Misery L, Meyronet D, Pichon M, Brutin J-L, Pestre P, Cambazard F
Service de Dermatologie, CHU Saint-Etienne.
Ann Dermatol Venereol. 2003 Feb;130(2 Pt 1):195-8.
Aquadynia (water-related cutaneous pain) is a very rare disorder, recently described.
A 40 year-old woman suffered from aquagenic pruritus, complicated by paresthesia and pain. There was no clinical argument in favor of a psychiatric disorder, Fabry's disease or any other disease. Clinical and histological cutaneous examinations were normal. Immunohistochemical study of neurotransmitters (substance P, calcitonin gene-related peptide or CGRP, vasoactive intestinal peptide or VIP, somatostatine) did not show any modification in nerve density. However, VIP-immunoreactive epidermal cells were observed. Electromyography and study of somesthesic-evoked potentials were normal. No treatment had provided any efficacy. Clonidine and capsaicin had been prescribed with partial success.
Three other cases of aquadynia have been reported. Differential diagnoses of aquadynia are aquagenic pruritus and urticaria, hysteria or simulation, Fabry's disease, erythermalgia, peripheral neuropathy or polycythemia vera. The presence of VIP-immunoreactive cells suggests that VIP could be produced by these cells after contact with water. The effects of propanolol and clonidine on aquadynia are in favor of an adrenal component.
水性疼痛（与水相关的皮肤疼痛）是一种最近才被描述的非常罕见的病症。
一名40岁女性患有水源性瘙痒症，并伴有感觉异常和疼痛。没有临床证据支持存在精神障碍、法布里病或任何其他疾病。临床和组织学皮肤检查均正常。对神经递质（P物质、降钙素基因相关肽或CGRP、血管活性肠肽或VIP、生长抑素）的免疫组织化学研究未显示神经密度有任何改变。然而，观察到了VIP免疫反应性表皮细胞。肌电图和躯体感觉诱发电位研究均正常。没有任何治疗方法有效。曾使用可乐定和辣椒素，有部分疗效。
另外还报告了3例水性疼痛病例。水性疼痛的鉴别诊断包括水源性瘙痒症和荨麻疹、癔症或伪装、法布里病、红斑性肢痛症、周围神经病或真性红细胞增多症。VIP免疫反应性细胞的存在表明，这些细胞在接触水后可能会产生VIP。普萘洛尔和可乐定对水性疼痛的作用提示存在肾上腺因素。
