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Aquagenic Wrinkling Syndrome involving forehead: An unusual presentation
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Clinical ImageA 34 yr old male† was referred to the department of Dermatology, Dr. Ram Manohar Lohia Hospital, New Delhi, India, in January 2016, with recurrent eruption of wrinkled whitish, erythematous sodden plaques over the forehead and both palms which aggravated following excessive sweating, for the past 2-3 years (Figure). He had no relevant medical or family history of any systemic disorders. A diagnosis of aquagenic wrinkling was made. The patient was administered oxybutynin 2.5 mg twice a day with topical aluminium hydroxide solution, a substantial improvement was observed in the disorder within two weeks, with sustained results observed over six months follow up. Aquagenic wrinkling is characterized by the formation of white papules and plaques on the palms and fingers within three minutes of water exposure, which is an accentuation of the normal response to water immersion-associated wrinkling. This uncommon disorder is rarely seen on the face and is often not treated properly. Knowledge of such a presentation is useful for proper patient management.
- Wrinkled whitish (arrow)-to-erythematous sodden plaques over the forehead, which aggravated following excessive sweating.
