PMC3573775_01
Comparison of pre- and postimmersion. a Palmar side of the hands, before washing under tap water. b White, flat papules, more prominent on the right palm after water immersion. c Close-up view of palmar papules.
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PMC3573775_01_cde-0005-0021-g01.jpg
F1
At the start of the physical examination, there weren't any cutaneous lesions on the patient's palms (fig. 1a). Following a 3-min hand wash under the tap water, white, flat papules appeared on both of his palms (fig. 1b, c).
a Orthokeratosis and eccrine ducts with irregular lumina and some dilatation (arrows) (hematoxylin and eosin, original magnification x100). b Hyperplasia of eccrine glandular epithelia (arrows) (hematoxylin and eosin, original magnification x200).
cde-0005-0021-g02.jpg
PMC3573775_01_cde-0005-0021-g02.jpg
F2
Histological evaluation showed compact orthohyperkeratosis and relative dilatation of eccrine ducts in the upper dermis (fig. 2a, b). Hyperplasia of the eccrine glandular epithelia was observed in the reticular dermis, and lumina of the eccrine glands had irregular shapes (fig. 2c).