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JAMA Dermatology Clinicopathological Challenge
March 23, 2022

Excessive Wrinkling on the Dorsum of the Hands and Wrists

Author Affiliations
  • 1Department of Dermatology, the First Hospital of China Medical University, Shenyang, China
JAMA Dermatol. 2022;158(5):577-578. doi:10.1001/jamadermatol.2022.0374

An otherwise healthy man in his 20s presented to the dermatology department with thickening and swelling of hands after immersion in water, accompanied by burning pruritus for 3 years. The lesions occurred as symmetrical white and transparent papules, white keratosis, excessive wrinkling on the dorsum of hands after water immersion and worsened in summer, and remitted in winter. He was treated with topical tretinoin ointment intermittently per a diagnosis of chronic eczema at the local clinic with little improvement. The lesions gradually aggravated, and the affected area dispersed to wrists and elbows during past the 1.5 years. He attributed these changes to the need for washing hands frequently in the period of the COVID-19 epidemic. He had no family history of similar skin problems and did not have a history of hyperhidrosis, cystic fibrosis, atopy, or trauma to the hands.

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