Questionnaire-Based Study Evaluating the Hand Hygiene Practices and the Impact of Disinfection in the COVID-19 Pandemic on Hand Skin Conditions in Poland.

During the COVID-19 pandemic, disinfection became an integral part of everybody's life in order to avoid spreading the coronavirus. In 2021, an original anonymous online survey was carried out. The questions concerned the usage of disinfectants. The study population included 56 subjects diagnosed by a physician with hand eczema (HE-derm group) and 114 subjects with no hand skin disease diagnosed by a specialist (non-derm). The HE and non-HE groups were distinguished. Nearly 80% of the HE group, and 10% of the non-HE group, experienced worsening of hand skin lesions caused by increased skin disinfection. HE-group respondents more often declared the occurrence of new hand skin symptoms, over 80% of the subjects of this group had more than 1 new symptom (compared to nearly 40% of the non-HE group). Exacerbations of the skin disease were more frequently observed by the HE group during the pandemic. There was a statistically significant decrease of the quality of life in the HE group compared to the non-HE group during the pandemic. The COVID-19 pandemic caused an increase in the prevalence of hand skin symptoms and deterioration of the skin condition. Education on appropriate disinfection techniques and skincare, as well as early dermatological intervention, might allow us to limit the development of hand skin diseases.

Hand Eczema in Apprentice Nurses during the COVID-19 Pandemic after a Skin Prevention Program.

BACKGROUND: Healthcare workers, particularly nurses and apprentice nurses, are at high risk of the development of hand eczema due to daily exposure to wet work. This study aimed to assess the occurrence of hand eczema in a group of first-, second-, and third-year apprentice nurses at the University Hospitals of Trieste (northeastern Italy) during the COVID-19 pandemic. METHODS: Two hundred forty-two Nursing School students were recruited. Data were collected using a standardized questionnaire based on the Nordic Occupational Skin Questionnaire, and all patients underwent a medical examination to evaluate their skin condition based on standard scores. Transepidermal water loss was also measured. The factors associated with hand eczema were investigated using univariate and multivariate logistic regression analyses. RESULTS: The prevalence of hand eczema was low in students both before and after the traineeship (17.9 and 21.5%, respectively), but clinical signs of mild skin damage, mainly skin dryness, were present in 52.3 and 47.2%, respectively. The factor associated with hand eczema was a personal history of atopic eczema (odd ratios 2.61, 95% confidence intervals 1.18-5.80), while exposure to irritants and glove use did not reach statistical significance. CONCLUSIONS: Our findings might be explained by the preventive measures adopted for skin protection among healthcare workers in Trieste since the apprenticeship.

Hand dermatitis: Readability, quality, and comprehensiveness of online patient health resources

Introduction: Hand dermatitis causes significant physical, psychosocial, and economic burden. The internet is a major source of health education for patients. Here, we evaluate the readability, quality, and comprehensiveness of online health resources on hand dermatitis. Methods: On July 27th 2021, a Google search was conducted with terms “hand dermatitis” and “hand eczema” and the first 40 items were evaluated. Articles that were advertisements, blogs, intended for professionals, scientific papers, or irrelevant were excluded. Contents of articles were evaluated using several validated grading tools/criteria for readability and quality and Pearson’s correlation assessed the relationship between readability and quality. Results: Twenty-three articles met inclusion criteria. Average readability was at the 11th-grade level (range 7.7-15.6). University-level reading comprehension (≥13th grade) was required for 5/23 websites. The highest quality website based on the Discern instrument was Medical News Today (55.5);nearly half of the websites (48%, 11/23) rated as poor or very poor. The average JAMA benchmark score was only 1.4/4. Nineteen websites contained images (83%) and only 4 websites (21%) included images representing hand dermatitis in skin of color (SOC). Quality and readability of the articles were significantly correlated (P =.02). Conclusion: Our results demonstrate that generally, articles were too difficult to read, have low quality, and lack representation of SOC images. With increases in hand dermatitis in the setting of frequent hand-hygiene practices during the COVID-19 pandemic, it is important for online health information to improve in readability, quality, and inclusion of SOC images to optimize online patient education.

Hand Eczema: Diagnostic approach and management

Hand eczema (HE) is a chronic inflammatory disorder of the hand with a prevalence of 14.5% worldwide. The incidence of HE has increased considerably during Coronavirus-19 (COVID-19) pandemic due to increased hand hygiene practice. Despite not affecting the mortality rate, HE can decrease the patient's quality of life significantly and increase morbidity. In general, HE can be classified based on its onset, etiology, precipitating factors, and clinical morphology. The diagnosis of HE is established through history taking and physical examination, however, several diagnostic tests should be performed to identify the etiology and exclude the differential diagnosis, including dermoscopic examination, histopathological examination, patch test, and prick test. In addition to diagnostic tests, the severity of HE should also be established to determine the appropriate therapy and monitor the therapeutic responses. After HE is identified, comprehensive management should be provided immediately so that HE will not progress into a chronic disorder which will further decrease the patient's quality of life.

Prevention of occupational hand eczema in healthcare workers during the COVID-19 pandemic: A controlled intervention study.

BACKGROUND: Occupational hand eczema (HE) is common among healthcare workers (HCWs) and has-in some regions of the world-increased during the COVID-19 pandemic due to related hygiene measures. OBJECTIVES: To evaluate the efficacy of an intervention for HE prevention in HCWs during the pandemic. METHODS: A prospective, controlled, unblinded interventional trial was conducted in 302 HCWs. The intervention group (IG) (n = 135) received online-based health education and free access to hand cleansing and hand care products. The control group (CG) (n = 167) did not receive any intervention within the study. At baseline (T0), after 3 (T1) and 6 (T2) months, participants completed standardized questionnaires. The Osnabrueck Hand Eczema Severity Index (OHSI) was assessed at T0 and T2. RESULTS: During the observation period, there were no new HE cases in the IG (n = 115) and 12 cases (8.8%) in the CG (n = 136). OHSI values at T2 were lower in the IG (b = -1.44, p < 0.001). Daily use of emollients was higher at work (b = 1.73, p < 0.001) and at home (b = 1.62, p < 0.001) in the IG at T2. CONCLUSIONS: The intervention was effective in HE prevention and improving skin care behaviour during the COVID-19 pandemic.

Hygiene in Dermatology: SARS-CoV-2 and Variants of Concern

Around the world the COVID-19 pandemic has severely impaired life and work. With the beginning of vaccinations, the hope of a turnaround increases. Nevertheless, COVID and intensive care units in hospitals are still heavily burdened. Often, for capacity reasons, medical dermatological as well as dermatological nursing specialists are involved in treatment and care of COVID-19 patients in clinics. As a result dermatological manifestations of COVID-19 could be recognized and classified more closely in the course of the pandemic. However, differentiated hygiene concepts, especially that of hand hygiene, reveal another dermatological problem associated with the pandemic: the development of hand eczema. This is not limited to medical professions and therefore shows a possible overriding importance of dermatology in the context of future pandemic strategies.

Contact dermatitis in healthcare workers: epidemic at the height of the COVID-19 pandemic?

Healthcare workers (HCWs) are generally exposed to a considerable amount of wet work - including a high frequency of hand washing and long wearing periods of protective gloves with accompanying heat congestion and sweating by occlusion - and thus a high risk of developing hand eczema (HE), mainly caused by irritant contact dermatitis. Intensified hand hygiene measures have been implemented for containing the coronavirus disease 2019 (COVID-19) pandemic which emerged in the beginning of 2020 and has led to increased skin strain in the general population and particularly in HCWs who face a double burden due to elevated hygiene measures both in private life and at work. Recent studies verify that prevalence of occupational dermatoses in HCWs has increased during the COVID-19 pandemic. Recommendations for preventing occupational HE include the use of adequate skin cleansing substances and skin care products, which can be taught within health education programs. It was previously shown that health education interventions are effective in the prevention of occupational dermatoses and especially HE. The unprecedentedly high incidence of contact dermatitis in HCWs associated with COVID-19-associated hygiene measures entails the need for tailored HE prevention strategies to preserve the working ability of HCWs who are urgently needed in tackling the pandemic and its consequences. Current findings and future perspectives will be discussed in this speech.

Corona Chronicles: A Cross-sectional Survey of Practices, Challenges, and Dermatological Impact of the COVID-19 Pandemic

OBJECTIVE: Mask usage and hand hygiene are the pillars of defense against the novel pathogen causing COVID-19. This study was conducted to compare these practices among healthcare workers (HCWs) and nonhealthcare workers (nonHCWs) and to examine the outlook toward the healthcare sector among the two. METHODS: A cross-sectional online survey (via Google forms) using snowball sampling was conducted. Appropriate ethical clearance was taken from the Institutional Ethical Committee (IEC). HCWs and nonHCWs 18 years of age or older with basic literacy in English and with internet access were included. RESULTS: There were 404 total respondents (M:F ratio: 0.87:1;mean age: 30.16±9.63 years). Among the respondents, 63.3 percent were HCWs while 35.6 percent were nonHCWs. Persons performing hand hygiene more than10 times/ day were found to be almost three times more likely to develop skin dryness (odds ratio [OR]: 2.95, 95% confidence interval [CI]: 1.372, 6.362). Female participants were found to be 2.5 times more likely to develop dryness (odds ratio: 2.594, 95% CI: 1.590, 4.234). Use of gloves was found to be a protective factor against development of dryness (odds ratio: 0.485,95% CI: 0.287, 0.818). A statistically significant correlation was found between mask acne and female respondents (p-value=0.000), HCWs (p-value=0.000), and use of N95 mask in combination with surgical mask (p-value=0.04). LIMITATIONS: Being an online survey, responses could not be captured from people with limited internet access and of lower socioeconomic strata. CONCLUSION: There is a considerable burden of preventive measures on HCWs and nonHCWs alike. Significant dermatological implications are seen with frequent hand hygiene and mask usage.

Hand hygiene and hand eczema: A systematic review and meta-analysis.

Hand eczema is a common inflammatory condition of the skin that has been linked to hand hygiene. This systematic review and meta-analysis aims to determine the risks of hand eczema associated with hand hygiene, including frequency of hand washing, wet work and use of alcohol hand rub. A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed for cohort, case-control or cross-sectional studies that analysed the association between hand hygiene and risk of hand eczema. Results of individual studies were presented in respective forest plots and pooled summary relative risks were estimated using a random-effects model. Forty-five studies were included in the analysis. Hand washing at least 8-10 times daily significantly increased risk of hand eczema (relative risk [RR] 1.51; 95% confidence interval [CI]: 1.35-1.68; p < 0.001). The risk was related to hand washing frequency, with higher pooled RR of 1.66 (95% CI: 1.51-1.83; p < 0.001) with increased hand washing at least 15-20 times daily. However, use of alcohol-based hand sanitizer was not significantly associated with risk of hand eczema. Given the widespread implementation of hand hygiene practices during the COVID-19 pandemic, there is a pertinent need to understand skin care habits specific to the hands to avoid a greater incidence of hand eczema.

Hand eczema, wet work exposure, and quality of life in health care workers in Denmark during the COVID-19 pandemic.

Background: The focus on hand hygiene during the pandemic has been reported to increase the hand eczema (HE) prevalence in health care workers (HCWs); however, detailed prospective data are missing. Objective: To evaluate changes in HE prevalence, exposures, and health-related quality of life among HCWs during the COVID-19 pandemic. Methods: In this prospective cohort study, HCWs employed at the hospitals in Copenhagen responded to a digital questionnaire at the beginning of the pandemic and 11 months thereafter. Results: A total of 795 HCWs responded to both questionnaires (83.4% women). The calculated 1-year HE prevalence decreased from 16.0% at baseline to 13.0% at follow-up. The number of hand washings decreased significantly, whereas the use of alcohol-based hand rubs on wet skin increased significantly. In a logistic regression model, increased use of alcohol-based hand rubs on wet skin was associated with HE at follow-up (odds ratio, 1.78; 95% CI, 1.11-2.87). Health-related quality of life worsened slightly at follow-up, with HE severity and frequent flareups being risk factors for a reduced health-related quality of life. Limitations: Sample size. Conclusion: In contrast to previous studies undertaken during the pandemic, we found a relatively low and stable HE prevalence. Our findings suggest that the interaction between changed exposures and HE is complex and cannot be linked to a single factor.

Evaluation of clinical efficacy of synthetic tannin and polidocanol-based agents and modern emollients in the hand eczema treatment. Use of new hand antiseptics during the pandemic in patients with hand eczema

Background. Patients with hand eczema account for 30–40% of dermatological patients. With the pandemic of new coronavirus infection COVID-19 and the need for frequent antiseptics use, there has been a steady increase in hand eczema incidence. The dominant symptoms in exacerbating eczema are skin inflammation and itching, which requires effective and safe skincare that is effective and safe. Objective. To evaluate the efficacy of the therapy with synthetic tannin and polidocanol-based agents and modern emollients, the time of resolution and degree of severity of clinical symptoms of eczema in patients, as well as the time and duration of remission, safety and compliance with sodium hypochlorite hand antiseptic spray. Materials and methods. Thirty-four patients with exacerbation of hand eczema were examined. The study was conducted in two stages. At the stage 1, before the remission, the patients received synthetic tannin and polidocanol-based agents and modern emollients;at the stage 2, monotherapy with modern emollients was used. Patients used sodium hypochlorite spray as a hand sanitizer throughout the study period. Results. The NESCI score became zero in 33 (96%) patients after the complex treatment of hand eczema. The Dermatology Life Quality Index by the end of stage 2 decreased 6-fold compared to the beginning of the study. No exacerbation of the dermatosis was observed in any of the patients included in the study during the use of sodium hypochlorite hand spray. Conclusion. The complex therapy with synthetic tannin, polidocanol-based agents, and modern emollients in hand eczema helps to achieve stable medical remission, decreases the itching intensity, and improves the patients’ quality of life. The use of new hand sanitizers during the pandemic in patients with hand eczema did not result in dermatosis exacerbations.

Effects of skin washing frequency on the epidermal barrier function and inflammatory processes of the epidermis: An experimental study.

BACKGROUND: Increased hand hygiene measures during the COVID-19 pandemic have led to an increased quantum of hand eczema (HE). OBJECTIVES: To examine the effects of varying washing frequencies using current mild cleansing agents-alongside with the effect of a rehydrating cream-on the epidermal barrier function and inflammatory processes of the stratum corneum(SC). METHODS: Standardized skin washings on the volar aspects of the lower arms of skin-healthy volunteers were performed using the automated cleansing device either 5 or 11 times within 4 h for 60 s each with a standard cleanser, a lipid-containing syndet, or a lipid-containing syndet followed by one-time application of a rehydrating cream. Skin bioengineering parameters (transepidermal water loss, SC hydration, erythema, and SC pH) and biochemical/immunological parameters (interleukin-1α, interleukin-1α receptor antagonist and natural moisturizing factor) of SCsamples collected by tape stripping were assessed. RESULTS: All applied washing procedures provided comparable, mild effects on the epidermal barrier function and skin inflammation. CONCLUSION: Occupational skin cleansers seem to have improved regarding skin barrier damaging effects. To further corroborate this, a study design, modified on the basis of our findings, applying longer washing periods for consecutive days seems desirable.

What do COVID-19-associated hygiene measures mean for the skin health of healthcare workers? Results of a controlled, prospective intervention study

Introduction: More than 100,000 occupational COVID-19 infections in healthcare workers (HCW) were reported in Germany from 12/2020 to 6/2021. Hygiene measures were consequently tightened further. We investigated the impact of current hygiene measures on the incidence of hand eczema (HE) and the effect of prevention measures during the above-mentioned period. Materials and Methods: 302 nurses from two hospitals were recruited for a controlled intervention study. The intervention group (IG, n=135) underwent a two-part intervention (online health education course and provision of a skin cleansing and skin care product ad libitum). The control group (CG, n=167) received no intervention. The skin condition of the hands was assessed by a dermatologist at baseline (T0) and after 6 months (T2) using the Osnabrueck Hand Eczema Severity Index (OHSI). Results: The drop-out rate was 16.9% at T2. New HE developed in none of the 115 participants of the IG but in 12 (8.8%) of the 136 participants of the CG. With the same baseline score (1.5 points in both groups at T0), the OHSI showed statistically significantly better values in the IG than in the CG at T2 (0.6 points vs. 2.1 points, p<.001). Conclusions: The intervention did not only contribute to maintenance but even to improvement of the skin condition. A decrease in hygiene measures is not to be expected in the foreseeable future. The use of the intervention concept in the context of the prevention of occupational HE among HCW seems reasonable. Skin protection and skin care recommendations of the online health education course can also be adapted for other high-risk occupations.

Risk factors for hand eczema in the general population of Saudi Arabia during the COVID-19 pandemic: An internet-based cross-sectional study.

BACKGROUND: Hand eczema (HE) is a common disorder that negatively impacts the quality of life. During the COVID-19 pandemic, several studies have shown an increase in HE in health care workers. However, data on the general population are lacking. OBJECTIVE: To assess the prevalence and risk factors of HE among the Saudi general population during the pandemic. METHODS: This cross-sectional study was conducted using an online questionnaire composed of 4 sections (participant characteristics, history of atopic disorders, hand hygiene methods, and HE symptoms). It was distributed on Twitter during the lockdown period, between August 2020 and September 2020. Descriptive, bivariate, and multivariable analyses were conducted using STATA v16. RESULTS: A total of 582 (52.6% women and 47.4% men) participants responded to the questionnaire. The 6-month prevalence of HE was 34%. In multivariable analysis, having a past history of eczema, rhinitis/conjunctivitis, using soaps for >5 times daily, using gloves daily, and using moisturizers were significantly associated with HE. Interestingly, using sanitizers for >5 times daily was not a statistically significant risk factor. LIMITATIONS: Due to its internet-based nature, the response rate cannot be accurately calculated. In addition, the response bias and the small sample size limit the generalizability of the results and prevent drawing broad conclusions and accurate measurement of prevalence. CONCLUSION: HE prevalence increased during the pandemic in the Saudi general population. Frequent use of soaps and gloves, but not sanitizers, increased HE risk.

Hand Dermatitis: A Comprehensive Review with Special Emphasis on COVID-19 Pandemic.

Hand dermatitis (HD) is a chronic, relapsing, and remitting inflammatory condition that adversely affects the quality of life of the individual and gravely impacts the mental and socioeconomic well-being by causing professional hindrance and often leading to loss of wages. Despite being one of the most common skin conditions seen by dermatologists, it is often underreported. With the coronavirus pandemic ongoing, there is an emphasis on hand hygiene-being a widely publicized and important preventive measure to control the spread of the Coronavirus disease (COVID-19) virus. Emphasis on hand hygiene has led to a surge in HD, and the presence of HD, in turn, leads to compromised hand hygiene practices and this breach in the skin barrier contributes to another portal of entry of infective agents. We undertook a comprehensive English literature search across multiple databases such as PubMed, SCOPUS, EMBASE, MEDLINE, and Cochrane using keywords and MeSH items to obtain and review several relevant articles. Thus, this review focuses on various clinical, diagnostic as well as therapeutic aspects of this much prevalent and debilitating skin condition which deserves more attention especially during the times of the COVID-19 pandemic where the utmost emphasis is being given to handwashing leading to a vicious cycle of a surge in the cases of HD and compromised skin barrier causing increased susceptibility to the COVID-19 infection.

Increased prevalence of irritant hand eczema in health care workers in a dermatological clinic due to increased hygiene measures during the SARS-CoV-2 pandemic.

BACKGROUND: Hand hygiene measures in the general population and in health care workers have increased considerably since the outbreak of the COVID-19 pandemic. OBJECTIVES: To investigate the prevalence and symptoms of hand eczema, as well as hygiene measures and concepts of care, in German health care workers. MATERIALS & METHODS: This was an observational questionnaire study to investigate hygiene and skin care habits, as well as the prevalence and symptoms of hand eczema in 66 nurses and doctors of our dermatology department before and during the SARS-CoV-2 pandemic. RESULTS: Hand washing and hand disinfection procedures increased significantly during the COVID-19 pandemic. Self-diagnosed hand eczema was reported by 33% of the participants, with a median duration of 14 days. The majority of staff currently affected by hand eczema were free of eczema a month previously (82%) and would treat their skin condition with emollients (77%). Erythema, scaling, burning and fissures were reported by 66.1% of the participants and were classified as predominant signs of toxic-irritant hand dermatitis rather than contact allergy. CONCLUSION: Overall, the SARS-CoV-2 pandemic has led to a significant increase in the incidence of signs of irritant hand eczema despite intensified emollient use as a preventive measure. Awareness of the prevalence of hand eczema in health care workers in Germany during the COVID-19 pandemic should be raised, and preventive measures should be intensified.

The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in the Mecca Region, Saudi Arabia.

PURPOSE: Due to the COVID-19 pandemic, recommendations to prevent infection suggest increasing the frequency of handwashing and disinfection; however, these measures can have negative implications on our skin. This study aims to evaluate whether these measures correlate with new-onset skin damage or can exacerbate hand eczema among the general population. MATERIALS AND METHODS: This was a descriptive, cross-sectional, survey-based study, including the general population of Mecca region, Saudi Arabia. To achieve the study's aim, an online questionnaire to the general population comprising 25 items was distributed via social media apps during the pandemic between October 23 and November 21, 2020. Data were automatically collected in Excel and entered into SPSS for analysis. RESULTS: A total of 783 participants were included in this study, of whom 695 (88.8%) were female. A history of hand eczema was reported among 123 (15.7%) participants, and 270 (34.5%) had a history of atopy. During the COVID-19 pandemic, 86 (13.0%) participants noticed new-onset skin irritation, while 81 (31.3%) of the participants reported exacerbation of earlier hand allergic dermatitis. The most frequent symptoms were dryness and feeling of tightness. Additionally, most participants among both groups noticed that skin lesions appeared for less than 10 days. The frequent handwashing statistically increased following the onset of the pandemic (p=0.001), there is association between new-onset symptoms and more frequent handwashing, as well as the use of hand disinfectants, during the pandemic (p=0.001). CONCLUSION: Our study suggests that the general population's skin was negatively affected by COVID-19 precautions, particularly those with a history of hand eczema. We recommend spreading awareness of skin protective modalities and the use of new infection prevention measures, such as regular skin moisturization for hand protection and possibly using less damaging skin disinfectants like ozonized water provided it is scientifically proven effective in disinfecting COVID-19 virus.

Hand Hygiene Habits and Prevalence of Hand Eczema During the COVID-19 Pandemic.

PURPOSE: This study aimed to explore the prevalence of and possible risk factors for hand eczema with respect to the dissemination of information about new hand hygiene habits to protect against ongoing COVID-19 cross-transmission. The authors conducted a survey among health care workers (HCWs) and non-HCW populations in Khon Kaen, Thailand. RESULTS: A total of 805 participants participated. The prevalence of hand eczema in the study population was 20.87%. There were several risk factors, including working as a HCW, having a history of previous hand eczema, having underlying atopic dermatitis, wearing gloves in everyday life, and washing hands frequently (more than 10 times/day). Hand hygiene with alcohol-based products was shown to be a risk factor for hand eczema, (OR (95% CI) 1.86 (1.03-3.35), P = .04). CONCLUSION: In terms of hand eczema prevention, we suggest that the use of alcohol-based products should be discontinued if other handwashing methods are available. The following factors increase the risk of hand eczema: being a HCW, having previous hand eczema, and having underlying atopic dermatitis. Proper strategies in terms of hand eczema prevention should be addressed, especially in this group, since we need to continue performing hand hygiene during the ongoing COVID-19 pandemic.

How does working in pandemic units affect the risk of occupational hand eczema in healthcare workers during the coronavirus disease-2019 (COVID-19) pandemic: A comparative analysis with nonpandemic units.

BACKGROUND: Hand eczema (HE) has increased among healthcare workers (HCWs) working in coronavirus disease-2019 (COVID-19) units, and was associated with increased hand hygiene practices. OBJECTIVES: To compare the prevalence and clinical characteristics of HE, and hand hygiene practices in HCWs working in COVID-19 and non-COVID-19 units. METHODS: A total of 244 HCWs working in COVID-19 (n = 118) and non-COVID-19 patient care units (n = 126) were examined by dermatologists with regard to demographic parameters and hand hygiene practices. The COVID-19 and non-COVID-19 groups were matched at a 1:1 ratio according to age, atopy, and generalized dry skin. RESULTS: HE was more frequent in the COVID-19 group (48.3% vs 12.7%, P < .001), whereas working years (P < .05) and additional housework at home (P < .001) were longer in the non-COVID-19 group. After the development of HE, moisturizing creams were reported to be more frequently used in the COVID group (P < .001). Topical corticosteroids were used in a minority (40% in the COVID group and 26.7% in the non-COVID group). CONCLUSIONS: HCWs in COVID-19 units developed HE more frequently. A majority increased the frequency of moisturizer use, instead of using topical corticosteroids, after the development of HE for the purpose of treating eczema. New approaches are needed for the prevention and management of HE in HCWs, especially by facilitating access to dermatologists.