Cover Image: Aquagenic wrinkling of the palms: a clue to underlying cystic fibrosis heterozygosity

Conflicts of interest: none declared. Dear Editor, Within 2 min of water immersion, this patient developed characteristic changes of aquagenic wrinkling of the palms (AWP). A rare dermatosis, AWP is distinguished by the transient appearance of white oedematous papules and plaques amid excessive wrinkling of volar skin within minutes of water exposure. It is common in cystic fibrosis (CF),1 and is reported in 9–25% of CF carriers.2 Despite having an unremarkable family history, our patient carried the often associated delta F508 mutation in CFTR. Although not validated, the timing to symptom onset may distinguish carrier status. Given the associations, CF screening and genetic testing should be considered for all patients with AWP.