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Finding relief for a perplexing skin condition

A young woman faced years of pain caused by swimming or showering, until two dermatologists diagnose her with aquagenic keratoderma and develop a treatment plan.

Josie's story

Josie Lopez
Josie Lopez – Sarasota, Florida
When I was 11 years old, I started having pain in my hands after swimming. I love swimming, and growing up, I would spend a lot of time with my friends at the pool. But after half an hour, the skin on my palms would turn bumpy and white, and I would have to get out of the water. I would start having an aching pain in my hands. Eventually, the pain got so bad that I couldn’t swim, and I could only bear to take very short showers. 

I didn’t know what it was or if it was contagious. I went to different physicians and described my symptoms and tried many different remedies, from exfoliating to different topical creams and even a biopsy. I thought it might be a bacterial or fungal infection, but tests said otherwise, and the pain never subsided.

At the end of high school, I met dermatologists Dr. Naomi Johansen and Dr. J.P. Galliani. They took one look at my palms and immediately knew I had aquagenic keratoderma — a very rare condition where the skin on the palms develops extreme, painful wrinkles after exposure to water.

Drs. Johannsen and Galliani worked with me to try different treatments to relieve the pain, including different barrier creams and solutions. My symptoms improved, but I still had discomfort, so we decided to try botulinum toxin injections into my palms. For the first time in seven years, I was able to swim, shower, and wash my hands without pain.

I am so grateful for Drs. Johansen and Galliani. It has truly been life-changing. Shortly after my first treatment, I was able to swim with dolphins during my family’s vacation — something I had only dreamed of doing.

The dermatologist's perspective

Jean-Pierre Galliani, MD, Dermatologist

“It’s important to really listen to patients. Even if a complaint seems odd or not life-threatening, it can really affect someone’s quality of life. I’m glad we were able to help Josie manage her condition and provide relief. ”

─ Jean-Pierre Galliani, MD Dermatologist, Dermatology Associates

Naomi Johansen, MD, Dermatologist, Dermatology Associates

“Josie’s condition is very rare; I remember learning about it in medical school grand rounds, and I didn’t think I would see the condition again. Josie has made great progress, and it’s important to share information about these rare conditions because they really impact our patients and their families”

─ Naomi Johansen, MD Dermatologist, Dermatology Associates

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