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1.
Contact Dermatitis ; 86(2): 98-106, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1511298

ABSTRACT

BACKGROUND: Apprentice nurses are considered at high risk to developing occupational skin diseases. OBJECTIVES: This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses. METHODS: The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. RESULTS: Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. CONCLUSIONS: Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.


Subject(s)
COVID-19/nursing , Dermatitis, Occupational/etiology , Eczema/etiology , Hand Dermatoses/etiology , Students, Nursing , Croatia , Female , Humans , Male , Pandemics , Patch Tests , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Young Adult
3.
J Med Virol ; 93(10): 5756-5767, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1432444

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.


Subject(s)
COVID-19/complications , Skin Diseases/etiology , COVID-19/drug therapy , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Dermatitis, Occupational/therapy , Diagnosis, Differential , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Drug Eruptions/pathology , Drug Eruptions/therapy , Humans , Personal Protective Equipment/adverse effects , SARS-CoV-2 , Skin Diseases/diagnosis , Skin Diseases/pathology , Skin Diseases/therapy
5.
Med Lav ; 112(4): 320-326, 2021 Aug 26.
Article in English | MEDLINE | ID: covidwho-1377151

ABSTRACT

BACKGROUND: Occupational hand dermatitis (OHD) is a skin disease occurring on employees' hands in certain jobs. Little is known about prevalence, incidence and characteristics of this adverse skin reaction and its associated risk factors during COVID-19 pandemic. To evaluate both prevalence and incidence of OHD and associated risk factors in Italian clinicians. METHODS: A cross-sectional study was performed using a self-report questionnaire. RESULTS: Two hundred and thirty clinicians responded to the survey and 82% of responders did not report previous OHD history before the COVID-19 pandemic. Daily use of gloves was reported by 80% of responders. OHD prevalence was 18%, while incidence was 80%. We found a protective effect on symptom occurrence for vinyl/nitrile gloves if the time with gloves was ≥ 6 hours per day. CONCLUSIONS: This survey reveals a high OHD incidence in an Italian population of clinicians. Furthermore, wearing vinyl/nitrile gloves for at least 6 hours a day had a protective effect on symptom onset.


Subject(s)
COVID-19 , Dermatitis, Occupational , Hand Dermatoses , Cross-Sectional Studies , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Gloves, Protective , Hand Dermatoses/epidemiology , Hand Dermatoses/etiology , Hospitals , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
6.
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
7.
Clin Exp Dermatol ; 46(8): 1504-1510, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1343831

ABSTRACT

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM: To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS: From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS: Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION: Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.


Subject(s)
Dermatitis, Occupational/etiology , Facial Dermatoses/etiology , Masks/adverse effects , Personnel, Hospital , Acne Vulgaris/etiology , Adult , COVID-19/prevention & control , Female , Hospitals, University , Humans , Male , Middle Aged , Pandemics/prevention & control , Pruritus/etiology , Republic of Korea , SARS-CoV-2 , Tertiary Care Centers
8.
Ital J Dermatol Venerol ; 156(2): 220-225, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1302863

ABSTRACT

BACKGROUND: During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks increased in the general population. We aimed to quantify the prevalence of mask-related cutaneous side effects and the differences between CE and non-CE approved masks. METHODS: In this multicenter prospective observational study conducted from March 20, 2020 to May 12, 2020(during and after quarantine), patients attending emergency departments for a dermatological consult were clinically assessed and their masks were inspected to detect CE marks and UNI (Italian National Unification Entity) norms. Patients with history of facial dermatoses or under current treatment for facial dermatoses were excluded. RESULTS: We enrolled 412 patients (318 during quarantine and 94 after quarantine). CE-approved masks were observed 52.8% vs. 24.5%, whilst subsets of non-CE approved masks were 9.7% vs. 14.9% (Personal protective equipment (PPE)-masks), 16.4% vs. 12.8% (surgical masks [SM]), and 21.1% vs. 47.9%(non-PPE) and (non-SM masks), respectively during and after quarantine. Remarkably, non-CE-approved masks resulted in patients displaying a statistically significant higher incidence of facial dermatoses and irritant contact dermatitis compared to CE-approved masks, and these differences were mainly driven by non-PPE non-SM masks. Comparing quarantine and after quarantine periods, no statistically significant differences were found for CE-approved masks, whilst differences were detected in non-CE-approved masks regarding incidence of facial dermatoses (P<0.0001)and irritant contact dermatitis (P=0.0041). CONCLUSIONS: Masks are essential to prevent COVID-19 but at the same time higher awareness regarding mask specifications should be promoted in the general population. Non-PPE and non-SM masks should undergo more rigorous testing to prevent the occurrence of cutaneous side effects and future patients' lawsuit damages.


Subject(s)
COVID-19 , Dermatitis, Occupational/etiology , Disease Outbreaks , Facial Dermatoses/etiology , Masks/adverse effects , Personal Protective Equipment/adverse effects , COVID-19/epidemiology , Humans , Italy/epidemiology , Masks/standards , Personal Protective Equipment/standards , Prospective Studies
9.
Ned Tijdschr Tandheelkd ; 128(6): 323-330, 2021 Jun.
Article in Dutch | MEDLINE | ID: covidwho-1259697

ABSTRACT

In recent decades, hand eczema has been seen more frequently in oral care practices. Hand eczema is a difficult problem, especially since the start of the current COVID-19-pandemic, and can lead to absence due to illness at work. The main trio in the development of eczema is predisposition (atopy), irritation and allergy. Irritative contact dermatitis is caused by damage to the skin barrier. In dentistry, this is often caused by frequent contact with water, soaps, disinfectants and the use of gloves. The cause of allergic contact dermatitis is related to the use of various materials in oral care practice, such as acrylates, rubber and rubber additives. Essential measures are very important in oral care practice to prevent hand eczema. Various measures are key: adequate skin care with liniments, good skin protection with proper gloves and no-touch techniques. Knowledge of possible allergens and adequate hand hygiene and hand care are crucial to minimize the risk of chronic eczema.


Subject(s)
COVID-19 , Dermatitis, Occupational , Hand Dermatoses , Occupational Health , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Dermatitis, Occupational/prevention & control , Hand Dermatoses/epidemiology , Hand Dermatoses/etiology , Hand Dermatoses/prevention & control , Humans , SARS-CoV-2
11.
Cutan Ocul Toxicol ; 40(3): 207-213, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1246634

ABSTRACT

INTRODUCTION: Coronavirus disease-2019 (COVID-19) is a highly contagious infectious disease that first appeared in Wuhan, China, in December 2019. Health care workers (HCWs) are at increased risk of infection because the virus is highly contagious and can be transmitted by a variety of routes. Health care workers are required to use a variety of personal protective equipment (PPE) for prolonged hours and, as a result, they face varying degrees of cutaneous complications. METHODS: We conducted a cross-sectional online questionnaire survey to investigate skin problems caused by the use of PPE and personal hygiene measures. We developed a survey with 32 questions using Google forms and distributed it via WhatsApp and Facebook groups. RESULTS: A total of 1142 responses were obtained. Among the respondents, 88.1% reported adverse skin reactions due to PPE and personal hygiene measures. Female sex, working as a nurse, wearing PPE more than 6 h/day, and working more than 3 days/week increase the risk of PPE-related skin problems. CONCLUSION: In this study, we highlighted skin problems related to PPE and found out risk factors for PPE-related skin problems.


Subject(s)
COVID-19/prevention & control , Dermatitis, Occupational/epidemiology , Health Personnel/statistics & numerical data , Personal Protective Equipment/adverse effects , Adult , Aged , COVID-19/epidemiology , COVID-19/transmission , Communicable Disease Control/instrumentation , Communicable Disease Control/standards , Cross-Sectional Studies , Dermatitis, Occupational/etiology , Female , Health Personnel/standards , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Middle Aged , Pandemics/prevention & control , Personal Protective Equipment/standards , Risk Factors , Sex Factors , Surveys and Questionnaires/statistics & numerical data , Time Factors , Young Adult
13.
Curr Allergy Asthma Rep ; 21(4): 26, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1155324

ABSTRACT

PURPOSE OF REVIEW: This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates. RECENT FINDINGS: Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.


Subject(s)
Allergens/adverse effects , COVID-19/epidemiology , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Occupational/diagnosis , Acrylates , Acyclic Monoterpenes/adverse effects , Allergy and Immunology/trends , Camphanes , Dermatitis, Occupational/etiology , Dermatology/trends , Health Personnel , Humans , Lavandula/adverse effects , Limonene/adverse effects , Pandemics , Patch Tests/adverse effects , Propylene Glycol , Societies, Medical , United States
15.
Dermatitis ; 32(2): 86-93, 2021.
Article in English | MEDLINE | ID: covidwho-1091202

ABSTRACT

Occupational contact dermatitis accounts for 95% of all cases of occupational skin disease with irritant contact dermatitis (ICD) constituting 80% to 90% of these cases. Health care workers, hairdressers, and food service workers are typically most affected by occupational ICD of the hands as these occupations require frequent hand hygiene and/or prolonged exposure to water, also known as "wet work." In the context of the current COVID-19 pandemic, frequent hand hygiene has become a global recommendation for all individuals, and new workplace guidelines for hand sanitization and surface sterilization are affecting occupations not previously considered at risk of excessive wet work including grocery or retail workers, postal workers, sanitization workers, and others. In this review, we discuss the etiology and pathogenesis of occupational ICD with additional focus on treatment and interventions that can be made at an institutional and even national level for education and prevention of ICD resulting from frequent hand hygiene.


Subject(s)
Dermatitis, Allergic Contact/epidemiology , Dermatitis, Irritant/epidemiology , Dermatitis, Occupational/epidemiology , Hand Dermatoses/epidemiology , Dermatitis, Allergic Contact/etiology , Dermatitis, Irritant/etiology , Dermatitis, Occupational/etiology , Female , Hand Dermatoses/etiology , Hand Hygiene/statistics & numerical data , Humans , Male , Occupational Exposure/statistics & numerical data
16.
J Eur Acad Dermatol Venereol ; 35(6): 1285-1289, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1082476

ABSTRACT

Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/MEDLINE (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term 'incidence of contact dermatitis in HCWs' according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohorts; 10 register-based) with follow-up periods between 1987 and 2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10 000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10 000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.


Subject(s)
COVID-19 , Dermatitis, Occupational , Occupational Diseases , Occupational Exposure , Dentists , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Health Personnel , Humans , Incidence , Professional Role , Prospective Studies , SARS-CoV-2
19.
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
20.
Ann Acad Med Singap ; 49(9): 674-676, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-973006

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic continues to spread globally at a staggering speed. At present, there is no effective treatment or vaccine for COVID-19. Hand disinfection is a cost-effective way to prevent its transmission. According to the Centres for Disease Control and Prevention (CDC) guidelines, we should wash our hands with soap and water for at least 20 seconds. If soap and water are not readily available, alcohol-based hand rubs (ABHRs) with at least 60% alcohol are the alternative. With diligent hand disinfection reinforced during COVID-19, there is an increased prevalence of contact dermatitis. This commentary highlights the fact that contact dermatitis is a readily treatable condition and should not cause any deviation of proper hand hygiene. In irritant contact dermatitis (ICD), the management strategies are selection of less irritating hand hygiene products, frequent use of moisturisers to rebuild the skin barrier, and education on proper hand hygiene practices. In allergic contact dermatitis (ACD), the identification and avoidance of the contact allergen is the key to treatment. However, ACD is less common and only accounts for 20% of the cases. The identified allergens in hand cleansers are predominantly preservative excipients and ACD attributable to ABHR are very uncommon. Alcohol-free hand rubs are widely available on the market but it is not a recommended alternative to ABHRs by the CDC.


Subject(s)
COVID-19/prevention & control , Dermatitis, Allergic Contact/therapy , Dermatitis, Irritant/therapy , Emollients/therapeutic use , Hand Dermatoses/therapy , Hand Disinfection/methods , Hygroscopic Agents/therapeutic use , 1-Propanol/adverse effects , 2-Propanol/adverse effects , Anti-Infective Agents, Local/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatitis, Irritant/etiology , Dermatitis, Occupational/etiology , Dermatitis, Occupational/therapy , Detergents/adverse effects , Ethanol/adverse effects , Hand Dermatoses/etiology , Hand Hygiene , Hand Sanitizers/adverse effects , Health Personnel , Humans
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