Background: Aquagenic wrinkling of the palms (AWP) is a rare condition characterised by the development of oedema and excessive wrinkling of the palms following exposure to water. It has frequently been associated with cystic fibrosis (CF). Early reports of AWP have only been case reports or small case series; there has only been one reported prevalence study of AWP in a CF population. Objective: To determine the incidence and characteristics of AWP in the adult CF population in Northern Ireland. Methods: 105 CF patients were interviewed. The patients were asked whether they noticed excess wrinkling of the hands when exposed to water. If they answered ‘yes’, further questions were asked regarding clinical characteristics. The atopic status, CF genotype and drug history were recorded for each patient. Formal testing of 7 patients was carried out. Results: Out of the 105 patients who were interviewed, 43 (41%) described AWP. Of the 43 patients with AWP, 20 were male and 23 were female. There was no association of AWP with genotype, atopy or concomitant drug intake. Conclusion: AWP appears to have an equal sex incidence, and the high number of cases in the population studied would suggest that this condition is underreported.

1.
Yan AC, Aasi SZ, Alms WJ, James WD, Heymann WR, Paller AS, Honig PJ: Aquagenic palmoplantar keratoderma. J Am Acad Dermatol 2001;44:696–699.
2.
Elliott RB: Wrinkling of skin in cystic fibrosis. Lancet 1974;ii:108.
3.
Katz KA, Yan AC, Turner ML: Aquagenic wrinkling of the palms in patients with cystic fibrosis homozygous for the ΔF508 mutation. Arch Dermatol 2005;141:621–624.
4.
Neri I, Bianchi F, Patrizi A: Transient aquagenic palmar hyperwrinkling: the first instance reported in a young boy. Pediatr Dermatol 2006;23:39–42.
5.
Lim KS, Ng SK: Aquagenic wrinkling of the palms in a boy with a congenital cardiac anomaly. J Eur Acad Dermatol Venereol 2007;21:985–986.
6.
Berk DR, Ciliberto HM, Sweet SC, Ferkol TW, Bayliss SJ: Aquagenic wrinkling of the palms in cystic fibrosis. Arch Dermatol 2009;145:1296–1299.
7.
Garcon-Michel N, Roguedas-Contios AM, Rault G, Le Bihan J, Ramel S, Revert K, Dirou A, Misery L. Frequency of aquagenic palmoplantar keratoderma in cystic fibrosis: a new sign of cystic fibrosis? Br J Dermatol 2010;163:162–166.
8.
Lowes MA, Khaira GS, Holt D: Transient reactive papulotranslucent acrokeratoderma associated with cystic fibrosis. Australas J Dermatol 2000;41:172–174.
9.
English JC, McCollough ML: Transient reactive papulotranslucent acrokeratoderma. J Am Acad Dermatol 1996;34:686–687.
10.
Itin PH, Lautenschlager S: Aquagenic syringeal acrokeratoderma (transient reactive papulotranslucent acrokeratoderma). Dermatology 2002;204:8–11.
11.
Betlloch I, Vergara G, Albares MP, Pascual J-C, Silvestre J-F, Botella R: Aquagenic keratoderma. J Eur Acad Dermatol Venereol 2003;17:306–307.
12.
MacCormack MA, Wiss K, Malhotra R: Aquagenic syringeal acrokeratoderma: report of two teenage cases. J Am Acad Dermatol 2001;45:124–126.
13.
Johns MK: Skin wrinkling in cystic fibrosis. Med Biol Ilus 1975;25:205–210.
14.
Carder KR, Weston WL: Rofecoxib-induced instant aquagenic wrinkling of the palms. Pediatr Dermatol 2002;19:353–355.
15.
Vildosola S, Ugalde A: Celecoxib-induced aquagenic keratoderma. Actas Dermosifiliogr 2005;96:537–539.
16.
Khuu PT, Duncan KO, Kwan A, Hoyme HE, Bruckner AL: Unilateral aquagenic wrinkling of the palms associated with aspirin intake. Arch Dermatol 2006;142:1661–1662.
17.
Ludgate MW, Patel DC, Lamb SR: Tobramycin induced aquagenic wrinkling of the palms. J Am Acad Dermatol 2006;54:AB61.
18.
Onwukwe MF, Mihm MC, Toda K: Hereditary papulotranslucent acrokeratoderma. Arch Dermatol 1973;108:108–110.
19.
Higashi Y, Kanekura T, Kanzaki T: Enhanced expression of cyclooxygenase (COX)-2 in human skin epidermal cancer cells: evidence for growth suppression by inhibiting COX-2 expression. Int J Cancer 2000;86:667–671.
20.
Leong J, Hughes-Fulford M, Rakhlin N, Habib A, Maclouf J, Goldyne ME: Cyclooxygenases in human and mouse skin and cultured keratinocytes: association of COX-2 expression with human keratinocyte differentiation. Exp Cell Res 1996;224:79–87.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.