that appear on the palms and soles and, once they appear, are persistent without any exposure to water.
Aquagenic palmoplantar keratoderma differs from hereditary papulotranslucent acrokeratoderma by transmission mode, clinical, histological and evolutive characteristics.