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A case of atopic dermatitis in a welder that was exacerbated by occupational exposure to welding associated ultraviolet-C (UVC) radiation was presented. A 32 year (yr) old male with a familial history of atopic dermatitis and a personal history of childhood scaly eczema, allergic asthma, and allergic rhinoconjunctivitis was evaluated at an occupational dermatitis clinic. He reported being employed twice as a welder, when he was between 25 and 26yr old and when he was 31yr old. Exposure to UVC radiation emanating from the welding torch resulted in serious exacerbation of his skin problems, primarily on his face and neck. The lesions regressed when he was off work and treatment with topical and systemic steroids controlled the condition. After the second stint of welding, this treatment was no longer effective and the patient had to be hospitalized. Topical corticosteroids cleared the lesions. Afterwards, when the patient returned to welding for 1 day, his lesions were again exacerbated. After this episode, the patient left welding work permamently. A followup evaluation performed 4 months later indicated that his skin had remained stable. Atopy screening revealed that the patient was sensitized to a wide range of common aeroallergens. The patient was evaluated to determine the minimum erythemic doses (MEDs) for ultraviolet-A (UVA) and ultraviolet-B (UVB) radiation. The UVA MED was significantly decreased from the normal range of 20 to 50 joules per square centimeter (J/cm2) to 5J/cm2. The UVB MED was within the normal range, 0.02 to 0.05J/cm2. Application of a sunscreen designed to protect against UVA and UVB radiation, but not UVC radiation, did not protect against exacerbation of the patient's skin lesion when he was exposed to UV light. The authors conclude that enhanced UVC radiation exposure as a result of his welding activities was responsible for exacerbating the patient's skin problems. Infrared radiation exposure, however, cannot be ruled out as a contributing cause.
Contact Dermatitis, 35(3):180-181, 1996. (12 references)
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