Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Aquagenic wrinkling of the palms

Marian Katz and Yuval Ramot
CMAJ December 08, 2015 187 (18) E515; DOI: https://doi.org/10.1503/cmaj.150074
Marian Katz
Private practice (Katz); Department of Dermatology (Ramot), Hadassah — Hebrew University Medical Center, Jerusalem, Israel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Yuval Ramot
Private practice (Katz); Department of Dermatology (Ramot), Hadassah — Hebrew University Medical Center, Jerusalem, Israel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: yramot@hadassah.org.il
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

A healthy 23-year-old woman presented with a six-month history of white lesions on her palms. The lesions would swell after being in water for 15 minutes and return to baseline 10–15 minutes after drying. The patient did not take medications except for oral contraceptive pills, and she was not aware of a family history of similar complaints. Physical examination showed white, slightly translucent papules on her palms (Figure 1A), which became swollen and edematous after a short period of water contact, accompanied by excessive wrinkling of the palms (Figure 1B). We diagnosed aquagenic wrinkling of the palms. Genetic testing showed a heterozygous mutation (ΔF508) in the cystic fibrosis transmembrane conductance regulator gene (CFTR).

Figure 1:
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1:

(A) White, slightly translucent papules on the left palm of a 23-year-old woman. (B) The papules became enlarged and edematous after a brief immersion in water, with excess wrinkling of the skin.

Aquagenic wrinkling of the palms is a rare disorder characterized by the appearance of papules and wrinkling of the palms after contact with water.1 The lesions may be accompanied by pruritus or a burning sensation and typically disappear 10–60 minutes after drying. Hot water hastens their appearance. The condition has been linked to several disorders, including focal hyperhidrosis, atopic dermatitis and Raynaud phenomenon, and to the use of COX-2 inhibitors.2 The strongest association is with cystic fibrosis, an autosomal recessive disease caused by mutations in CFTR. Aquagenic wrinkling of the palms is considered a clinical sign of cystic fibrosis and is seen in as many as 80% of people with the disease.2,3 It has also been reported in people who are cystic fibrosis carriers, although the sign takes longer to manifest following water immersion in this population.4 Genetic testing should be performed in patients who present with aquagenic wrinkling of the palms.

Acknowledgement

The authors thank Prof. Abraham Zlotogorski for his valuable advice and help in the preparation of this manuscript.

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

  • The authors have obtained patient consent.

References

  1. ↵
    1. Weibel L,
    2. Soinas R
    . Aquagenic wrinkling of palms in cystic fibrosis. N Engl J Med 2012;366:e32.
    OpenUrlCrossRefPubMed
  2. ↵
    1. Arkin LM,
    2. Flory JH,
    3. Shin DB,
    4. et al
    . High prevalence of aquagenic wrinkling of the palms in patients with cystic fibrosis and association with measurable increases in transepidermal water loss. Pediatr Dermatol 2012;29:560–6.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Garçon-Michel N,
    2. Roguedas-Contios AM,
    3. Rault G,
    4. et al
    . Frequency of aquagenic palmoplantar keratoderma in cystic fibrosis: A new sign of cystic fibrosis? Br J Dermatol 2010;163:162–6.
    OpenUrlPubMed
  4. ↵
    1. Gild R,
    2. Clay CD,
    3. Morey S
    . Aquagenic wrinkling of the palms in cystic fibrosis and the cystic fibrosis carrier state: a case–control study. Br J Dermatol 2010;163:1082–4.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 187 (18)
CMAJ
Vol. 187, Issue 18
8 Dec 2015
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Aquagenic wrinkling of the palms
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Aquagenic wrinkling of the palms
Marian Katz, Yuval Ramot
CMAJ Dec 2015, 187 (18) E515; DOI: 10.1503/cmaj.150074

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Aquagenic wrinkling of the palms
Marian Katz, Yuval Ramot
CMAJ Dec 2015, 187 (18) E515; DOI: 10.1503/cmaj.150074
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Acknowledgement
    • Footnotes
    • References
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Chronic cutaneous ulcer from drug use
  • A low-barrier, flexible safe supply program to prevent deaths from overdose
  • Digital gangrene in a woman with scleroderma
Show more Practice

Similar Articles

Collections

  • Sections
    • Clinical Images
  • Topics
    • Dermatology
    • Genetics

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2022, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire