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2.
Eur J Dermatol ; 31(2): 199-204, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1352754

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, wearing face masks is mandatory not only for health care workers (HCWs) but also for the general population in many countries around the globe. OBJECTIVES: The aim of the study was to investigate the onset of adverse facial skin reactions due to compulsory face masks during the COVID-19 pandemic in HCWs and non-HCWs, and draw awareness of this new dermatological condition and its preventive measures. MATERIALS & METHODS: A questionnaire was distributed to 550 patients and HCWs from the Department of Dermatology and Allergy of the University Hospital Munich (LMU), Germany. Participants were surveyed regarding mask type, duration of usage and adverse facial skin reactions. Information on symptoms and the use of skin care products and topical drugs were retrieved. RESULTS: The duration of wearing masks showed a significant impact on the prevalence of symptoms (p < 0.001). Type IV hypersensitivity was significantly more likely in participants with symptoms compared to those without symptoms (p = 0.001), whereas no increase in symptoms was observed in participants with atopic diathesis. HCWs used facial skin care products significantly more often than non-HCWs (p = 0.001). CONCLUSION: Preventive and therapeutic measures should be established in order to avoid "face mask dermatitis", especially for people with underlying risk factors.


Subject(s)
COVID-19/prevention & control , Dermatitis, Contact/etiology , Dermatitis, Occupational/etiology , Facial Dermatoses/etiology , Health Personnel , Masks/adverse effects , Dermatitis, Contact/epidemiology , Dermatitis, Occupational/epidemiology , Facial Dermatoses/epidemiology , Germany/epidemiology , Humans
4.
Int J Dermatol ; 60(3): 327-331, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-977494

ABSTRACT

BACKGROUND: Coronavirus Disease 2019 (COVID-19) is a viral illness caused by the novel coronavirus SARS-CoV-2 which spreads via droplets from an infected person. There has been an unprecedented rise in the use of personal protective equipment and practice of personal hygiene measures against COVID-19. The extended use of protective measures (PM) can lead to ill effects on the skin. Our aim was to investigate PM-induced dermatoses amongst healthcare workers and the general population during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted over a period of 2 months. The study subjects were patients who presented to dermatology outpatient clinics or sought teleconsultation for skin problems related to the use of PMs against COVID-19. A detailed history was obtained and cutaneous examination was documented for all the patients in a pre-set proforma. Diagnoses of the adverse skin effects were formulated based upon history and clinical examination. RESULTS: A total of 101 cases with cutaneous adverse effects due to the use of PMs against COVID-19 were included in the study. The general population and healthcare workers were affected similarly, comprising of 54.5% and 45.5%, respectively. The mean age of the study participants was 36.71 ± 15.72 years. The most common culprit material was soap and water (56.4%). Contact dermatitis was found to be the most common adverse effect in the majority of our patients (72.3%). The most common symptom reported was pruritus (45.5%). The wearing of personal protective equipment for a longer duration was significantly associated with multiple symptoms (P = 0.026). CONCLUSION: The enhanced use of different PMs against COVID-19 can result in a variety of adverse skin effects. In our study, the use of soap and water was the most common culprit PM, and contact dermatitis was the most common adverse effect noted.


Subject(s)
COVID-19/prevention & control , Dermatitis, Contact/epidemiology , Dermatitis, Occupational/epidemiology , Hand Hygiene/standards , Pandemics/prevention & control , Personal Protective Equipment/adverse effects , Adult , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Communicable Disease Control/instrumentation , Communicable Disease Control/standards , Cross-Sectional Studies , Dermatitis, Contact/etiology , Dermatitis, Occupational/etiology , Female , Hand Hygiene/methods , Humans , Male , Middle Aged , Personal Protective Equipment/standards , SARS-CoV-2/pathogenicity , Soaps/adverse effects , Young Adult
5.
Dermatol Ther ; 33(6): e14528, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-917742

ABSTRACT

Given the current lack of a therapeutic vaccine for coronavirus disease 2019 (COVID-19), preventive measures including mask wearing are crucial in slowing the transmission of cases. However, prolonged wearing of protective respirators, medical and fabric masks can easily generate excessive sweating, moisture and friction. Closed and warm environments heighten the skin's permeability and sensitivity to physical or chemical irritants, leading to chronic cumulative irritant contact dermatitis or, rarely, even allergic contact dermatitis. Although not representing a life-threatening condition, contact dermatitis can have a significant impact on emergency management, as it is potentially able to reduce work performance and create emotional discomfort due to the involvement of evident body areas. To minimize the skin breakdown, adherence to standards on wearing protective and safe equipments and avoidance of overprotection should be performed. At the same time, some measures of skin care are recommended. Here, we offer some tips on how to prevent and manage contact dermatitis due to masks not only in health care workers, but also in the general population during this COVID-19 outbreak.


Subject(s)
COVID-19/prevention & control , Dermatitis, Contact/prevention & control , Dermatitis, Occupational/prevention & control , Facial Dermatoses/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Inhalation Exposure/prevention & control , Masks/adverse effects , N95 Respirators/adverse effects , Skin Care , Administration, Cutaneous , Adrenal Cortex Hormones/administration & dosage , Anti-Allergic Agents/administration & dosage , Anti-Bacterial Agents/administration & dosage , COVID-19/transmission , Dermatitis, Contact/diagnosis , Dermatitis, Contact/etiology , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/etiology , Facial Dermatoses/diagnosis , Facial Dermatoses/etiology , Humans , Inhalation Exposure/adverse effects , Occupational Health , Protective Factors , Risk Assessment , Risk Factors , Treatment Outcome
6.
Int J Dermatol ; 59(12): 1437-1449, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-892266

ABSTRACT

Numerous unexplained pneumonia cases were reported to the World Health Organization (WHO) by Wuhan, China, in December 2020. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a zoonotic pathogen, came into sight, spreading coronavirus disease 2019 (COVID-19) all over the globe. Association of cutaneous signs and symptoms with COVID-19 is being studied worldwide, principally, to determine if these dermatoses can help in early recognition of SARS-CoV-2 infection. These dermatological manifestations can range from erythematous rash, urticaria to livedo reticularis, and acrocyanosis in patients of all age groups. Correspondingly, dermatologists treating COVID-19 patients, suffering from inflammatory dermatoses, with biologics or immunomodulators should exert caution and use specific protocols to adjust the doses of these medications. Prevention of person-to-person transmission of COVID-19 is being promoted universally, with the use of personal protective equipment (PPE), hand washes, and hand sanitizers around the clock. However, an array of cutaneous adverse effects such as contact dermatitis, irritant contact dermatitis, friction blisters, contact urticaria, acne, and infections are associated with the use of PPE. Extra-pulmonary manifestations of COVID-19 are still emerging in the community, and physicians and researchers are working together globally to strengthen the clinical management of these patients. Cases of COVID-19 continue to rise across the world, and an unprecedented approach has been taken to develop effective vaccines and therapeutic strategies against existing and forthcoming mutagenic strains of SARS-CoV-2.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Dermatitis, Contact/epidemiology , Dermatology/trends , Pneumonia, Viral/epidemiology , Skin Diseases, Infectious/epidemiology , Betacoronavirus/isolation & purification , COVID-19 , Communicable Disease Control/instrumentation , Communicable Disease Control/methods , Communicable Disease Control/standards , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Dermatitis, Contact/diagnosis , Dermatitis, Contact/etiology , Dermatology/standards , Hand Hygiene/standards , Humans , Pandemics/prevention & control , Personal Protective Equipment/adverse effects , Personal Protective Equipment/standards , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/virology
8.
Clin Exp Dermatol ; 46(1): 142-144, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-670754

ABSTRACT

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.


Subject(s)
COVID-19/complications , Dermatitis, Irritant/etiology , Personal Protective Equipment/adverse effects , SARS-CoV-2/genetics , Awareness , COVID-19/epidemiology , COVID-19/pathology , COVID-19/virology , Case-Control Studies , Cross-Sectional Studies , Dermatitis, Contact/etiology , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Emollients/therapeutic use , Female , Hand Disinfection , Health Personnel , Humans , Ireland/epidemiology , Irritants/adverse effects , Male
9.
J Am Acad Dermatol ; 83(6): 1730-1737, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-665321

ABSTRACT

The recent COVID-19 pandemic has resulted in increased hand hygiene and hand cleansing awareness. To prevent virus transmission, the Centers for Disease Control and Prevention recommends frequent hand washing with soap and water. Hand hygiene products are available in a variety of forms, and while each of these formulations may be effective against COVID-19, they may also alter skin barrier integrity and function. As health care workers and the general population focus on stringent hand hygiene, the American Contact Dermatitis Society anticipates an increase in both irritant contact and allergic contact hand dermatitis. Alcohol-based hand sanitizers with moisturizers have the least sensitizing and irritancy potential when compared to soaps and synthetic detergents. This article provides an overview of the most frequently used hand hygiene products and their associations with contact dermatitis as well as recommendations from the American Contact Dermatitis Society on how to treat and prevent further dermatitis.


Subject(s)
Dermatitis, Contact/prevention & control , Dermatitis, Occupational/prevention & control , Hand Dermatoses/prevention & control , Hand Hygiene/standards , Practice Guidelines as Topic , Anti-Infective Agents, Local/administration & dosage , Anti-Infective Agents, Local/adverse effects , Betacoronavirus/pathogenicity , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Coronavirus Infections/virology , Dermatitis, Contact/etiology , Dermatitis, Occupational/etiology , Hand Dermatoses/chemically induced , Health Personnel , Humans , Irritants/administration & dosage , Irritants/adverse effects , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Soaps/adverse effects , Societies, Medical/standards , United States
11.
Medicine (Baltimore) ; 99(24): e20603, 2020 Jun 12.
Article in English | MEDLINE | ID: covidwho-593909

ABSTRACT

In December 2019, a new coronavirus was found in Wuhan, Hubei Province, China, and spread rapidly throughout the country, attracting global attention. On February 11, the World Health Organization (WHO) officially named the disease caused by 2019-nCoV coronavirus disease 2019 (COVID-19). With the increasing number of cases, health care workers (HCWs) from all over China volunteered to work in Hubei Province. Because of the strong infectivity of COVID-19, HCWs need to wear personal protective equipment (PPE), such as N95 masks, latex gloves, and protective clothing. Due to the long-term use of PPE, many adverse skin reactions may occur. Therefore, the purpose of this study is to explore the adverse skin reactions among HCWs using PPE.Questionnaires were used for the research; a quantitative study was carried out to determine the incidence of adverse skin reactions among HCWs using PPE.A total of 61 valid questionnaires were collected. The most common adverse skin reactions among HCWs wearing N95 masks were nasal bridge scarring (68.9%) and facial itching (27.9%). The most common adverse skin reactions among HCWs wearing latex gloves were dry skin (55.7%), itching (31.2%), and rash (23.0%). The most common adverse skin reactions among HCWs wearing protective clothing were dry skin (36.1%) and itching (34.4%).When most HCWs wear PPE for a long period of time, they will experience adverse skin reactions. The incidence of adverse skin reactions to the N95 mask was 95.1%, that to latex gloves was 88.5%, and that to protective clothing was 60.7%.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Personnel , Occupational Diseases/etiology , Pandemics/prevention & control , Personal Protective Equipment/adverse effects , Pneumonia, Viral/prevention & control , Skin Diseases/etiology , COVID-19 , Dermatitis, Contact/etiology , Exanthema/etiology , Female , Humans , Male , Masks/adverse effects , Protective Clothing/adverse effects , Pruritus/etiology , Respiratory Protective Devices/adverse effects , SARS-CoV-2 , Surveys and Questionnaires
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