Personal protective equipment-related dermatoses in COVID-19 frontline health workers. A lesson learned from 1-year single center in the UAE.

Since COVID-19 was declared a pandemic in March 2020, frontline health care workers wear personal protective equipment (PPE, surgical masks, N95 or similar respirators, gloves, goggles, face shields, and gowns). Alcohol-based sanitizers and wipes were recommended. Such measures lead to disruption of the natural skin habitat and skin barrier and various cutaneous reactions. The aim was to assess the prevalence and characteristics of PPE-related dermatoses among health care workers in Sheikh Khalifa Medical City (SKMC), a COVID-19 facility, Abu Dhabi, United Arab Emirates. We conducted a voluntary, cross-sectional anonymous survey among first-line health care workers addressing types of PPE used, dermatoses classified as PPE related, and factors that influence them. Facial, nasal, and hand dermatoses were the most prevalent with 40.2%, 19.9%, and 14.1%, respectively. The changes are primarily attributed to surgical masks, N-95 masks, and gloves. The shift duration is a contributing factor correlating with the severity of skin damage. Results of this study encouraged decision makers to recognize PPE-related dermatoses as a continuously growing burden, reorganized the shift duration and PPE exposure, animated the personal to apply preventive measures, and promoted the well-being of medical professionals in new waves of the pandemic.

COVID-19: Topical agents and therapeutic prevention of nasal viral acquisition.

Since the spread of SARS-CoV-2 became a pandemic, the number of cases has been continuously growing worldwide. Numerous recommendations and suggestions have been published to prevent the acquisition and spread of the SARS-CoV-2, especially to protect health workers and front-line caregivers. SARS-CoV-2 is transmitted by aerosol, rendering air defense with suitable ventilation and adequate mask use pivotal. Recently, locally applied antiseptic, antiviral, or structure competitive receptor blockers were suggested to attack the virus at its main point of invasion, the nasal mucosa and nasopharynx. We discuss the most plausible and safe ideas to reduce viral load at the point of entry, and subsequently the spread of SARS-CoV-2 to the lower respiratory tract, lungs, and other organs. In addition, we analyze the value and recommend clinical trials employing topical trichloroacetic acid (TCA), a substance well known from dermatologic and cosmetic procedures. It has been proven to successfully block the nasal entry for airborne allergens, preventing the development of allergic rhinitis and asthma, and to be curative for early stages of viral infections entering through the oral mucosa. For SARS-CoV-2, TCA in a single, short-time application is expected to remodel the nasal and nasopharyngeal epithelia, eliminating both the receptors and cells responsible for viral entry and subsequent viral spread to the lower respiratory tract. Moreover, this may have therapeutic benefits for those recently infected by reducing local viral replication. Such procedures are cheap, safe, and can be conducted in almost every setting, especially in regions with inadequate financial and logistic resources.

Interrupting aerosol spread and nasal acquisition of SARS-CoV-2 with topical trichloroacetic acid.

The devastating effects of the coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have merited many approaches to combat COVID-19. Since it is transmitted largely by fine droplets and aerosols, air defense with suitable ventilation and mask use might be enhanced by attacking the virus and its likely main point of invasion, the nasal mucosa. We recommend formal clinical trials employing topical trichloroacetic acid (TCA), which successfully blocks the nasal entry point for airborne allergens and to be curative for the early stages of viral infections of the oral mucosa. TCA chemically redesigns the nasal and nasopharyngeal epithelia to in effect remove receptors and cell, allowing SARS-CoV-2 viral attachment. TCA fits the ideal category for medication, being inexpensive, readily available, easy-to-use, and proven to be safe for suggested use. We postulate its potential efficacy in SARS-CoV-2 infection and urge consideration of clinical trials. Local delivery of TCA in the form of contact application directly to the nasal cavity may have a preventive effect, potentially neutralizing virus entry and subsequential virus spread to the lower respiratory tract, especially for those at high risk. In addition, TCA may diminish the local viral load and its replication potential in those newly infected.