ABSTRACT
Background: The COVID-19 pandemic has fostered many new patterns of behavior. One of the more popular strategies has been facialmask wearing. Outbreaks of skin reactions secondary to mask wearing have been commonplace findings in outpatient primary care offices and Conclusions: Facial mask wearing has been extensively utilized throughout the COVID-19 pandemic. The classic mask is made of polypropylene, a non-woven fabric which is an effective barrier for transmission of viruses and other microorganisms (1). Materials such as cotton and polyester are also used. Some masks even contain copper and trace metals , so it is not unusual that ubiquitous mask wearing would increase the incidence of facial dermatoses (2).What we have observed is that these new facial eruptions have mimicked other known facial skin entities prompting referrals to specialty offices, misdiagnoses, patient misconceptions, and the potential initiation of erroneous treatments. These facial skin presentations, which we refer to as “mask dermatitis”, have brought about a new “masquarade syndrome”. Recent literature has described similar facial dermatoses which have been termed “maskne” (3). It is surmised that alterations in skin temperature, pH, and humidity apparently affect sebum secretion in the face leading to inflammatory changes (4). Although the analogy to acne is certainly plausible, we feel that our cases may be more consistent with contact dermatitis. We found that simply discontinuing mask wearing often resolves the facial outbreaks and prevents the need for unnecessary topical therapy, oral medications and needless surgical biopsies. In the wake of the recent COVID-19 pandemic, we feel strongly that “mask dermatitis” should be considered as part of the differential diagnosis in all patients presenting with facial skin eruptions.