Author(s): Dr Stanley Leong, Dermatology and Paediatric Registrar, 2023. Reviewing dermatologist: Dr Ian Coulson (2023)
Edited by DermNet content department
A 25-year old female presented with rapid swelling, mottling and pain on both palms when exposed to water for a brief time (3-5 minutes). The symptoms resolve within 30 minutes after the hands are dried.
Aquagenic wrinkling of the palms. It is a rare dermatosis that usually presents in the 2nd decade of life with equal sex incidence.
It is an exaggeration of the normal finger wrinkling that occurs when fingers are soaked in water for a prolonged period.
The exact pathology is unknown, however it is likely due to salt imbalance in the skin cells, resulting in increased water retention and transepidermal water loss.
Aquagenic wrinkling of the palms has a strong association with cystic fibrosis (CF), affecting up to 84% of patients with CF and 35% of carriers. It can be the first presenting sign of CF carrier status in otherwise healthy individuals or non-classical CF.
It can also be drug related (aspirin and COX inhibitors).
