IMPACT of the COVID-19 PANDEMIC on PRIMITIVE MELANOMA DIAGNOSES at the IDI-IRCCS of ROME

Background: Due to the COVID-19 pandemic, some planned medical activities have been postponed, for both national directives and out of concern of the patients who were afraid to go to hospitals.1 In our study we tried to evaluate if the pandemic has had any detrimental effect on melanoma diagnosis both in 2020 and 2021. Method(s): We collected all consecutive primary melanoma from the Pathology Registry of IDI-IRCCS of Rome (Breslow, ulceration and other main histological features). During year 2020 we divided the COVID-19 Italian pandemic into three phases: pre-lockdown (1 January- 9 March), lockdown (10 March-3 May), post-lockdown (4 May-6 June). We compared these data with the same period of year 2021. Result(s): In the year 2020 mean number of melanoma diagnoses per day were as follows: 2.3 in the pre-lockdown phase, 0.6 during the lockdown and 1.3 after the lockdown (in 20182019, we had 2.3/day). Mean Breslow thickness was 0.88 (95% CI, 0.501.26) pre-lockdown and 1.96 (95% CI, 1.162.76) post-lockdown. Proportion of ulceration was 5.9% (95% CI, 2.411.7%) pre-lockdown and 23.5% (95% CI 10.841.2%) post-lockdown. During the same period of year 2021 we observed a constant number of new melanoma cases, with a daily number similar to the 2020 pre-lockdown period. Overall, we observed a higher number of nodular melanoma and superficial spreading melanoma with nodule compared to 2020 pre-lockdown period. The proportion of in situ melanoma in 2021 (about 28%) is constant and it is very close to the observed values for 2018 (23.8%), 2019 (26.4%) and 2020 (25%). Conclusion(s): Our data support the hypothesis that during the COVID-19 lockdown period of year 2020, melanoma diagnoses may have been delayed. In 2020 a significant increase has been observed for men (from 0.96 to 2.70) but not for women (0.79 to 1.44), and in patients 50 years old or older. Regarding the year 2021, our data support the hypothesis that the number of new melanoma diagnoses returned to the pre-lockdown period, but the higher Breslow thickness and the largest number of thicker melanomas (nodular and superficial spreading with nodule) suggest it could be caused by the postponed prevention during the previous year. The constant proportion of in situ melanoma indicate that more health-conscious people were more likely to defy the 2020- 2021 lockdown limitations than people who might have been underestimating the severity of their lesions.

Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes on quality of life issues in dermatologic patients during the COVID-19 pandemic.

The pandemic of COVID-19 is a global challenge for health care, and dermatologists are not standing apart from trying to meet this challenge. The European Academy of Dermatology and Venereology (EADV) has collected recommendations from its Task Forces (TFs) related to COVID-19. The Journal of the EADV has established a COVID-19 Special Forum giving free access to related articles. The psychosocial effects of the pandemic, an increase in contact dermatitis and several other skin diseases because of stress, disinfectants and protective equipment use, especially in healthcare workers, the temporary limited access to dermatologic care, the dilemma whether or not to pause immunosuppressive therapy, and, finally, the occurrence of skin lesions in patients infected by COVID-19 all contribute to significant quality of life (QoL) impairment. Here, we present detailed recommendations of the EADV TF on QoL and patient-oriented outcomes on how to improve QoL in dermatologic patients during the COVID-19 pandemic for several different groups of patients and for the general population.