Aquagenic wrinkling of palm

Abstract

Aim Aquagenic Wrinkling of Palm (AWP) is an uncommon condition in Paediatric Population. The authors report a clinical case of a 14 years old girl with Idiopathic Aquagenic wrinkling of Palms. Method A Case report and Review of Literature. Results 14 year old healthy girl presented with nine month History of excessive Palmar wrinkling of hands within minutes of exposure of hands to water. There was no history of involvement of feet. Apart from wrinkling, there was swelling and tenderness that followed by development of blisters. There was also excessive shedding of skin particularly around the nail bed. These changes resolved after 30 minutes. There were no signs and symptoms suggestive of Cystic fibrosis or history of any medication. These symptoms resolved spontaneously after two months. Conclusion AWP is a rare dermatological disorder that is well recognised in young adults but rarely reported in children. The exact pathophysiology is unknown. Idipoathic cases have been reported. There is well recognised association with Cystic Fibrosis suggesting that a Chloride Channel defect may be involved. It is also known to be linked with use of COX-2 inhibitors, Salicylates and Tobramycin. Treatment varies from Water Avoidance, Topical aluminium Chloride and in extreme cases, injection of Botulinium Toxins.