COVID-19 and impact of personal protective equipment use: from occupational to generalized skin care need

ABSTRACT

During the COVID-19 pandemic in Italy, our Dermatology Clinic experienced an increased number of consultations for contact dermatitis, and skin injuries, requested by the colleagues and sanitary personnel of other wards, often sending images by smart phones applications to avoid visits in presence. The most affected sites included the nasal bridge, hands, cheek, periocular, and perioral regions. Dryness, itching, but also stinging sensations were common. Although majority of PPE related manifestations were mild, self-healing when the use was stopped for sufficient time, restand recovery was not always viable in current situation. The critical point is that adherence to strict PPE protocol is paramount, and presence of even mild abrasion, itching, or burning sensation might induce inadvertent protocol breaches, such as mask touching and PPE adjustment. For mild face dermatitis,we prescribed the application of moisturizers on intact skin and topical antibiotic ointment, mainly fusidic acid on super-infected skin. For sustained contact dermatitis, low- to medium-potency not fluorinated topical glucocorticoids were allowed. Hand and sometimes feet maceration were relieved with normal saline hydropathic compress and topical use of zinc oxide ointment. When erosion and exudation occurred, the application of topical glucocorticoid cream was added. Sustained dermatosis, worsening of preexisting diseases such as psoriasis or atopic dermatitis or allergic reactions might require more complex assessment and management, including the temporary removal from work for health care personnel.