Iatrogenic dermatitis in times of COVID‐19: a pandemic within a pandemic

Bhatia, Ravi; Sindhuja, Tekumalla; Bhatia, Subhash C.; Dev, Tanvi; Gupta, Abhishek; Bajpai, Meenu; Gupta, Shruti

doi:10.1111/jdv.16710

Cited by 44 publications

(62 citation statements)

References 8 publications

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“…It seems possible that these results are due to more strict hygiene practices, that is, more frequent use of soaps and alcohol‐based hand sanitizers which might lead to the development of contact dermatitis 26 . Indeed, an increased incidence of dermatitis associated with the hygiene practices and the use of personal protective equipment (PPE) during the pandemic has been reported 27,28 . Despite the efforts for the prevention of contact dermatitis associated with hygiene practices, 29 there still seems to be room for improvement in community education on safe and effective hygiene practices.…”

Section: Discussionmentioning

confidence: 99%

Public interest in dermatologic symptoms, conditions, treatments, and procedures during the COVID‐19 pandemic: Insights from Google Trends

Esen-Salman

Akın-Çakıcı

Kardeş

et al. 2021

Dermatologic Therapy

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Coronavirus disease 2019 (COVID-19) pandemic had substantial effect both on daily life and medical practice. Internet data have been used to analyze the trends in public interest in various medical conditions and treatments. The aim of this study is to analyze the public interest in dermatologic symptoms, conditions, treatments, and procedures during the COVID-19 pandemic. Google Trends was queried for a total of 120 dermatological search queries. Three periods of 2020 ([March 15-May 9], [May

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Section: Discussionmentioning

confidence: 99%

Public interest in dermatologic symptoms, conditions, treatments, and procedures during the COVID‐19 pandemic: Insights from Google Trends

Esen-Salman

Akın-Çakıcı

Kardeş

et al. 2021

Dermatologic Therapy

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“…Retro-auricular ACD due to facemask ear loops composed of different materials including thermoplastic elastomer, rubber, and latex has been described [96]. Other potential allergens contained within PPE include rubber accelerators (thiuram, carbamates), other preservatives ( m e t h y l d i b r o m o g l u t a r o n i t r i l e , q u a t e r n i u m -1 5 , imidazolinylurea), paraphenylenediamine, and aluminum [100]. Upon identification of a relevant contact allergen through patch testing, the mainstay of ACD management is avoidance of that particular substance.…”

Section: Allergic Contact Dermatitismentioning

confidence: 99%

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Mawhirt

Frankel

Diaz³

2020

Curr Allergy Asthma Rep

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Purpose of Review COVID-19 (coronavirus viral disease 2019), due to the novel SARS-CoV-2, may present with different types of cutaneous manifestations of varying pathophysiology. During the ongoing pandemic, publications reporting dermatologic findings in COVID-19 continue to emerge. Recent Findings Cutaneous vasculopathy and microthrombus-related changes including acral and sacral lesions, retiform purpura, livedo reticularis, and cutaneous vasculitis are notable findings in adult patients. Other exanthems include urticaria or angioedema, morbilliform/maculopapular exanthems, erythema multiforme, and vesicular eruptions. Increased recognition of these findings, especially those consistent with cutaneous microthrombi or vasculitis, is of particular importance. Additionally, occupational dermatologic disease related to extended personal protective equipment (PPE) use, such as skin damage and irritant or allergic contact dermatitis (ACD), represents another emerging problem amidst the pandemic. Summary In this review, we highlight the various cutaneous manifestations associated with COVID-19 in adult patients and occupational dermatitis in health care workers (HCWs) caring for this patient population. Keywords COVID-19. SARS-CoV-2. Cutaneous manifestations. Dermatologic. Rash. Contact dermatitis Abbreviations AAD American Academy of Dermatology ACD Allergic contact dermatitis ACE2 Angiotensin-converting enzyme 2 AD Atopic dermatitis AGEP Acute generalized exanthematous pustulosis ARDS Acute respiratory distress syndrome COVID-19 Coronarvirus viral disease 2019 CSSV Cutaneous small vessel vasculitis DIC Disseminated intravascular coagulation DiHS/DRESS Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms HCW Health care worker ICD Irritant contact dermatitis ITP Immune thrombocytopenic purpura PPE Personal protective equipment PT Patch test RT-PCR Reverse transcriptase polymerase chain reaction SARS-CoV-2 Severe acute respiratory distress syndrome coronavirus 2 SDRIFE Symmetrical drug-related intertriginous and flexural exanthema This article is part of the Topical Collection on Allergic Skin Diseases

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“…Pressure, friction and the hyperhydration effect caused by masks and goggles often result in skin indentation, mechanical skin damage, and epidermal barrier breakdown [ 12 , 15 ]. N95 masks specifically have increased air impermeability and a higher local pressure, increasing the risk of dermatological symptoms [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

“…Risk factors for pressure damage are the following: prolonged wearing of personal protective equipment (PPE) [ 14 - 17 ], repeated wearing of PPE [ 15 ], use of grade 3 PPE [ 14 ], joint use of masks and goggles [ 7 ], high humidity [ 15 ], and heavy sweating [ 14 ]. Conflicting findings based on the relevance of gender and pressure-related injuries were reported in several studies [ 7 , 14 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…Measures to reduce pressure-related injuries include the following: education of health care workers [ 7 , 17 ], wearing a properly fitted mask to minimize friction at specific points [ 7 , 11 ], regular moisturizing before and after the use of facial protective equipment for skin barrier repair [ 6 , 7 , 11 , 16 ], and limiting the time spent using a mask; published guidelines suggest limiting mask-wearing to 2 hours [ 6 , 11 , 13 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

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Does Wearing a Face Mask During the COVID-19 Pandemic Increase the Incidence of Dermatological Conditions in Health Care Workers? Narrative Literature Review

Wilcha¹

2021

JMIR Dermatol

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Background COVID-19 is a health emergency. SARS-CoV-2 was discovered in Wuhan (Hubei Province, China) and has rapidly spread worldwide, leaving no country untouched. COVID-19 is a respiratory infection characterized by a pneumonia of unknown etiology. It is transmitted through respiratory droplets; for example: through breathing, talking, and coughing. Transmission of the virus is high. Health care workers play important roles in helping those affected by COVID-19; this could not be done without the use of personal protective equipment (PPE). PPE involves the use of goggles, masks, gloves, and gowns and is known to reduce COVID-19 transmission; however, multiple reports of skin disease and damage associated with occupational mask-wearing have emerged. Objective The objective of this study is to review the literature for newly emerging dermatological conditions as a result of occupational mask-wearing during the COVID-19 pandemic. Methods A narrative review of new reports of dermatological conditions associated with occupational mask-wearing was carried out in May 2020 by referencing keywords including: “covid mask dermatology,” “covid dermatological damage,” “covid mask skin,” “covid N95 mask damage,” and “covid mask skin damage” from PubMed, supplemented by searches on both Google Scholar and ResearchGate. A total of 287 articles were found, of which 40 were successfully included in this study, and an additional 7 were selected from the reference lists of these 40 articles. The findings were tabulated and analyzed under the following headings: dermatological diagnosis, causes, and management. Results Qualitative analysis of the reviewed data was carried out. A number of dermatological conditions were found to increasingly occur owing to prolonged and frequent use of face masks. Pressure-related injuries were often the most serious complaint; recommendations to reduce this type of injury include the use of hydrocolloid dressings, plastic handles, education, and regular moisturization. Innovation in PPE as well as services, such as virtual clinics, need to be advanced to protect the welfare of health care staff. Conclusions In these unprecedented times, PPE has been an effective barrier to the transmission of COVID-19 among health care workers. This has allowed health care workers to provide care to patients, with minimal risk. However, our findings suggest that despite the obvious benefits of using face masks to protect the respiratory system, there are also considerable health consequences to the skin. Future research studies are required to focus on improving face masks to ensure both the protection of the respiratory system as well as skin care, which, according to our study, has been overlooked.

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Iatrogenic dermatitis in times of COVID‐19: a pandemic within a pandemic

Cited by 44 publications

References 8 publications

Public interest in dermatologic symptoms, conditions, treatments, and procedures during the COVID‐19 pandemic: Insights from Google Trends

Public interest in dermatologic symptoms, conditions, treatments, and procedures during the COVID‐19 pandemic: Insights from Google Trends

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Does Wearing a Face Mask During the COVID-19 Pandemic Increase the Incidence of Dermatological Conditions in Health Care Workers? Narrative Literature Review

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