key: cord-0687993-sn5yzdcb
authors: Alves, Pedro Botelho; Alves, Marta Pires; Todo‐Bom, Ana; Regateiro, Frederico S.
title: Concomitant allergic contact dermatitis and aquagenic urticaria caused by personal protective equipment in a healthcare worker during the COVID‐19 pandemic
date: 2021-05-27
journal: Contact Dermatitis
DOI: 10.1111/cod.13897
sha: c4c0983c8e3184d7c9d86fae1ef525c76c3ea280
doc_id: 687993
cord_uid: sn5yzdcb

nan

Aquagenic urticaria (AU) is a chronic, rare type of physical urticaria that is elicited by skin contact with water, including sweat and tears. 1 Due to its rarity and the existence of other skin diseases caused by water exposure, exclusion of differential diagnoses is essential. 2 We, here, describe a patient with concomitant AU and allergic contact dermatitis (ACD) that impaired her work ability during the coronavirus disease 2019 (COVID-19) pandemic.

A 22-year-old woman presented with a 7-year history of generalized pruritus and erythematous wheals dispersed over her trunk and limbs 10 minutes after contact with sea water or warm bath water, with spontaneous resolution. Symptoms with exercise were limited to sweating areas only. During the past year, she had started working as a nurse on a COVID-19-dedicated ward, and experienced the same symptoms on the anterior trunk and dorsal hands minutes after sweating inside her personal protective equipment (PPE), which contains both a disposable full cover gown or a cover all with hood, plastic apron (changeable between patients), head cap, and shoe covers.

No episodes occurred during hand-washing, emotional stress, eating spicy foods, or temperature changes. She also reported pruriginous vesicular erythema located on her hands and wrists, hours after wearing latex gloves, that persisted for more than 24 hours and was allevi- 

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Cutaneous manifestations in adult patients with COVID-19 and dermatologic conditions related to the COVID-19 pandemic in health care workers