Aquagenic syringeal acrokeratoderma is a rare condition affecting the palms of the hands. It is characterized by the appearance or worsening of a palmar eruption, following brief exposure to water. The palmar eruption is made up of small, white or shining pimples that can conjoin into plaques. The feet are unaffected. Symptoms include a burning pain and a tightening sensation in the palms, as well as too much sweating. There are two variants. Most commonly, it is a temporary and recurrent condition that appears after submersion in water, known as the “hand in the bucket sign,” that gets better within minutes to hours of drying. A less common variant is characterized by persistent lesions that are worsened after water submersion.
[1][2][3] The cause of aquagenic syringeal acrokeratoderma is unknown, but likely relates to sweating. Several studies have found that it is present in about 40% to 84% of
cystic fibrosis patients and also in
carriers, which suggest that it may be caused by
mutations in the
CFTR gene.
[3] It is more often found in young women. Besides cystic fibrosis, it is also seen in wasting (
marasmus) and
nephrotic syndrome and also with the use of aspirin and other drugs such as
rofecoxib and
celecoxib.
[4] In most cases it does not need any treatment and resolves spontaneously. When necessary, it can be treated with topical
aluminum chloride or
salicylic acid ointment or with
tap water iontophoresis.
[3][5]
Last updated: 4/19/2016
