Urticaria Associated With Welding
This rash on the face and neck of a 27-year-old man appeared periodically over a 2-month period. During this time, the patient’s work involved welding inside a steel oil tank. This photo was taken immediately after the patient had stopped working. He had no accompanying fever or respiratory symptoms. The urticaria was pruritic and resolved the following morning.
Urticaria has been reported to occur in association with welding steel profiles filled with polyurethane and other metals, such as zinc.1-3 The reaction is suspected to be caused by inhalation of the metal fumes. He was treated with triamcinolone injection. For the past 2 years, the patient has been symptom-free. He has welded outside of tanks and has had no recurrence of the urticaria.
1. Farrell FJ. Angioedema and urticaria as acute and late phase reactions to zinc fume exposure, with associated metal fume fever-like symptoms. Am J Ind Med. 1987;12:331-337.
2. Kanerva L, Estlander T, Jolanki R, et al. Occupational urticaria from welding polyurethane. J Am Acad Dermatol. 1991;24:825-826.
3. Kanerva L, Elsner P, Wahlberg JE, Maibach HI, eds. Handbook of Occupational Dermatology. New York: Springer-Verlag; 2000:599.