Clinical considerations for managing dermatology patients on systemic immunosuppressive or biologic therapy, or both, during the COVID-19 pandemic

Sanchez, Daniela P.; Kirsner, Robert S.; Lev‐Tov, Hadar

doi:10.1016/j.jaad.2020.04.143

Cited by 6 publications

(12 citation statements)

References 2 publications

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“…Furthermore, the risk and benefit ratio should be balanced before starting these drugs during the pandemic. 9,17 The decreasing trend in biologic agent use in the present study was most probably due to the concerns related to COVID-19 infection. Furthermore, similar hospitalization rates between the two groups reflected the application of standardized protocols for dermatologic diseases before and during the pandemic.…”

Section: Discussionmentioning

confidence: 79%

“…Although these medications may be continued in patients without COVID‐19 infection who are already taking them, the physicians should be cautious in suspected/confirmed cases. Furthermore, the risk and benefit ratio should be balanced before starting these drugs during the pandemic 9,17 . The decreasing trend in biologic agent use in the present study was most probably due to the concerns related to COVID‐19 infection.…”

Section: Discussionmentioning

confidence: 87%

“…[16][17][18][19] Nearly all of them reached an agreement on some major points like postponing elective procedures, more frequent use of teledermatology, assessing the potential risk of biologic agents/immunosuppressive therapies, and taking necessary precautions for the prevention of disease transmission. [16][17][18][19] Another important issue was the change in health-care policy during the pandemic. Lock-down, social distancing, application of triage protocols, assignment of dermatology specialists in pandemic centers, and patients' hesitation to hospital admission all affected the clinical practice of dermatologists.…”

Section: Discussionmentioning

confidence: 99%

“…International organizations and committees have made recommendations for the optimal management of dermatologic care during the COVID‐19 pandemic 16‐19 . Nearly all of them reached an agreement on some major points like postponing elective procedures, more frequent use of teledermatology, assessing the potential risk of biologic agents/immunosuppressive therapies, and taking necessary precautions for the prevention of disease transmission 16‐19 . Another important issue was the change in health‐care policy during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

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Changing trends in dermatology practice during COVID ‐19 pandemic: A single tertiary center experience

Tanacan

Saraç

Emeksiz

et al. 2020

Dermatologic Therapy

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Objective To evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID‐19) pandemic. Method This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: 1) the Pre‐pandemic period (March‐May 2019) and 2) the Pandemic period (March‐May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Results Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (p values were 0.02, 0.04, and 0.006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (p values were 0.007, <0.001, 0.009, 0.04 and 0.03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (p values were <0.001 and 0.002, respectively). The hospitalization rate was similar between the groups (p=0.51). However, the use of biologic agents significantly decreased during the pandemic period (p=0.01). Conclusion Updated clinical protocols should be established for the new normal period in accordance with these findings. This article is protected by copyright. All rights reserved.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Changing trends in dermatology practice during COVID ‐19 pandemic: A single tertiary center experience

Tanacan

Saraç

Emeksiz

et al. 2020

Dermatologic Therapy

View full text Add to dashboard Cite

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“…Another statement from the European Task Force on Atopic Dermatitis also recommended biologics such as dupilumab for atopic dermatitis during the COVID‐19 pandemic, because they are not considered to increase the risk of viral infection 35 . However, clinical evidence for continuing biologics for dermatological diseases is insufficient, and there are concerns derived from clinical trials of biologics reporting an increasing risk of various infectious diseases, such as those caused by bacteria and fungi or tuberculosis 19,36,37 …”

Section: Discussionmentioning

confidence: 99%

Association of COVID‐19 with skin diseases and relevant biologics: a cross‐sectional study using nationwide claim data in South Korea*

Cho

Kim

2020

Br J Dermatol

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Summary Background As the coronavirus disease 2019 (COVID‐19) pandemic has spread, information about COVID‐19 and skin disease or related biologics is still lacking. Objectives To identify the association between COVID‐19 and skin diseases or biologics. Methods A nationwide claim dataset relevant to COVID‐19 in South Korea was analysed. This dataset included insurance claim data before and during COVID‐19 treatment and clinical outcomes. Claim data related to skin diseases and relevant biologics were analysed to determine the association of COVID‐19 with skin diseases and relevant biologics. Results The dataset contained a total of 234 427 individuals (111 947 male and 122 480 female) who underwent COVID‐19 testing. Of them, 7590 (3·2%) were confirmed as having COVID‐19, and 227 (3·0%) confirmed patients died. Among various skin diseases and biologics, no significant increase in the presence of specific skin diseases or exposure to biologics was observed in the COVID‐19‐positive group, even after adjusting for or matching covariates. The presence of skin diseases and exposure to biologics also did not seem to affect clinical outcomes including mortality. Conclusions Underlying skin diseases did not appear to increase susceptibility to COVID‐19 or mortality from COVID‐19. Considering the risks and benefits, biologics for dermatological conditions might be continuously used during the COVID‐19 pandemic.

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