Rash – Aquagenic Wrinkling of the Palms

Aquagenic Wrinkling of the Palms (also called Acquired Aquagenic Syringeal Acrokeratoderma) is a rare condition that I occasionally encounter in both my The Woodlands dermatology and Conroe dermatology offices.  White papules occur on the palm of the hands 5-10 minutes after exposure to water and are very sharply demarcated from the rest of the skin.  A large pore can be seen in the center of the white papules.  The affected skin appears to have a macerated look as if the hands have been immersed in water for hours.  It is commonly seen in patients with Cystic Fibrosis, but can be a hereditary condition that is transmitted through autosomal dominance meaning that it does not skip generations.  Treatment is usually ineffective but Drysol (20% aluminum chloride) applied nightly to the palms typically is most effective.