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Aquagenic Syringeal Acrokeratoderma
Author(s) -
Scalf L.A.,
Baldwin B.,
Messina J.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320go.x
Subject(s) - hyperkeratosis , dyskeratosis , hyperhidrosis , eccrine sweat , medicine , dermatology , biopsy , pathology , vellus hair , family history , palm , atopy , perspiration , sweat , anatomy , surgery , scalp , physics , immunopathology , quantum mechanics , psychiatry
A 24 year‐old man with a 3‐year history of hyperhidrosis presented with intermittent bilateral, burning, whitish translucent patches with excessive wrinkling of the palms. These symptoms occurred within minutes of exposure to water or sweat. He complained of pain with hand flexion during flares. Symptoms usually resolved within an hour of drying. Soles were spared. No relationship to pressure or trauma existed. He had no history of atopy, other skin disease, or family history of a similar disorder. Physical examination revealed several macerated patches in the center of the palms. After immersion in water for several minutes, the palms and lateral fingers became whitish, translucent, edematous, thickened, intensely wrinkled, and painful. There was no response to topical emollients and aluminum chloride. Biopsy revealed hyperkeratosis; the epidermis was otherwise unremarkable. Eccrine ostia were unremarkable. No significant inflammation was present. The eccrine epithelium was distinctively hyperplastic and papillated, with focal stratification. Glandular cells were enlarged with abundant, granular cytoplasm. To our knowledge, this is the first reported case of aquagenic syringeal acrokeratoderma in a male patient. All other reported cases have been in women from 9 to 33 years old. The histologic features of the present case are also unique.