Aquagenic wrinkling of the palms (AWP) is a rare condition that mainly affects young women, and often occurs in patients with cystic fibrosis. It may also occur in carriers of the cystic fibrosis gene. It has previously been called transient reactive papulotranslucent acrokeratoderma, aquagenic keratoderma, aquagenic syringeal acrokeratoderma, and simply wrinkling of the skin.
The cause of AWP is unknown. It may be caused by a salt imbalance in the skin cells, which results in increased water retention within these cells. Some cases have been related to different medications, such as non-steroidal anti-inflammatories and some antibiotics.
AWP resembles the exaggerated wrinkling of the palms which is caused by spending too long in a bath or pool. Clinically, it is characterized by the appearance or worsening of a palmar eruption, following brief exposure to water. The palmar eruption is comprised of small, white or translucent papules that coalesce into plaques. The feet are unaffected. Patients may report an uncomfortable tight or burning sensation during an eruption. In most cases the palmar skin returns to normal within a few hours of exposure to water, however, in some cases the eruption can persist for longer periods.
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