Dermatological Manifestations of Patients with COVID 19: A Cross-sectional study

Background: A Global pandemic Coronavirus disease-19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was isolated in December 2019 in Wuhan (China). Skin manifestations of COVID-19 disease are overlooked in the clinical approach to those suspected of this virus focusing on the pulmonary findings. Objectives: This study aimed to describe the dermatological manifestations of COVID-19 in Iraqi patients. Materials and methods: A cross-sectional study was carried out at general hospitals, primary care centers, and private clinics in three Iraqi cities Baghdad, Babil, and Karbala. The study covered the period from October 2020 to February 2021. Data regarding the demographic and clinical characteristics of each participant were registered. A thorough physical examination by a dermatologist was conducted for every subject. The data were entered and analyzed using SPSS version 25. Results: One hundred COVID-19 patients with cutaneous manifestations were enrolled in this study. There were 59 females. Their ages ranged from 19-62 years. Most of the patients were from the age group ≤ 40 years (68). Just above half of the participants were non-healthcare workers. The highest blood group of the patients was A (45) and the least AB (11). Half of the subjects were presented within the first 7 days from the onset of the disease. Fifty-one cases were with mild disease form. In 54 patients, dermatological manifestations have appeared in the active stage of the disease. Hair loss was the commonest manifestation (30), all of them in the age group ≤ 40 years, and the majority of the cases (26) was affecting the female. While the least manifestation was acrocyanosis in 2 patients, both of them were male and from the age group> 40 years. There were highly statistically significant differences between the skin manifestations and the age and gender (P-value = 0.000). Conclusion: Most of the patients were from the age group ≤ 40 years and female. Hair loss was the commonest skin abnormality due to COVID-19. The majority of cutaneous manifestations were started in the active phase of the infection. The age and gender determined the type of dermatological manifestations. © 2022, Al-Anbar Medical Journal.

Image processing for the diagnosis of COVID-19

Introduction: The positive diagnosis of COVID-19 in paucisymptomatic patients is a priority to minimize the spread of the disease. The absence of respiratory manifestations makes diagnosis difficult and facilitates the spread. Given this situation, it is necessary to adopt technical solutions that allow diagnosis in this type of patient. Objective: Describe rheumatological and dermatological image processing software in the diagnosis of paucisymptomatic patients with COVID-19.Methods: A software based on the algorithm for the diagnostic approach of COVID-19 in paucisymptomatic patients was designed and developed. The procedure consisted of three stages;the first one was related to image processing and all its related elements;the second stage was oriented towards the identification of questions as a medical anamnesis. The third stage focused on the identification and analysis of laboratory test results and the definition of final recommendations based on the final result.Results: A software was designed based on an algorithm that includes three stages and is based on coincidence percentages, guiding the user in the behavior to follow depending on the coincidence percentage. It begins with the capture of an image and is followed by clinical, epidemiological and laboratory aspects of COVID-19. Conclusions: The algorithm for the diagnostic approach to COVID-19 is easy to use, low cost of use, and easy to implement, making it a technological tool at the service of human health to stop the spread of COVID-19.

Dermatological Complications of COVID 19 Vaccines: An Updated Review

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the 2019 coronavirus disease (COVID-19) pandemic, have been rapidly developed and authorized. However, re-cent studies showed that COVID-19 vaccination is associated with a wide range of dermatological reactions. The most prevalent adverse dermatological reaction observed in observational studies was a delayed large local reaction (DLRs), which is characterized by the appearance of an erythematous and edematous patch at the injection site four days or more after vaccination. Most of these reactions are common in females and resolve spontaneously within a few days to a weak. The second dose of the vaccine was associated with a higher incidence of cutaneous reactions compared to the first dose but milder in intensity. It seems that the Moderna vaccine is associated with a higher incidence of these adverse events compared to the Pfizer vaccine. Fur-thermore, mRNA vaccines had a higher incidence than vector-based and inactivated vaccines. There is a lack of evidence regarding the side events of the Johnson & Janssen vaccine. Further long-term, multicenter studies are required to compare these vaccines and highlight the best practice in managing these reactions. © 2023, MedSci Publications. All rights reserved.

Cardiovascular side effects of medications for skin diseases

Although many conditions can be successfully managed using the wide range of locally applied physical and pharmacological therapies, systemic administration of drugs is often necessary in dermatology. This chapter gives a brief survey of some of the most important systemic agents used by dermatologists, agents that may induce cardiovascular side effects or, sometimes, may benefit cardiovascular function. © Springer Nature Switzerland AG 2021.

Impact of COVID-19 pandemic on the diagnosis of patients with skin cancer: a systematic review protocol.

INTRODUCTION: The COVID-19 pandemic has changed aspects of patient care in the many scheduled medical activities, restricted access to healthcare facilities, and affected the diagnosis and organisation of patients with other health problems, specifically skin cancer. Skin cancer, the uninhibited progress of atypical skin cells, happens with unrepaired DNA genetic faults that lead them to multiply and create malignant tumours. Currently, dermatologists perform skin cancer diagnosis based on their specialised experience using the results of pathological tests from the skin biopsy. Sometimes, some specialists advise sonography imaging to check the skin tissue as a non-invasive method. The outbreak has led to postponements in the treatment and diagnosis of patients with skin cancer, including diagnostic delays because of limitations of diagnostic capacities and delays in referring patients to the physician. The purpose of this review is to improve our understanding of the impact of the COVID-19 outbreak on the diagnosis of patients with skin cancer and conduct a scoping review to identify whether routine skin cancer diagnoses are affected by the persistent incidence of COVID-19. METHODS AND ANALYSIS: The structure of research was compiled using Population/Intervention/Comparison/Outcomes/Study Design and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. First, we will find the main keywords to capture scientific studies related to the impact of the COVID-19 pandemic on the diagnosis of skin cancer: COVID-19 and skin neoplasms. To warrant sufficient coverage and identify potential articles, we will search the combination of four electronic databases PubMed/MEDLINE, Scopus, Web of Science and EMBASE, and ProQuest from 1 January 2019 until 30 September 2022. The screening, selection and data extraction of studies will be performed by two independent authors, who will then assessed the quality of the included studies according to Newcastle-Ottawa Scale. ETHICS AND DISSEMINATION: As this study will be a systematic review without human participants' involvement, no formal ethical assessment is required. Findings will be presented at conferences related to this field and will be disseminated in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42022361569.

Impact of the COVID-19 Pandemic on Dermatology Care in the Chilean Public Health Sector.

Due to the Coronavirus-19 (COVID-19) pandemic, most resources of the public health system were allocated to the increasing demand from respiratory patients. From this, it is expected that specialty consultations would decrease drastically. Access to dermatology care in the Chilean public health has been historically limited. To evaluate the impact of the pandemic on dermatology care, the total number of dermatological consultations (DCs) to the Chilean public sector in 2020 is analyzed according to sex and age range and compared with the available databases from 2017 to 2019. From this, 120,095 DCs were performed during 2020, with an incidence of 6.3 consultations per 1000 inhabitants. When compared to 2019 (n = 250,649), there was a 52.1% decrease. The regions most affected were located in the central part of Chile, which correlates with the regions most affected by the pandemic. Age and sex distributions remained similar to previous years but lower in amplitude. The month with the lowest number of consultations was April, with a gradual increase observed thereafter until December 2020. Although DCs decreased drastically in the Chilean public sector during 2020, sex and age range proportions were conserved, thus affecting all groups in a similar manner.

Dermatological Manifestations in COVID-19: A Case Study of SARS-CoV-2 Infection in a Genetic Thrombophilic Patient with Mthfr Mutation.

The present case study describes the dermatological manifestations of COVID-19 in a patient with genetic thrombophilia (MTHFR-C677T mutation) and the identification of a SARS-CoV-2 variant of interest (VOI). A female patient, 47 years old, unvaccinated, with thrombophilia, was diagnosed with COVID-19. She presented with urticarial and maculopapular eruptions from the seventh day of symptoms, which progressed to multiple lesions with dark centers (D-dimer value > 1450 ng/mL). The dermatological manifestations disappeared after 30 days, corroborating the reduction in D-dimer levels. Viral genome sequencing revealed infection by the VOI Zeta (P.2). Antibody testing, performed 30 days after the onset of symptoms, detected only IgG. The virus neutralization test showed the highest neutralizing titer for a P.2 strain, validating the genotypic identification. Lesions were suggested to be due to infection in skin cells causing a direct cytopathic effect or release of pro-inflammatory cytokines triggering erythematous and urticarial eruptions. In addition, vascular complications are also proposed to be due to the MTHFR mutation and increased D-dimer values. This case report is an alert about COVID-19 in patients with pre-existing vascular diseases, especially in unvaccinated patients, by VOI.

A neglected pyoderma gangrenosum following COVID-19: A case report

COVID-19 infection is related to many skin problems. The pathogenesis is under search, but mainly involves inflammatory and vasculopathic injuries. Pyoderma gangrenosum is an ulcerative sterile inflammatory reaction of the skin. The etiology is unknown in around 50% of the cases. This article reported a 47-years old soldier man with COVID-19 who developed big, very painful, indurated ulcers on his abdomen and another small one at back, treated as pyoderma gangrenosum and established very good improvement on prednisolone and azathioprine. In conclusion, patients of COVID-19 may be at increased risk for emerging pyoderma gangrenosum with significant overlap in disease pathogenesis. Medical doctors should suspect pyoderma gangrenosum in an individual with coronavirus infection who has non-healing ulcers. Copyright © 2023 Pakistan Association of Dermatologists. All rights reserved.

Hyper-eosinophilic syndrome with myocarditis after inactivated SARS-CoV-2 vaccination - a case study.

INTRODUCTION: COVID-19 vaccine induced serious adverse reactions are rare. Hyper-eosinophilia syndrome with myocarditis has not been reported earlier following BBV152 vaccine administration. CASE PRESENTATION: A young man without any co- morbidities presented with persistent periorbital swelling along with itchy swelling over fingers, resting tachycardia and exertional breathlessness following first dose of an inactivated SARS-CoV-2 vaccination (BBV152, COVAXIN). On investigation, patient had elevated blood eosinophils (maximum 21.5% with absolute eosinophil count of 2767/mm3) and myocarditis (Lake Louise Criteria). He was successfully treated with steroid and supportive treatment. CONCLUSION: This is the first reported case of hyper-eosinophilia syndrome after COVAXIN administration. Prior history of allergic disease may be a predisposing factor in this case. Hyper-eosinophilia can present with variable symptoms. In the current case, myocarditis was present with presentation as persistent resting tachycardia and dyspnea. Steroid and antiallergic drugs may be successfully used for the treatment of vaccine induced hyper-eosinophilia with myocarditis. Increased vigilance is needed for such adverse events.

Compression of images of dermatological manifestations of paucisymptomatic COVID-19 patients through periodic principal components

Introduction: The management of medical images has been gaining followers based on the advantages it offers for the diagnosis of diseases, which, like COVID-19, present with clinical manifestations that can be captured in the form of images.Objective: Take advantage of the quasi-periodicity of the principal components (PCs) in the decomposition into PCs of medical images, which represent dermatological manifestations in paucisymptomatic patients of COVID-19.Methodology: Here, a set of photos was taken of one of the most frequent patterns in COVID-19, the maculopapular pattern, characterized by an erythmatopapular rash, and compression of one of the medical images was performed. Said compression was carried out in different ways: (1) using two PCs, (2) using both a periodic PC and a non-periodic PC, (3) using two periodic PCs, (4) using a single PC, and (5) using a single periodic PC. Result: The results of this research proved that it is possible to work with acceptable reconstructions of compressed images in the field of dermatology, without losing the quality and characteristics that allow to reach a correct diagnosis. In addition, this achievement permits to correctly classify many diseases without fear of being wrong.Conclusion: With the method presented, the use of a robust medical image compression technique that could be very useful in the field of health is proposed. The images allow the diagnosis of diseases such as COVID-19 in paucisymptomatic patients, understanding them allows minimizing their weight without losing quality, which facilitates their use and storage.

Prevalence and risk factors of work-related contact dermatitis symptoms among healthcare cleaners during the COVID-19 pandemic in Northwest Ethiopia: a multicentre cross-sectional survey.

OBJECTIVE: This study was aimed to explore the prevalence and risk factors of work-related contact dermatitis (WRCD) symptoms among cleaners working in healthcare institutions in Gondar city, Northwest Ethiopia, during the COVID-19 pandemic. DESIGN: A multicentre cross-sectional study was conducted from September to October 2021. An interviewer-administered standardised Nordic Occupational Skin Questionnaire, V.2002 (NOSQ-2002) was used to assess WRCD. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING: The study was conducted in Gondar city healthcare institutions, Northwestern Ethiopia. PARTICIPANTS: A total of 409 cleaners participated in this study. OUTCOME MEASURES: The primary outcome is the prevalence of WRCD symptoms, which was measured using the NOSQ-2002. RESULTS: The response rate was 95.6%. The majority, 302 (73.8%), of the study participants were female. The mean age (±SD) was 31 (±7.87) years old. The overall prevalence of self-reported WRCD during the last 12 months was 213 (52.1%) (95% CI (47.1% to 57.0%)). The highest symptoms reported were skin redness, 51.6% (n=110), and the most affected skin body sites were hands (hand dermatitis), 74.2% (n=158). Hand washing frequency more than 20 times per day (AOR=1.73, 95% CI (1.03 to 2.92)), personal history of eczema (AOR=1.46, 95% CI (1.01 to 2.42)) and lack of training on skin hazards (AOR=2.06, 95% CI (1.16 to 3.63)) were factors influencing the occurrence of WRCD. CONCLUSIONS: This study revealed the prevalence of WRCD is common during the COVID-19 pandemic. Adjusting hand washing frequency per day, educating people with atopy about the avoidance of exposure to skin irritants and providing training on skin hazards were recommended to minimise the condition.

Study protocol of the BASINEL Study: a pragmatic randomised controlled trial investigating treatment versus no treatment of low-risk basal cell carcinomas in older persons.

INTRODUCTION: Basal cell carcinomas (BCCs) represent 70% of all skin cancers. These tumours do not metastasise but are locally invasive if left untreated. There is a high incidence of BCC in the elderly, and clinicians frequently face important treatment dilemmas. The approach to BCC in the elderly should be investigated thoroughly. METHODS AND ANALYSIS: Data on health-related quality of life (HrQoL), survival and complication rate will be examined in a treatment and a non-treatment arm (1:1 allocation). In the non-treatment arm, in vivo biological behaviour of low-risk BCCs in elderly patients will be examined. The main objective is to combine tumour characteristics with demographic data, in order to determine whether treatment will positively affect the patients' HrQoL within a predetermined time frame. A monocentric randomised controlled trial (RCT) was designed at the Ghent University Hospital. The study population consists of patients with the minimum age of 75 years and a new diagnosis of (a) low-risk BCC(s). Patients in the treatment arm will receive standard care. Patients in the non-treatment arm will be closely monitored: the tumour will be intensively evaluated using multispectral dermoscopy, reflectance confocal microscopy and high-definition optical coherence tomography. All patients will be asked to fill in a questionnaire concerning their HrQoL at consecutive time points. Patient-reported side effects will be evaluated via an additional questionnaire.Primary outcomes will include the difference in HrQoL and the difference in complication risks (treatment vs non-treatment) at different time points of the study. Secondary endpoints are the evolution of the BCCs in the non-treatment arm and the long-term survival in both study arms. Tertiary endpoint is the treatment effectiveness in the treatment arm. The sample size calculation was performed and resulted in a target sample size of 272 patients in this study with a 1:1 allocation. ETHICS AND DISSEMINATION: Subjects can withdraw from participating in this study at any time for any reason without any consequences. Approval for this study was received from the Ethics Committee of the Ghent University Hospital on 26 August 2021.The results of this RCT will be submitted for publication in one or more international, peer-reviewed medical journals, regardless of the nature of the study results. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT05110924).

Rare Heterogeneous Adverse Events Associated with mRNA-Based COVID-19 Vaccines: A Systematic Review.

Background: Since the successful development, approval, and administration of vaccines against SARS-CoV-2, the causative agent of COVID-19, there have been reports in the published literature, passive surveillance systems, and other pharmacovigilance platforms of a broad spectrum of adverse events following COVID-19 vaccination. A comprehensive review of the more serious adverse events associated with the Pfizer-BioNTech and Moderna mRNA vaccines is warranted, given the massive number of vaccine doses administered worldwide and the novel mechanism of action of these mRNA vaccines in the healthcare industry. Methods: A systematic review of the literature was conducted to identify relevant studies that have reported mRNA COVID-19 vaccine-related adverse events. Results: Serious and severe adverse events following mRNA COVID-19 vaccinations are rare. While a definitive causal relationship was not established in most cases, important adverse events associated with post-vaccination included rare and non-fatal myocarditis and pericarditis in younger vaccine recipients, thrombocytopenia, neurological effects such as seizures and orofacial events, skin reactions, and allergic hypersensitivities. Conclusions: As a relatively new set of vaccines already administered to billions of people, COVID-19 mRNA-based vaccines are generally safe and efficacious. Further studies on long-term adverse events and other unpredictable reactions in close proximity to mRNA vaccination are required.

Physiological Hazard Assessment While Wielding Personal Protective Equipment (PPE) Among Health Care Workers.

Introduction Accurate use of personal protective equipment (PPE) is an essential part of infection prevention and control measures to protect health care workers and patients from various hazardous conditions. Health care workers caring for patients with potentially infectious health conditions are using PPE for long periods of time. However, long-term use of PPE can cause many physiological health hazards among health care workers. So, the current study was carried out to assess the general health problems and dermatological problems experienced by health care workers with PPE use. Materials and methods A descriptive cross-sectional survey has been carried out in two selected tertiary care hospitals in central India by recruiting 301 health care workers. Non-probability convenient sampling technique was used to select participants for the study. Sociodemographic Performa and structured questionnaires were used to collect data on demographic characteristics of the participants and various health problems experienced by health care workers with PPE use. Collected data were analyzed using appropriate descriptive and inferential statistics. Results The current study reported excessive sweating (86.4%), difficulty in reading (85%), dry mouth (80.7%), and breathing difficulty (74.1%) as the most common problem associated with PPE use. In addition to this, adverse reactions like headache, restlessness, and dizziness were reported by 70.1%, 64.5%, and 50.8%. Indentation and pain on the back of the ears (76.1%), skin soaking (67.1%), and excessive sweating (76.1%) were identified as the most common problems related to N-95 masks, gloves, and coverall use.  Conclusion The current study revealed a higher incidence of various health problems with PPE use among health care workers. The findings of the study highlight the importance of developing various guidelines to reduce the negative impact of PPE use and implementing preventive measures to decrease health problems associated with PPE use.

TELOGEN EFFLUVIUM AS A SEQUEL TO COVID-19

At the beginning of January 2020, the World Health Organization-WHO named SARS-CoV-2 a new virus discovered in Wuhan, China at the end of 2019 and that causes COVID-19. The disease spread rapidly throughout the city and spread to the country and the rest of the world, causing it to be declared a pandemic in March 2020. With this announcement, the entire world was affected by the restrictions that several countries implemented in order to stop the rate of infection. As the disease is being investigated and better characterized, several symptoms have been recorded that can be attributed to previous infection with this virus. This is the case of telogen effluvium, which has been characterized as a sequel to COVID-19, occurring an average of 1.5 months after the initial infection. This work will describe telogen effluvium as a pathology, its clinical manifestations and possible causes, taking into account into account its role as a new sequel described for the COVID-19 disease.

Sonography of a case series of talar callosities.

Talar callosity is an uncommon condition characterized by asymptomatic hyperkeratotic plaques located on the dorsum of one or both feet. We have detected an increased number of children presenting with this condition after the COVID-19 lockdown. High-frequency ultrasound was performed in all patients who consulted because of talar callosity. All four cases shared similar ultrasound findings: thickening of the epidermis with effacement of the subepidermal low-echogenic band and diffuse thickening of the dermis and subcutaneous cellular tissue, with a diffuse decrease in echogenicity. The bone cortex was respected in all cases. No increase in vascularization was detected. Although it is a benign condition, it is important to recognize talar callosity to exclude worse conditions and to prevent unnecessary biopsies. To our knowledge, we are the first to describe ultrasonographic findings of talar callosity.

Taiwan dermatological association recommendations for coronavirus disease of 2019 vaccination in patients treated with immunotherapeutics

This article aims to present current COVID-19 vaccination considerations for patients on immunotherapeutics for the management of immune-mediated dermatological diseases and summarize the recommendations relevant to clinical practice in Taiwan. These Taiwan Dermatological Association (TDA) recommendations are intended to be dynamic in nature and serve as an interim guide to optimize patient care at this current juncture. It is expected that our clinical practice would continually evolve and be informed by new evidence that emerges in this pandemic. © 2021 Dermatologica Sinica Published by Wolters Kluwer-Medknow.

Four Distinct Cases of Multisystem Inflammatory Syndrome in Adults Associated With SARS-CoV-2 Infection at a Community Hospital in New Jersey.

Multisystem inflammatory syndrome (MIS) is a rare entity that usually presents with a constellation of symptoms such as fever, hypotension, gastrointestinal symptoms, cardiac dysfunction, or dermatological involvement, representing an inflammatory state. During the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, several cases of multisystem inflammatory syndrome in children (MIS-C) have been described in the literature. The Centers for Disease Control and Prevention (CDC) has acknowledged the increasing incidence of the same entity in adults, referred to as multisystem inflammatory syndrome in adults (MIS-A). This case series describes four patients who presented to the Monmouth Medical Center in New Jersey with symptoms suggestive of MIS-A associated with SARS-CoV-2 infection and their clinical outcomes. All patients were within the age group of 20-40 years with no underlying medical condition. The period between SARS-CoV-2 infection and the development of MIS-A varied from 10 days through a month. Presentations ranged from a mild flu-like illness to shock requiring vasopressors. A positive SARS-CoV-2 antibody test was essential for the diagnosis. Inflammatory markers, such as ferritin, D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6), were elevated on admission. The Use of immunomodulatory agents, namely steroids and intravenous immunoglobulin (IVIG), resulted in positive clinical outcomes. Inflammatory markers and imaging on admission did not appear to predict the disease course. A positive SARS-CoV-2 polymerase chain reaction (PCR) did not appear to influence the response to treatment. Given the high probability of MIS-A with negative viral testing, the use of both antibody and viral testing with the addition of inflammatory markers may be essential to diagnose this SARS-CoV-2-associated condition.

Impact of Water Exposure and Temperature Changes on Skin Barrier Function.

The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest® (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g·h-1·m-2), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g·h-1·m-2) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g·h-1·m-2) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 °C) of the TempTest. No significant differences were found after contact with the cold region (4 °C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands.

Safety of conventional immunosuppressive therapies for patients with dermatological conditions and coronavirus disease 2019: A review of current evidence.

The effect of coronavirus disease 2019 (COVID-19) on patients receiving conventional immunosuppressive (IS) therapy has yet to be fully determined; however, research on using IS therapy for treating COVID-19 in acutely ill patients is increasing. While some believe that IS therapy may be protective, others argue that these agents may make patients more susceptible to COVID-19 infection and morbidity and advocate for a more cautious, individualized approach to determining continuation, reduction, or discontinuation of therapy. In this review, we aim to provide an overview of COVID-19 risk in dermatological patients who are receiving conventional IS therapies, including mycophenolate mofetil, methotrexate, cyclosporine, azathioprine, apremilast, JAK inhibitors, and systemic steroids. Additionally, we provide recommendations for management of these medications for dermatological patients during the COVID-19 pandemic. Treatment of dermatological disease during the COVID-19 pandemic should involve shared decision-making between the patient and provider, with consideration of each patient's comorbidities and the severity of the patient's dermatological disease.