What Is Aquagenic Pruritus?

Water-borne pruritus (AP) is a skin disease that is caused by contact with water and is characterized by severe itching and no skin lesions. It can be considered as another special type of systemic pruritus. The disease was recognized as an independent disease in 1981, but clinically, it is not uncommon.

Water pruritus

Water-borne pruritus (AP) is a skin disease that is caused by contact with water and is characterized by severe itching and no skin lesions. It can be considered as another special type of systemic pruritus. The disease was recognized as an independent disease in 1981, but clinically, it is not uncommon.

On February 21, 2014, the British "Daily Mail" disclosed that a woman in the United Kingdom suffered from a rare illness-water allergy. As soon as she touched the water droplets, her skin felt like a fire. Because of his sensitivity to saliva, Prince couldn't kiss his fiance.

The report states that as of February 2014, only 35 people worldwide had the disease. ^[1]

The characteristics of the disease are:

After contact with water (immersion, shower or swimming), severe unbearable itching occurs in the skin in contact with the water for several minutes or ten minutes after stopping contact with the water, and there is a needle tingling or burning sensation. Onset, and soon spread to the upper limbs, chest and whole body, ranging from 10 minutes to several hours. But there was no visible change in the skin.

Most of them are related to the temperature and nature of the water (natural water, tap water or sea water), and have nothing to do with the season.

It can occur at any age, but it is mostly young and middle-aged. Males are slightly more common than females, but there is no significant difference in the age of men and women. About one-third of patients have a family history, and symptoms often persist, but some patients can stop for months.

The patient is generally in good condition. The urine and whole blood counts and blood chemistry tests are in the normal range, without all kinds of physical urticaria (water contact, cholinergic, cold, heat, stress and artificial). Urticaria, etc.). Although itching occurs in some patients after exposure to water, it is not necessarily caused by water itself, especially for patients with physical urticaria. For example, the temperature of the water during bathing, the irritation of the towel, and the friction of the towel can cause itching of the skin; the artificial urticaria (skin scratch sign) caused by the strong spray of the shower, and the water is only a tool for transmitting mechanical forces, not really Pathogenic factors. There are no other pruritic skin diseases and systemic diseases, but it can be accompanied by neuropsychiatric manifestations. About 55% of patients are prone to agitation, fever attack, or depression. This kind of pruritus and emotional changes without skin changes can easily be considered by the family members or even medical staff as mental or neurological abnormalities, and then increase the patient's mental burden. Therefore, it is very important to diagnose the disease.

Seasonal pruritus

The pruritus of some patients may be exacerbated by the season, which is called seasonal water-borne pruritus. Aggravation has been reported in all seasons, and some only occur in summer or autumn.

Senile pruritus

75% of women suffer from water-borne pruritus in the elderly. Itching usually lasts 10-20 minutes, but can also last up to 1 hour or longer. The degree of itching increases with age and is directly proportional to dry skin, which is more severe in winter. Heat, exercise, and mood swings have no effect on the disease. The test showed that the intensity and duration of itching after contact with water increased with the increase of water temperature and time; the patient was asymptomatic when immersed in water, and once the skin on the body was dry, itching appeared and quickly intensified; Air drying is more likely to cause itching than towel drying.

Polycythemia vera watery pruritus

Another type of erythrocytosis water-borne pruritus is associated with sudden temperature changes, especially cold skin, accompanied by erythrocytosis, and may have varying degrees of iron deficiency. Itching occurs within a few minutes after exposure to water, and lasts 15 to 60 minutes. Undressing and sweating can also cause itching. Itching often occurs 1 to several years before the diagnosis of polycythemia vera is diagnosed.

The pathogenesis of water-borne pruritus may be that the hydration of the stratum corneum causes transdermal absorption of substances, leading to the release of acetylcholine from nerve endings, which in turn promotes the release of histamine or other transmitters from mast cells, and eventually triggers itching.

Regarding the treatment of water-borne pruritus, there is currently no completely effective method. Antihistamines, ultraviolet radiation, and sunbathing are all unsatisfactory. Adding sodium bicarbonate to water or bathing in mineral water is a safe, economical, and effective method.

For senile water-borne pruritus, systemic application of antihistamines, sedatives, or hypnotics is not only ineffective, but it can make itching worse in some patients. Topical glucocorticoids and ultraviolet radiation cannot alleviate symptoms. The key to treatment is to improve skin dryness. External lubricants: such as vaseline or water-in-oil emulsions can be applied immediately after bathing to prevent itching. For watery pruritus of erythrocytosis, iron supplementation can reduce symptoms, and antihistamines have some effect, but the most effective method is oral aspirin. For prevention, patients with this disease can take a short bath with a sponge, do not soak for a long time, avoid contact with some potentially irritating substances, such as soap, detergent, etc., and avoid long-term application of glucocorticoid preparations and drugs that increase skin moisture content ( Such as salicylic acid, 5% salicylic acid, 20% urea, 2.5% crude coal tar, 20% propylene glycol, etc.) Although these drugs may be effective within a few weeks after use, most patients will eventually get worse after long-term application Itching.

In February 2014, the British "Daily Mail" reported that a woman (Prince) in the United Kingdom suffered from a rare condition "allergic to water". The symptom is that as soon as she touches the water droplets, the skin is like a fire. The patient is also sensitive to saliva, so he cannot kiss his fiance.

Prince, a 26-year-old woman from Derbyshire, United Kingdom, suffers from the rare "water-borne pruritus". From the age of 12, she found she was allergic to water, and even a single drop of water would make her skin irritated for several hours. Prince said water allergies felt like they were on fire. Even her own sweat and tears can make her allergic.

Prince cannot go out on a rainy day. He will always watch the weather forecast before going out. He always has a hat, coat and umbrella. Prince should also not drink cold water, because it would make her throat red and swollen. But Prince said she felt okay with drinks such as juice. ^[1]