Recurrent White Papules on Her Palm

  • Sara MantiEmail author
  • Valeria Dipasquale
  • Andrea Barbalace
  • Caterina Cuppari

Practical Points

  • The “hand-in-the-bucket sign” for the diagnosis of aquagenic palmar keratoderma (APK) means that lesions appear more readily when the patients puts hands in water

  • The natural history, clinical features, and histology provide the “key points” to differentiate APK from other diagnoses

  • APK can be an alarm for underlying cystic fibrosis


Aquagenic palmar keratoderma Hand-in-the-bucket sign Cystic fibrosis 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sara Manti
    • 1
    Email author
  • Valeria Dipasquale
    • 1
  • Andrea Barbalace
    • 1
  • Caterina Cuppari
    • 1
  1. 1.Unit of Pediatric, Department of PediatricsUniversity of MessinaMessinaItaly

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