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A 24-year-old woman presented with a six-year history of a recurring, somewhat painful and pruritic palmar rash. The rash developed on either hand within minutes of exposure to water or sweating and disappeared after about an hour of drying. She arrived at the office with a bucket of water in which to submerge her hand to demonstrate the problem. Her medical history was otherwise unremarkable. Physical exam of the sodden hand revealed confluent, edematous, hypopigmented-to-translucent papules with visibly prominent ductal openings.

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