Transient reactive papulotranslucent acrokeratoderma associated with cystic fibrosis

Area of Science:

• Dermatology
• Genetics
• Internal Medicine

Background:

• Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs.
• Punctate keratodermas are a group of inherited skin conditions characterized by small, horny papules.
• Transient reactive papulotranslucent acrokeratoderma is a recently identified condition with unknown triggers.

Observation:

• A 20-year-old female with a known diagnosis of cystic fibrosis presented with a distinct palmar skin eruption.
• The eruption consisted of white papules on the palms, appearing after water exposure.
• No prior family history of keratoderma was reported in the patient.

Findings:

• Biopsy revealed hyperkeratosis (thickened skin) surrounding dilated eccrine ostia (sweat gland openings).
• The histological features were consistent with transient reactive papulotranslucent acrokeratoderma.
• This represents the first reported association between cystic fibrosis and this specific keratoderma variant.

Implications:

• The findings suggest a potential, previously undescribed association between cystic fibrosis and transient reactive papulotranslucent acrokeratoderma.
• Further research may elucidate the underlying mechanisms connecting CFTR dysfunction to this skin manifestation.
• This case expands the clinical spectrum of skin conditions associated with cystic fibrosis.