水源性肢端角化症1例

A Case of Aquagenic Acrokeratoderma

患者男,31岁,双手接触水数分钟后局部出现皮疹伴紧绷感,离开水约10min(皮肤干燥)后症状全部消退约半年。有慢性荨麻疹病史10年。皮肤科情况:双手皮肤未接触水前外观正常。用水和高渗氯化钠溶液浸泡进行"水桶征"试验:水浸泡(+);高渗氯化钠溶液浸泡(-)。取26℃水浸泡10min后诱发的右手掌尺侧缘皮损进行活检组织病理检查结果示:表皮角化过度,棘层轻度增厚,真皮汗腺分泌旺盛,部分汗管扩张。诊断:水源性肢端角化症。

A 31 -year-old man presented with six months history of whitish papules, localized tightness on the palms and lateral aspect of fingers after brief immersion in water and resolved within 10 minutes （ skin dry） after removal of the hand from water. He had chronic urticaria for ten years . ＂Hand in the bucket sign＂ tests were per- formed both in water and in hypertonic sodium chloride solution. The results showed positive in water and negative in hypertonic sodium chloride solution. A 4-mm punch biopsy specimen was taken from the margo ulnare right hand of after water immersion at 26~C for 10 minutes. Histopathology revealed hyperkeratosis and aeanthosis in the epidermis, and secretion prosperity of eccrine glands and ectasia of some sudoriferous duct in dermis. Diagnosis： Aquagenic acrokeratoderma.