Aquagenic palmar wrinkling

Again, I think we as a CF community are so fortunate to have Mandy and all of her amazing research around treatments for CF. I have learned so much from her and this post is another testament to her dedication to the lives of all CFers.

As many of you know, I have been drinking green smoothies in an attempt to get more greens in my diet - I truly eat like a crazy teenager, which I know is not good for my health. I really love the smoothies and they taste wonderful.

A benefit I didn't realize I could expect from these wonderful smoothies is my aquagenic palmar wrinkling has disappeared. It took about 4 weeks of drinking the smoothies everyday, but it worked!

Now what exactly the health consequences are of this, we aren't sure. But we do know that those with CF and those who are CFTR carriers wrinkle much faster when submerged in water.

I'll continue to keep you all posted on any other exciting changes!

Aquagenic Wrinkling Of The Palms in Cystic Fibrosis And The Cystic Fibrosis Carrier State - A Case Control Study.

Br J Dermatol. 2010 Jun 18.

Aquagenic Wrinkling Of The Palms in Cystic Fibrosis And The Cystic Fibrosis Carrier State - A Case Control Study.

Gild R, Clay C, Morey S.

Princess Alexandra Hospital, Department of Dermatology, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102, Australia.

Abstract

Abstract Background Aquagenic wrinkling of the palms is hyperwrinkling occurring within three minutes of exposure to water. It is associated with cystic fibrosis and has been reported in a cystic fibrosis carrier.

Objectives

To ascertain if aquagenic wrinkling of the palms is a sign of the cystic fibrosis carrier state and to test for an association between Cystic Fibrosis Transmembrane Regulator protein function and time to wrinkling. Patients/Methods 21 patients, 13 carriers and 15 controls were recruited. Hands were immersed in water and time to wrinkling was measured.

An analysis of variance was performed with mean time to wrinkling as the dependent variable and cystic fibrosis status as the independent variable. Patients with a time to wrinkling of less than or equal to three minutes were defined as having aquagenic wrinkling. A test of proportions was performed to assess if the proportion of patients with aquagenic wrinkling varied between groups.

Results

Mean time to wrinkling was 11 minutes in controls, 7 minutes in carriers and 2 minutes in cystic fibrosis patients. Aquagenic wrinkling of the palms was not seen in controls, but occurred in 80% of cystic fibrosis patients and 25% of carriers. There was a significant difference between groups. (p<0.0001) Conclusions The study demonstrated that aquagenic palmar wrinkling is a sign of both cystic fibrosis and the carrier state. It suggests that time to wrinkling decreases with decreased cystic fibrosis transmembrane regulator protein function. Patients presenting with aquagenic wrinkling should be offered screening for both cystic fibrosis and the carrier state.

PMID: 20560957 [PubMed - as supplied by publisher]

Arch Dermatol. 2009 Nov;145(11):1296-9.

Aquagenic wrinkling of the palms in cystic fibrosis: comparison with controls and genotype-phenotype correlations.

Berk DR, Ciliberto HM, Sweet SC, Ferkol TW, Bayliss SJ.

Department of Internal Medicine and Pediatrics, Division of Dermatology, Washington University School of Medicine and St Louis Children's Hospital, Campus Box 8123, 4921 Parkview Place, St Louis, MO 63110, USA. dberk@dom.wust.edu

OBJECTIVE: To determine the prevalence of aquagenic wrinkling of the palms (AWP) in patients with cystic fibrosis (CF) compared with control patients, and evaluate for genotype-phenotype correlations.

Since its first description over 30 years ago, AWP has frequently been anecdotally associated with CF, but this association has not been confirmed in a rigorous prospective case-control study.

DESIGN: Blinded comparison.

SETTING: The CF and dermatology clinics at St Louis Children's Hospital.

PARTICIPANTS: Forty-four individuals with CF from a CF clinic and 26 controls from a dermatology clinic. Intervention Participants were tested for AWP using 3 minutes of water immersion with room-temperature tap water.

Main Outcome Measure The degree of AWP was scored from 0 (no wrinkling) to 4 (severe wrinkling) by 3 blinded physicians. F

or genotype-phenotype correlations, patients with CF were divided into those homozygous for the DeltaF508 mutation and those with other genotypes.

RESULTS: The mean AWP score of the CF group was significantly higher than the mean score of the control group (1.5 vs 0.6; P < .001). Patients with CF who were homozygous for the DeltaF508 mutation (n = 27) had significantly higher scores than patients with CF who were not homozygous for the DeltaF508 mutation (n = 17) (1.7 vs 1.1; P = .02). The 17 patients with CF who were not homozygous for the DeltaF508 mutation still had higher scores than the control group (1.1 vs 0.6; P = .03). There was no correlation between sweat chloride concentrations measured at the time of diagnosis and AWP score.

CONCLUSIONS: Our results confirm the association between AWP and CF. Among patients with CF, greater AWP occurs in those who are homozygous for the DeltaF508 mutation.

Tobramycin-induced aquagenic wrinkling of the palms in a patient with cystic fibrosis.

Funny - I just asked my CF doc less than 5 days ago why this happens to me so quickly when I go swimming!

Tobramycin-induced aquagenic wrinkling of the palms in a patient with cystic fibrosis.

from PubMed: cystic fibrosis by Ludgate MW, Patel D, Lamb S

Related Articles

Tobramycin-induced aquagenic wrinkling of the palms in a patient with cystic fibrosis.

Clin Exp Dermatol. 2009 May 5;

Authors: Ludgate MW, Patel D, Lamb S

Summary Aquagenic wrinkling of the palms (AWP) is a rare condition, defined clinically by the appearance or accentuation of an asymmetrical, translucent to white, papular eruption on the palms after immersion in water. It is associated with cystic fibrosis (CF), and approximately half of all reported cases occur in patients with documented CF. We report a case of AWP in a young woman with CF, where the AWP was related to treatment with the aminoglycoside antibiotic, tobramycin. Although the mechanism of AWP is unknown, influx of water across an osmotic gradient into eccrine ducts has been proposed. Aminoglycosides may affect AWP by blocking various cell surface channels and receptors, which may influence cell-volume regulation.

PMID: 19438544 [PubMed - as supplied by publisher]