RESUMO O objetivo deste artigo é analisar as duas leis monetárias mais importantes que têm sido implementadas em El Salvador, nomeadamente a Lei de Integração Monetária (MIL) e a Lei Bitcoin. Serão analisados os artigos mais importantes de ambas as leis, bem como as consequências da dolarização, e as possíveis vantagens e riscos associados à adopção da moeda de curso legal Bitcoin. Embora esta medida possa ter alguns aspectos positivos ao encorajar a inovação financeira e facilitar as remessas, o risco macroeconómico é muito elevado devido à volatilidade desta moeda criptográfica. Até agora não foram alcançados resultados positivos, uma vez que a aceitação tem sido muito baixa e tem havido uma depreciação do ativo nos últimos meses. Salvador MIL (MIL Bitcoin dolarização remessas criptográfica meses

ABSTRACT The objective of this article is to analyze the two most important monetary laws that have been implemented in El Salvador, namely the Monetary Integration Law (MIL) and the Bitcoin Law. The most important articles of both laws will be analyzed, as well as the consequences of dollarization, and the possible advantages and risks associated with the adoption of Bitcoin as legal tender. Although this measure may have some positive aspects by encouraging financial innovation and facilitating remittances, the macroeconomic risk is very high due to the volatility of this cryptocurrency. So far no positive results have been achieved as the acceptance has been very low and there has been a depreciation of the asset in recent months. Salvador MIL (MIL analyzed dollarization tender remittances cryptocurrency months

Abstract: Seeds of the genus Eugenia have high regenerative capacity, producing roots and shoots from seeds with reduced cotyledon matter. In addition, seeds of this genus regenerate new roots and shoots when the first roots and shoots are eliminated, and this characteristic is maintained even when the seed reserves are reduced by up to half. The aim of this study was to analyze the limits of new root and shoot regenerative capacity in whole and fractionated Eugenia candolleana seeds at different maturity stages. The regenerative capacity of seeds stored for six months was also evaluated. The seeds were sown; and when the first roots and shoots were produced, they were eliminated, simulating herbivory conditions. The results showed that the seed not only has high regenerative capacity at different maturity stages, but also that it maintains root regeneration when the seed is reduced by half, even after the storage period. Such information may indicate that seeds of the Eugenia genus can await the next crop season by regenerating several times as a way to withstand or tolerate predation. This ability can be understood as a propagation strategy of the species.

Resumo: Sementes do gênero Eugenia apresentam alta capacidade regenerativa, produzindo raízes e partes aéreas a partir de sementes que tiveram redução da massa cotiledonar. Também, foi observado, para sementes deste gênero, a regeneração de novas raízes e partes aéreas, quando as primeiras raízes e partes aéreas são eliminadas, ainda, tal característica se mantém quando a semente teve suas reservas reduzidas pela metade. Este estudo teve como objetivo analisar os limites das regenerações de novas raízes e partes aéreas em sementes inteiras e fracionadas de Eugenia candolleana, em diferentes estádios de maturação. Avaliou-se também, a capacidade regenerativa em sementes armazenadas por seis meses. As sementes foram semeadas e quando emitiram as primeiras raízes e partes aéreas, estas foram eliminadas, simulando uma condição de herbivoria. Os resultados mostraram que, além de apresentar alta capacidade regenerativa em diferentes estádios de maturação, a semente reduzida pela metade, a regeneração de raízes se manteve, inclusive após o período de armazenamento, tais informações podem indicar que sementes do gênero Eugenia são capazes de aguardar a próxima safra regenerando diversas vezes, como maneira de suportar ou tolerar a predação. Essa habilidade pode ser entendida como estratégia de propagação da espécie.

Resumen Antecedentes: El tratamiento del traumatismo esplénico se basa en medidas conservadoras no quirúrgicas o en el uso de radiología intervencionista. La cirugía conservadora del bazo en el traumatismo esplénico sigue siendo inusual. Objetivo: El análisis de seguridad y eficacia del tratamiento quirurgico conservador en el traumatismo esplénico. Método: Se realizó un estudio retrospectivo durante un período de 16 años con la intención de registrar la actitud diagnóstica y terapéutica en un hospital de segundo nivel, enfocándose en los pacientes que recibieron tratamiento quirúrgico conservador esplénico por traumatismo esplénico, excluyendo esplenectomías y tratamientos no quirúrgicos. Resultados: 110 pacientes presentaron traumatismo esplénico. La cirugía conservadora esplénica se realizó en 15 pacientes. Los grados de lesiones esplénicas fueron: 1 paciente con grado I, 1 paciente con grado II, 7 pacientes con grado III y 6 pacientes con grado IV. El tratamiento quirúrgico fue esplenorrafia en 5 pacientes (33%), agentes hemostáticos y malla de ácido poliglicólico en 4 (26%), esplenectomía parcial con colocación de malla de ácido poliglicólico en 3 (20%), esplenectomía parcial en 2 (13%) y hemostasia con electrocauterio en 1 (6%). Ninguno de los pacientes tratados inicialmente con cirugía conservadora requirió esplenectomía posterior y ningún paciente falleció. Conclusiones: La cirugía conservadora esplénica puede ser útil y segura en traumatismos esplénicos, la cual tendría su lugar en traumatismos de grados II, III y IV en centros hospitalarios en los que no se cuente con radiología intervencionista urgente.

Abstract Background: Treatment of splenic trauma is currently based on non-surgical treatment or the use of interventional radiology. The conservative surgery of the spleen in splenic trauma remains marginal. Objective: To analyze the safety and efficacy of conservative surgical treatment in splenic trauma. Method: A retrospective study was performed over a 16-year period with the intention of recording the diagnostic and therapeutic attitude in a second level hospital, focusing on patients who received conservative splenic surgical treatment for splenic trauma, excluding splenectomies and non-surgical treatment. Results: 110 patients presented splenic trauma. Spleen-sparing surgery was performed in 15 patients. The grades of splenic lesions were: 1 patient with grade I, 1 patient with grade II, 7 patients with grade III and 6 patients with grade IV. Surgical treatment was splenorrhaphy in 5 patients (33%), hemostatic agents and polyglycolic acid mesh in 4 (26%), partial splenectomy with placement of polyglycolic acid mesh in 3 (20%), partial splenectomy in 2 (13%), and electrocautery in 1 (6%). None of the patients initially treated with conservative surgery required posterior splenectomy and no patient died. Conclusion: We provide evidence supporting the usefulness and safety of conservative splenic surgery in splenic trauma, which would have its place in grades II, III and IV trauma in health centers that do not have urgent interventional radiology.

Resumen Antecedentes: El trastorno de déficit de atención e hiperactividad (TDAH) constituye una condición crónica con riesgos asociados a largo plazo. Objetivo: Analizar el estado clínico, la ocupación y las dificultades de la vida diaria de dos cohortes de niños con diagnóstico de TDAH (2004 y 2009) después cinco y 10 años. Material y método: Estudio descriptivo y longitudinal de la base de datos WOMI correspondiente a Oviedo, Asturias, España. Se incluyeron niños detectados con TDAH por su pediatra de atención primaria. Se solicitó una entrevista telefónica voluntaria de seguimiento. Las variables de resultado fueron estado clínico y ocupacional al momento de la entrevista, síntomas de TDAH según SNAP-IV y Cuestionario de Fortalezas y Dificultades (SDQ). Resultados: La muestra entrevistada estuvo formada por 95 sujetos, de los cuales 71 respondieron a los cuestionarios SNAP-IV y SDQ; 60.7 % de la muestra no recibía tratamiento en el momento del seguimiento, 4.7 % no tenía ninguna ocupación, 25.4 % mantenía síntomas globales de TDAH en nivel superior al punto de corte clínico y 66.2 % presentaba dificultades con interferencia moderada. Conclusiones: Los síntomas del TDAH disminuyen conforme las personas crecen. Las comorbilidades de salud mental y el abandono académico no se confirmaron en la muestra.

Abstract Background: Attention deficit/hyperactivity disorder (ADHD) is a chronic condition with long-term associated risks. Objective: To analyze the clinical status, occupation, and daily life difficulties of two cohorts of children diagnosed with ADHD (2004 and 2009) after five and 10 years. Material and method: Descriptive, longitudinal study using the WOMI database corresponding to Oviedo, Asturias, Spain. Children with ADHD detected by their primary care pediatrician were included. A voluntary follow-up telephone interview was requested. Outcome variables were current clinical and occupational status, ADHD symptoms according to SNAP-IV, and Strengths and Difficulties Questionnaire (SDQ). Results: The interviewed sample consisted of 95 subjects, out of whom 71 answered the SNAP-IV and SDQ questionnaires; 60.70% of the sample did not receive treatment at the time of follow-up, 4.7% had no occupation, 25.40% still had ADHD global symptoms above the clinical cutoff point, and 66.2% had difficulties with moderate interference. Conclusions: ADHD symptoms decline as people grow up. Mental health comorbidities and academic dropout were not confirmed in the sample.

Resumen El síndrome de Mayer-Rokitansky-Küster-Hauser (SMRKH) es una anomalía del tracto genital femenino caracterizada por ausencia congénita del útero y porción superior de la vagina. Ocurre en uno de cada 4,500 nacimientos y se diagnostica normalmente durante la adolescencia al presentarse amenorrea primaria. Su función ovárica está preservada, pero la información actual respecto al potencial reproductivo de estas pacientes es limitada. Se presenta el caso de una mujer con diagnóstico de SMRKH sometida a estimulación ovárica para transferencia de embriones a útero subrogado y se discute su potencial reproductivo: técnicas de reproducción asistida, intervenciones e impacto psicológico.

Abstract Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a congenital anomaly of the female genital tract characterized by congenital absence of the uterus and upper part of the vagina. It occurs in 4,500 female births and diagnosis is usually made during adolescence when primary amenorrhea presents. They have functioning ovaries but data regarding their reproductive potential is limited. We hereby report the case of a woman diagnosed with MRKH syndrome in whom assisted reproductive techniques were used to try to achieve pregnancy by gestational surrogacy and their reproductive potential is discussed: assisted reproductive techniques, procedures, and psychological impact.

Abstract Background Knowledge about regulating transcription factors (TFs) for osteoblastogenesis from mesenchymal stem cells (MSCs) is limited. Therefore, we investigated the relationship between genomic regions subject to DNA-methylation changes during osteoblastogenesis and the TFs known to directly interact with these regulatory regions. Results The genome-wide DNA-methylation signature of MSCs differentiated to osteoblasts and adipocytes was determined using the Illumina HumanMethylation450 BeadChip array. During adipogenesis no CpGs passed our test for significant methylation changes. Oppositely, during osteoblastogenesis we identified 2462 differently significantly methylated CpGs (adj. p < 0.05). These resided outside of CpGs islands and were significantly enriched in enhancer regions. We confirmed the correlation between DNA-methylation and gene expression. Accordingly, we developed a bioinformatic tool to analyse differentially methylated regions and the TFs interacting with them. By overlaying our osteoblastogenesis differentially methylated regions with ENCODE TF ChIP-seq data we obtained a set of candidate TFs associated to DNA-methylation changes. Among them, ZEB1 TF was highly related with DNA-methylation. Using RNA interference, we confirmed that ZEB1, and ZEB2, played a key role in adipogenesis and osteoblastogenesis processes. For clinical relevance, ZEB1 mRNA expression in human bone samples was evaluated. This expression positively correlated with weight, body mass index, and PPARγ expression. Conclusions In this work we describe an osteoblastogenesis-associated DNA-methylation profile and, using these data, validate a novel computational tool to identify key TFs associated to age-related disease processes. By means of this tool we identified and confirmed ZEB TFs as mediators involved in the MSCs differentiation to osteoblasts and adipocytes, and obesity-related bone adiposity.

Abstract Solid dispersions (SDs) of ursolic acid (UA) were developed using polyvinylpyrrolidone K30 (PVP K30) in combination with non-ionic surfactants, such as D-α-tocopherol polyethylene glycol 1000 succinate (TPGS) or poloxamer 407 (P407) with the aim of enhancing solubility and in vitro release of the UA. SDs were investigated using a 24 full factorial design, subsequently the selected formulations were characterized for water solubility, X-ray diffractometry (XRD), differential scanning calorimetry (DSC), particle diameter, scanning electron microscopy, drug content, physical-chemical stability and in vitro release profile. SDs showed higher UA water-solubility than physical mixtures (PMs), which was attributed by transition of the drug from crystalline to amorphous or molecular state in the SDs, as indicated by XRD and DSC analyses. SD1 (with P407) and SD2 (with TPGS) were chosen for further investigation because they had higher drug load. SD1 proved to be more stable than SD2, revealing that P407 contributed to ensure the stability of the UA. Furthermore, SD1 and SD2 increased UA release by diffusion and swelling-controlled transport, following the Weibull model. Thus, solid dispersions obtained with PVP k-30 and P407 proved to be advantageous to enhance aqueous solubility and stability of UA.

Antecedentes: Los índices simples subrogados (ISS) que evalúan la función de célula beta, sensibilidad a la insulina (SI) y resistencia a la insulina (RI) son herramientas sencillas y económicas que se usan en la práctica clínica para identificar alteraciones del metabolismo de la glucosa. Objetivo: Evaluar la validez y confiabilidad de ISS para estimar la función de célula beta, SI y RI usando como referencia los parámetros de la prueba de tolerancia a la glucosa intravenosa con muestreo frecuente (FSIVGTT). Material y Métodos: Se incluyeron 62 sujetos de 20-45 años, con índice de masa corporal normal y sin diabetes mellitus o prediabetes. Los ISS se compararon con la respuesta aguda de la insulina a la glucosa (AIRg), índice de sensibilidad a la insulina (Si) e índice de disposición (DI) obtenidos de la FSIVGTT en base al modelo mínimo. La mitad de los participantes (n = 31) se seleccionaron aleatoriamente para acudir dos semanas después y evaluar la confiabilidad de todas las variables. Resultados: HOMA1-%B y HOMA2-%B presentaron una correlación significativa con AIRg (Rho de Spearman (rs) = 0,33 and 0,37, respectivamente, p < 0,01). Los ISS para evaluar SI/RI que mostraron mayor correlación (rs > 0,50) con Si fueron insulina en ayuno, HOMA1-IR, HOMA2-IR, HOMA1-%S, HOMA2-%S, QUICKI y el índice de McAuley. Los parámetros que tuvieron buena confiabilidad (coeficiente de correlación intraclase > 0,75) fueron AIRg, HOMA1-%S, HOMA2-%S y QUICKI. Conclusiones: La mayoría de los ISS son instrumentos útiles y confiables.

ABSTRACT Background: Simple surrogate indexes (SSI) to assess beta-cell function, insulin sensitivity (IS) and insulin resistance (IR) are an easy and economic tool used in clinical practice to identify glucose metabolism disturbances. Aim: To evaluate the validity and reliability of SSI that estimate beta-cell function, IS and IR using as a reference the parameters obtained from the frequently sampled intravenous glucose tolerance test (FSIVGTT). Material and Methods: We included 62 subjects aged 20-45 years, with a normal body mass index and without diabetes or prediabetes. SSI were compared with the acute insulin response to glucose (AIRg), insulin sensitivity index (Si) and disposition index (DI) obtained from the FSIVGTT using the minimal model approach. Half of the participants (n = 31) were randomly selected for a second visit two weeks later to evaluate the reliability of all the variables. Results: HOMA1-%B and HOMA2-%B had a significant correlation with AIRg (Spearman Rho (rs) = 0.33 and 0.37 respectively, p < 0.01). The SSI evaluating IS/IR that showed stronger correlation (rs > 0.50) with Si were fasting insulin, HOMA1-IR, HOMA2-IR, HOMA1-%S, HOMA2-%S, QUICKI, and the McAuley index. The parameters that showed good reliability with an intraclass correlation coefficient (ICC) > 0.75 were AIRg, HOMA1-%S, HOMA2-%S, and QUICKI. Conclusions: Our results suggest that most of the SSI are useful and reliable.

Abstract Objective: Several bariatric surgeries have been related to the T2DM improvement in obese patients. Despite the different mechanism invoked for this improvement, many evidences showed that the pancreas cellularity is conditioned for the homeostatic physiological changes after these surgeries. Many authors reported the changes in beta-cell mass after some surgeries in healthy rats. We purpose to analyze the changes in β-cell cellularity and β-cell-mass after a severe malabsorptive surgical method. Thus, we studied several parameters of the islet morphometric composition after a massive jejunal resection. Materials and methods: We employed Goto-Kakizaki diabetic non-obese rats, which underwent the 50% resection of middle portion of the jejunum versus a control group. After 3 months, rats were sacrificed and pancreas was immunohistochemicaly studied. Results: The β-cell mass was analyzed and several parameters about the endocrine islet size distribution were studied. We report an increase of β-cell mass in massive resection surgical group versus controls. The islet distribution was significant different between both groups. Endocrine islets of surgical group were bigger with a different cellular distribution. Conclusion: According to the enteroendocrine changes related to surgeries in jejunum, as in other gastrointestinal portions, the cellularity of islets changes as an adaptive process to glycemic demands.

Resumen Objetivo: Varias técnicas quirúrgicas bariátricas han sido relacionadas con el mejoramiento de la T2DM en pacientes obesos. Se han invocado distintos mecanismos de porqué se da este mejoramiento y muchas evidencias apuntan a que la celularidad del páncreas cambia por las condiciones fisiológicas tras estas cirugías. Se han publicado cambios en la celularidad beta en ratas sanas sometidas a estos procesos. Y nos proponemos observar dichos cambios en ratas diabéticas tras una resección jejunal masiva. Estudiamos varios parámetros sobre la masa beta y la morfometría de los islotes, que indiquen los procesos celulares que han tenido lugar. Material y metodo: Empleamos Goto-Kakizaki, un modelo de rata diabética no obesa, a la que se sometió a una resección del 50%de la poción media del yeyuno. Tras tres meses de supervivencia, las ratas se estudiaron los páncreas mediante inmunocitoquímica. Resultados: Mostramos un incremento de la masa beta en las ratas resecadas frente a los controles. La distribución de islotes fue significativamente distinta entre los grupos, donde los islotes eran mayores en las ratas diabéticas. Conclusión: Los cambios glucémicos tras las resecciones masivas yeyunales cambian la celularidad del páncreas como una muestra de la capacidad adaptativa del mismo a las modificaciones.

Background: Medical students are especially prone to anxiety and depression. Aim: To characterize the presence of anxiety and depression and their association with gender and academic year among medical students. Material and Methods: Standardized electronic surveys about anxiety and depression symptoms were sent to 498 medical students with a response rate of 78%. Results: We analyzed 359 surveys. A mean of 11.4 points out of 27 was observed in the depression symptoms scale. Also, 23 and 10% of respondents had moderately severe or symptoms of depression, respectively. A mean of 8.9 out of 21 points in the anxiety symptoms scale was observed. Moderate or severe anxiety symptoms were present in 26 and 15% of respondents, respectively. Women and preclinical students had higher depression and anxiety scores. Conclusions: A high presence of anxiety and depression symptoms was characterized among medical students during the pandemic. Preclinical students and women had higher scores in both scales.

Abstract Background. A brain-machine interface (BMI) is a device or experimental setup that receives a brain signal, classifies it and then uses it as a computer command. There is not a consensus on which kind of learning methodology (deep learning, convolutional networks, AI, etc.) and/or type of algorithms in each methodology, are best to run BMI’s. Objective. The aim of this work was to build a low-cost, portable, easy-to-use and a reliable Motor Imagery Electro-encephalography (EEG-MI) based BMI; comparing different algorithms to find the one that best satisfies such conditions. Methods. In this study, motor imagery (MI) EEG signals, from both PhysioNet public data and our own laboratory data obtained using an Emotiv headset, were classified with four machine learning algorithms. These algorithms were: Common spatial patterns (CSP) combined with linear discriminant analysis (LDA), Deep neural network (DNN), convolutional neural network (CNN) and finally Riemannian minimum distance to mean (RMDM). Results. The mean accuracy for each method was 78%, 66%, 60% and 80% respectively. The best results were obtained for the baseline vs Motor Imagery (MI) comparison. With global-training public data, an accuracy between 86.4% and 99.9% was achieved. With global-training lab data, the accuracy was above 99% for the CSP and RMDM cases. For lab data, the classification/prediction computing time per event were 8.3 ms, 18.1 ms, 62 ms and 9.9 ms, respectively. In the discussion a comparison between the results presented here and state-of-the-art of methodologies and algorithms for BMI’s can be found. Conclusions. The CSP and RMDM algorithms resulted in fast (computing time) and effective (success rate) tools for their implementation as deep learning algorithms in BMIs.

Resumen El objetivo fue llevar a cabo un proceso participativo de rescate y conservación de caprinos criollos en los sistemas silvoagropecuarios, para incorporarlos a una estrategia de desarrollo de la región indígena y marginada de la Montaña de Guerrero(MG), México. El agroecosistema caprino se estudió para describir la dinámica de desarrollo, identi ficación de las zonas caprinas en 13 municipios y la caracterización zoométrica de 680 cabras. Se encuestó a 110 productores para evaluar la percepción de la producción de cabras, 57 productores fueron formados en manejo holístico y cuatro productores para la crianza de 300 cabras en rebaños sobresalientes. Los datos se analizaron utilizando redes sociales, componentes principales y correspondencia. Se identificaron dos agroecosistemas caprinos: 1) Agrosilvopastoralismo, con proceso de hibridación alta de las poblaciones de cabras y 2) el tradicional, de pastoreo en vegetación nativa con cabra criolla. Se caracteri zaron tres tipos de cabras: 1) mosaico mixteco (61%), 2) cabras pastoreñas (31,8%) y 3) cruzas (7,2%), discriminadas por el diámetro bicostal, profundidad de pecho, longitud del cuerpo, perímetro torácico, alzada a la cruz, distancia entre encuentros y peso vivo. Los productores de caprinos de la MG prefieren las cabras criollas porque son más productivas y mejor adaptadas a las condiciones ambientales.

Abstract The objective was to implement a participatory process involving rescue and conservation of Creole goats in agro-silvopastoral systems, as a development strategy for the indigenous and marginalized region of the Mountains of Guerrero (MG), Mexico. The study focused on the caprine agroecosystem, documenting aspects of goat development and identifying caprine areas in 13 municipalities, zoometrically characterizing 680 goats. One hundred and ten goat producers were interviewed for evaluating farmer perception of goat production. Fifty-seven producers were trained in holistic management, and four producers raised 300 goats in outstanding herds. Data were analyzed using social networks, principal component analysis and correspondence analysis. Two goat agroecosystems were identified: 1) agro-silvopastoralism, with crossbreeding of goat populations and, 2) traditional systems, involving grazing of Creole goats on native vegetation. We identified three types of goats: 1) Mixteco mosaic (61%), 2), Pastoreña (31.8%), and 3) Crossbreeds (7.2%), based on bicoastal diameter, chest depth, body length, thoracic perimeter, height at withers, shoulder point width and liveweight. Smallholder goat farmers in the MG preferred Creole goats for their greater productivity and better environmental adaptation.

Abstract Background: Aquagenic keratoderma is triggered in the palms and soles after contact with water, and is characterized by the appearance of translucent papules forming macerated plaques. It may be associated with medications and diseases such as cystic fibrosis, atopy, and malnutrition, or be idiopathic. Case report: We describe the case of a 17-year-old female patient with chronic functional abdominal pain. She presented with a 2-month history of “wrinkling” of palms after contact with water. After stimulation with water, palmar hyperlinearity and whitish, translucent papules forming macerated-looking plaques with a central depression were observed. Dermoscopically, we observed whitish and anfractive structures with coral appearance and microdroplets of water. In the histological study, we observed continuous hyperkeratosis and acrosyringium dilation from the middle dermis to the stratum corneum. With the clinical presentation and histological findings, aquagenic keratoderma was diagnosed, and treatment was started with partial improvement. Conclusions: Aquagenic keratoderma is an underdiagnosed entity. Despite its indolent course, it could be considered as a marker of a systemic disease such as cystic fibrosis. Since the discussion about the terminology of the disease has arisen, we considered adjusting to a descriptive nomenclature, proposing the term whitish macerated aquagenic plaques of the acrosyringium. It is necessary to continue reporting these cases to understand the disease better and offer adequate management and comprehensive follow-up to the patients.

Resumen Introducción: La queratodermia acuagénica se desencadena tras el contacto de las palmas de las manos y las plantas de los pies con el agua. Se caracteriza por la aparición de pápulas translúcidas que forman placas de aspecto macerado. Puede asociarse con el consumo de ciertos medicamentos y con afecciones como la fibrosis quística, la atopia y la desnutrición, o ser idiopática. Caso clínico: Se describe el caso de una paciente de 17 años con dolor abdominal crónico funcional. Presentó una dermatosis de 2 meses de evolución que afectaba las palmas con «arrugamiento» después del contacto con el agua. Tras el estímulo con el agua, se observaron hiperlinealidad palmar y pápulas blanquecinas y translúcidas que formaban placas de aspecto macerado con una depresión central. Dermatoscópicamente se observaron estructuras blanquecinas anfractuosas de apariencia coraliforme y microgotas de agua. En el estudio histológico se observaron hiperqueratosis continua y dilatación del acrosiringio desde la dermis media hasta el estrato córneo. Con el cuadro clínico y los hallazgos histológicos, se confirmó el diagnóstico de queratodermia acuagénica y se inició el tratamiento, con el que se observó una mejoría parcial. Conclusiones: La queratodermia acuagénica es una afección subdiagnosticada y poco reportada. A pesar de cursar de forma indolente, puede considerarse como un marcador de enfermedad sistémica como la fibrosis quística. Ya que existe discusión sobre la nomenclatura de la enfermedad, consideramos ajustarnos a una nomenclatura descriptiva, como «placas blanquecinas y maceradas acuagénicas del acrosiringio». Es necesario continuar reportando estos casos para comprender mejor la enfermedad, ofrecer un manejo adecuado y dar seguimiento integral a los pacientes.