O/E: The eruption is comprised of 1 - 2 mm in diameter white papules, discrete and confluent, on the palms. We demonstrated these lesions in the office and they cleared within 10 minutes. Here feet are unaffected, by history.
Clinical Photos provided by patient: (directly after shower, and when returned to baseline.
Diagnosis: Aquagenic Wrinkling of the Palms
Question: The literature states that this is more common in people with cystic fibrosis and CF carriers. This patient has no history to suggest CF. Should genetic testing be offerred?
Reference: There are many case reports; but the Dermnet site is a great overview.
CF Genetic Testing. (from Cystic Fibrosis Foundation web site)
In the United States, the number of people who carry a CF gene mutation is about:
- 1 in 29 Caucasian-Americans
- 1 in 46 Hispanic-Americans
- 1 in 65 African-Americans
- 1 in 90 Asian-Americans