Image of the Week: Wrinkling of the palms after water exposure

A 16-year-old female presents to her family physician with a 1-year history of skin changes to both palms. She describes these as transient in nature, appearing after she washes her hands, does the dishes, or takes a bath. Examination reveals pitted white papules and marked wrinkling of her palms, 5 minutes after her hands are immersed in water. Which of ...