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      The first Danish family reported with an AQP5 mutation presenting diffuse non-epidermolytic palmoplantar keratoderma of Bothnian type, hyperhidrosis and frequent Corynebacterium infections: a case report

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          Abstract

          Background

          An autosomal dominant form of diffuse non-epidermolytic palmoplantar keratoderma, palmoplantar keratoderma of Bothnian type, is caused by mutations in the AQP5 gene encoding the cell-membrane water channel protein aquaporin 5 leading to defective epidermal-water-barrier function in the epidermis of the palms and soles.

          Case presentation

          We report the first Danish family diagnosed with diffuse non-epidermolytic palmoplantar keratoderma of Bothnian type in which fourteen individuals are potentially affected. The proband, a 36-year-old male had since childhood been affected by pronounced hyperhidrosis of the palms and soles along with palmoplantar keratoderma. He reported a very distinctive feature of the disorder, aquagenic wrinkling, as he developed pronounced maceration of the skin with translucent white papules and a spongy appearance following exposure to water. The patient presented recurrent fungal infections, a wellknown feature of the condition, but also periodic worsening with pitted keratolysis and malodour due to bacterial infections.

          Conclusions

          Palmoplantar keratoderma of Bothnian type, which may be associated with hyperhidrosis, is frequently complicated by fungal infections and may be complicated by Corynebacterium infections.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12895-016-0044-3) contains supplementary material, which is available to authorized users.

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          Most cited references14

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          Mutations in AQP5, encoding a water-channel protein, cause autosomal-dominant diffuse nonepidermolytic palmoplantar keratoderma.

          Autosomal-dominant diffuse nonepidermolytic palmoplantar keratoderma is characterized by the adoption of a white, spongy appearance of affected areas upon exposure to water. After exome sequencing, missense mutations were identified in AQP5, encoding water-channel protein aquaporin-5 (AQP5). Protein-structure analysis indicates that these AQP5 variants have the potential to elicit an effect on normal channel regulation. Immunofluorescence data reveal the presence of AQP5 at the plasma membrane in the stratum granulosum of both normal and affected palmar epidermis, indicating that the altered AQP5 proteins are trafficked in the normal manner. We demonstrate here a role for AQP5 in the palmoplantar epidermis and propose that the altered AQP5 proteins retain the ability to form open channels in the cell membrane and conduct water. Copyright © 2013 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
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            Palmoplantar keratodermas.

            The palmoplantar skin is a highly specialized tissue which is able to resist mechanical trauma and other physical stress. In recent years the more descriptive classification of keratodermas has switched to an exact molecular genetic view where gene functions are considered. Palmoplantar keratodermas can be separated in the following functional subgroups: disturbed gene fuctions in structural proteins (keratins), cornified envelope (loricrin, transglutaminase), cohesion (plakophilin, desmoplakin, desmoglein1), cell-to-cell communication (connexins), and transmembrane signal transduction (cathepsin C). This review intends to emphasize the typical clinical aspects and symptom complexes associated with palmoplantar keratodermas which enable the astute dermatologist to make a clinical diagnosis. In addition the molecular genetic knowledge on the topic is given which is necessary to confirm the clinical diagnosis.
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              Aquagenic (pseudo) keratoderma: a clinical series with new pathological insights.

              Aquagenic keratoderma is an uncommon condition that occurs after brief water exposure. An association with cystic fibrosis has been suggested. Histopathology is considered to be nonspecific.
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                Author and article information

                Contributors
                +45 65411973 , +45 65414875 , anne.kroeigaard@rsyd.dk
                Journal
                BMC Dermatol
                BMC Dermatol
                BMC Dermatology
                BioMed Central (London )
                1471-5945
                3 June 2016
                3 June 2016
                2016
                : 16
                : 7
                Affiliations
                [ ]Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
                [ ]Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
                [ ]Department of Clinical Pathology, Odense University Hospital, Odense, Denmark
                [ ]Centre for Cell Biology and Cutaneous Research, Blizard Institute, Bart and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
                Article
                44
                10.1186/s12895-016-0044-3
                4891830
                27255181
                1e479b85-1d97-4c0f-abc3-e6245d2f9874
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 January 2016
                : 23 May 2016
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2016

                Dermatology
                diffuse non-epidermolytic palmoplantar keratoderma,palmoplantar keratoderma of bothnian type,corynebacterium infection,aqp5 gene,aquaporin 5,“hand-in-the-bucket-sign”,aquagenic wrinkling

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