Figurate eczema of the forearm in a hairdresser

Hairdressers are among high risk professions for occupational skin diseases development, and major attention is usually dedicated to contact allergy. However, infections are behind the corner, and should not be undervalued. We present an emblematic case of tinea incognita, for the iconography, typical history of misdiagnosis, mimicking contact eczema and incongruous treatment with corticosteroids. Actual COVID-19 pandemic restrictive measures caused an additional diagnostic delay, blocking the access to outpatient dermatology service. However, the diagnosis is very simple, when direct microscopic examination is available or grace to selective culture medium disposal. The latter do not require incubation, the dermatophytes growing at room temperature in few days, inducing the change in the medium color. Further identification of the dermatophyte species requires a more experienced mycology laboratory, but it is not essential for the treatment choice. Copyright © by Journal of Applied Cosmetology.

Respect for service users' human rights, job satisfaction, and wellbeing are higher in mental health workers than in other health workers: A study in Italy at time of the Covid pandemic

Background: This study aimed to evaluate the respect for users' rights, job satisfaction, and well-being between mental health workers (MHWs) compared to non-mental health care workers (nMHWs) from the same Italian region. Methods: The sample was recruited from community mental health and non-mental health outpatient centers in Sardinia. Participants fulfilled the WellBeing at work and respect for human-rights questionnaire (WWRR). The sample included 240 MHWs and 154 nMHWs. Results: MHWs were more satisfied with their work and workplace compared to nMHWs. MHWs had stronger beliefs that users were satisfied with the care received, and both workers and users' human rights were respected in their workplace. MHWs reported to need more rehabilitation therapists and psychologists in their services, while nMHWs needed more nurses and professionals for users' personal care. Italian MHWs are more satisfied with their work and workplace, and more convinced that users are satisfied with the care received and that users' and staff human rights are respected in their workplaces, compared to nMHWs. Conclusions: The historic link between the community mental health network and other support networks in Italy and the consequent perception of proximity to the citizens of the care network may be the reason for this optimal situation of Italian MHWs.

Exercise in Older Adults to Prevent Depressive Symptoms at the Time of Covid-19: Results of a Randomized Controlled Trial with Follow-Up

Background: This study aimed to verify, through a randomized controlled trial, whether a medium-intensity mixing/aerobic/anaerobic exercise (accessible to older adults even with mild chronic diseases) can effectively counteract depressive episodes. A characteristic of the trial was that the follow-up coincided (unscheduled) with the lockdown due to Covid-19. Methods: Participants (N=120) were randomized into an intervention group, performing physical exercise, and a control group. Participants, aged 65 years and older, belonged to both genders, living at home, and cleared a medical examination, were evaluated with a screening tool to detect depressive episodes, the PHQ9, at pre-treatment, end of the trial (12-week), and follow-up (48-week). Results: A decrease in the frequency of depressive episodes after the trial (T1) was found in both groups;however, a statistically significant difference was observed only in the control group (p=0.0039). From T1 to follow-up (conducted during the lockdown), the frequency of depressive episodes increased in the control group, reaching a frequency equal to the time of study entry (p=0.788). In the experimental group, the frequency of depressive episodes did not change at the end of the trial but reached a statistically significant difference compared to the start of the study (p = 0.004) and was higher than the control group (p=0.028). Conclusion: Moderate-intensity physical exercise can be conducted safely, benefitting older adults even suffering from mild chronic disorders. Physical exercise seems to guarantee a long-term preventive effect towards depressive symptoms, especially in serious stressful situations such as the lockdown due to the Covid-19 pandemic. Clinical Trial Registration Number (NCT03858114).

COVID-19 and impact of personal protective equipment use: from occupational to generalized skin care need

During the COVID-19 pandemic in Italy, our Dermatology Clinic experienced an increased number of consultations for contact dermatitis, and skin injuries, requested by the colleagues and sanitary personnel of other wards, often sending images by smart phones applications to avoid visits in presence. The most affected sites included the nasal bridge, hands, cheek, periocular, and perioral regions. Dryness, itching, but also stinging sensations were common. Although majority of PPE related manifestations were mild, self-healing when the use was stopped for sufficient time, restand recovery was not always viable in current situation. The critical point is that adherence to strict PPE protocol is paramount, and presence of even mild abrasion, itching, or burning sensation might induce inadvertent protocol breaches, such as mask touching and PPE adjustment. For mild face dermatitis,we prescribed the application of moisturizers on intact skin and topical antibiotic ointment, mainly fusidic acid on super-infected skin. For sustained contact dermatitis, low- to medium-potency not fluorinated topical glucocorticoids were allowed. Hand and sometimes feet maceration were relieved with normal saline hydropathic compress and topical use of zinc oxide ointment. When erosion and exudation occurred, the application of topical glucocorticoid cream was added. Sustained dermatosis, worsening of preexisting diseases such as psoriasis or atopic dermatitis or allergic reactions might require more complex assessment and management, including the temporary removal from work for health care personnel.