Piloting Photographic Photonic Patch Testing: Pioneering Equitable Diagnosis of Contact Dermatitis

Objectives: Due to restricted access to cutaneous patch testing (PT) during the SARS-CoV-2 pandemic innovative strategies were necessary to promote equitable healthcare. Photonics generates, detects and manipulates physical light (photons) which can assess blood-flow in a clinical photograph and potentially act as a surrogate marker for cutaneous inflammation. We wished to assess if clinical photography and photonic image analysis could improve the virtual interpretation of PT results. Methods: PT photographs of 30 consecutive patients were taken using a 40- megapixel colour camera contemporaneous to PT assessment by study investigators. Photographs were then analysed using HyperCube using Principal Component Analysis (PCA), a technique used to reduce the dimensionality of datasets. Photonic images were then examined to determine a combination of variables or colour patterns indicating a positive result. Results: Thirty patients were recruited from September-November 2020. Two blinded investigators determined whether the results were positive, ?positive, irritant or other. Photonic, photographic and clinical results were compared. Initial blinded photonic evaluation captured 40% of positive PT while photographic assessment captured 51%. Unblinded evaluation captured 90% of both PCA and clinically positive results. Conclusions: The SARS-CoV-2 pandemic catalysed many changes in healthcare delivery and introduced opportunities to produce patient centred care. This pilot study employs innovative technology to improve rural accessibility to PT, promote inclusivity and reduce carbon emissions by reducing patient travel. Further development is necessary as while PCAanalysis of digital images improves pick-up of positive PTvirtually it remains inferior to face-to-face assessment. Multispectral imaging has the potential to expand the range of wavelengths further.

Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study.

COVID-19 healthcare workers (HCWs) require frequent handwashing and use of personal protective equipment (PPE) to prevent infection. However, evidence is emerging that these practices are causing adverse effects on their skin integrity. A single-centre, cross-sectional study of HCWs from an Irish hospital was undertaken to evaluate the degree of COVID-19-related irritant contact dermatitis (ICD) between April and May 2020. Of 270 participants surveyed, 223 (82.6%) reported symptoms of ICD. The hands were the most commonly affected site (76.47%) and the most frequently reported symptom was dry skin (75.37%). Nearly all (268; 99.26%) HCWs had increased hand-washing frequency, but 122 (45.35%) did not use emollients. In the ICD group, 24.7% cited a history of dermatitis compared with 4.3% of unaffected staff (P < 0.001). The ICD group recorded PPE usage for an average of 3.15 h compared with the non-ICD group at 1.97 h (P = 0.21). Promoting awareness of COVID-19-related ICD is vital to highlight prevention and treatment for frontline staff.