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A case of contact urticaria syndrome (CUS) and multiple urticarias from formaldehyde exposure was examined. A 42 year (yr) old female nurse with urticaria accompanied by rhinitis and occasional bronchospasm was evaluated. She was nonatopic and had worked in the surgical department of a hospital for 11yr. She reported that the urticarial episodes occurred more frequently at work than at home. She had also experienced a slight intermittent hand eczema over the past 5yr. Previous patch testing using a standard allergen series and a health care allergen series had given positive results to Kathon-CG and Peru-balsam and an equivical result to formaldehyde. Physical examination revealed that the urticarial lesions tended to occur more frequently on exposed skin and that the patient had demographic, aquagenic, cholinergic, and delayed urticaria. Open tests performed on her back with Kathon-CG, Peru-balsam, and formaldehyde produced urticarial reactions on the face, neck, trunk, and forearm accompanied by shivering, oculorhinitis, eyelid edema, and bronchospasm. Open tests with the formaldehyde releasers quaternium-15, bronopol, and imidazolidinyl-urea also produced positive reactions. The patient was diagnosed with CUS from formaldehyde exposure and multiple physical urticaria. She was transferred from her current job and advised to avoid formaldehyde exposure. She now only occasionally experiences mild urticarial reactions. The authors conclude that formaldehyde probably caused airborne contact urticaria in the nurse as a result of its volatility probably by a nonimmunologic mechanism.
Contact Dermatitis, 35(3):174-175, 1996. (7 references)
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