Aquagenic acrokeratoderma.
BACKGROUND
Aquagenic acrokeratoderma (AA) is a rare condition with female predilection that occurs after brief water exposure and disappears minutes to an hour after drying. The pathogenesis remains unclear.


METHODS
Four Chinese patients with AA were reported and analyzed.


RESULTS
There were 2 males and 2 females (age range: 14-33 years) who presented with a 2-week to more than 10-year history of small white papules coalescing into edematous plaques on the hands; lesions appeared within 5-10 minutes of water exposure, began to regress in 3-20 minutes and disappeared within 5 minutes to one hour after drying. Warm water provoked the lesions more rapidly than cold water. Lesions of a female patient could be triggered by detergent. In another female patient, lesions also involved the feet and were associated with palmoplantar erythema and hyperhidrosis. Biopsy from the lesion of one patient after water exposure revealed hyperkeratosis, mild hypergranulosis, and dilatated eccrine ducts. Biopsy from the lesion of another patient after drying showed normal epidermis and dermis. Two patients were treated with topical formalin 3% in alcohol, and two with 3% potassium aluminium sulfate solution with partial relief without any adverse effects.


CONCLUSIONS
AA may occur in both males and females and may involve the feet. Warm water triggers the lesions more rapidly than cold. Topical formalin 3% in alcohol and 3% potassium aluminium sulfate solution may be optional therapy.
Luo
Di-Qing
DQ
Department of Dermatology, Huangpu Hospital of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. luodq@mail.sysu.edu.cn
Zhao
Yu-Kun
YK
Zhang
Wu-Jun
WJ
Wu
Liang-Cai
LC
D000293:Adolescent; D000328:Adult; D000534:Alum Compounds / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004439:Eccrine Glands / Q000473:pathology; D005260:Female; D005557:Formaldehyde / Q000627:therapeutic use*; D006801:Humans; D007645:Keratoderma, Palmoplantar / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D008297:Male; D014867:Water / Q000009:adverse effects*; D055815:Young Adult
D000534:Alum Compounds; D003879:Dermatologic Agents; D014867:Water; D005557:Formaldehyde; C041524:aluminum sulfate