Aquatic skin diseases from chemical and physical causes

Various dermatological conditions with physical and chemical causes are connected with salt- or freshwater. Aquagenic urticaria, induced simply by skin contact with the water, regardless of its physical and chemical properties, starts some minutes after the contact and resolves after about an hour: the lesions are intensely itchy and punctiform. Cold urticaria, that features skin or mucosal pomphoid lesions that develop after contact with cold water or after the ingestion of cold drinks or foods, presents under various guises: familial or acquired, immediate or delayed, localized or systemic, primitive or secondary. Aquagenic pruritus manifests during bathing or immediately after coming out of the water and lasts some minutes or hours; in many cases it is observed in patients with polycythaemia rubra vera. Prolonged immersion in seawater causes electrolytic alterations due to percutaneous absorption (“immersion syndrome”). Swimmers, hydrotherapists, physiotherapists, cleaners and swimming pool attendants present dehydration of the skin and hair because of the chlorine and bromine compounds used to disinfect the water. Both professional and amateur scuba divers are exposed to a variety of risks including skin complaints. An occupational chronic traumatic scleroedema of the hands, of various etiologies, is frequently observed in fishermen; the complaint, that can also affects the forearms, can persist for many years after abandonment of the work activity.