151
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Affiliation(s)
- R J Hay
- Faculty of Life Sciences & Medicine, Kings College London, London, SE1 9RT, UK
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152
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Han C, Shi J, Chen Y, Zhang Z. Increased flare of acne caused by long-time mask wearing during COVID-19 pandemic among general population. Dermatol Ther 2020; 33:e13704. [PMID: 32472634 PMCID: PMC7300566 DOI: 10.1111/dth.13704] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Changxu Han
- Department of Dermatology, Hong Kong University Affiliated Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Jialiang Shi
- Department of Dermatology, Hong Kong University Affiliated Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Yan Chen
- Department of Dermatology, Hong Kong University Affiliated Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Zhenying Zhang
- Department of Dermatology, Hong Kong University Affiliated Shenzhen Hospital, Shenzhen, Guangdong Province, China
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153
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Almutairi N, Schwartz RA. COVID-19 with dermatologic manifestations and implications: An unfolding conundrum. Dermatol Ther 2020; 33:e13544. [PMID: 32385869 PMCID: PMC7261983 DOI: 10.1111/dth.13544] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 01/08/2023]
Abstract
The novel coronavirus SARS‐CoV‐2 has caused Coronavirus Disease 2019, widely known as COVID‐19, now a pandemic with extraordinary infectivity, mortality, and fomite adhesiveness. We delineate cutaneous manifestations of COVID‐19, some of which may represent adverse cutaneous drug reactions, and skin changes associated with COVID‐19 lifestyle alterations in patients and health care workers. We review COVID‐19 from both a dermatologic and public health perspective.
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Affiliation(s)
- Nawaf Almutairi
- Kuwait University, Faculty of Medicine and Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Robert A Schwartz
- Kuwait University, Faculty of Medicine and Rutgers New Jersey Medical School, Newark, New Jersey, USA
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154
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Manchanda Y, Das S, De A. Coronavirus Disease of 2019 (COVID-19) Facts and Figures: What Every Dermatologist Should Know at this Hour of Need. Indian J Dermatol 2020; 65:251-258. [PMID: 32831363 PMCID: PMC7423240 DOI: 10.4103/ijd.ijd_360_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Coronavirus disease of 2019 (COVID-19) pandemic has affected India and the world as a whole, like nothing in the recent history and we, dermatologists, are also affected directly or indirectly. In this review, we have tried to address the COVID-19-related information we need to be aware of as a health-care professional. We have discussed the relevant details of the disease: the agent, the symptomatology, common preventive measures, investigations, and management outline. We have also discussed the implications of COVID-19 in dermatology practice and given a basic guideline for dermatology practice during the pandemic.
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Affiliation(s)
- Yashpal Manchanda
- From the Dermatology Clinic, Farwaniya Hospital, Sabah Al Nasser, Kuwait
| | - Sudip Das
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
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155
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Bothra A, Das S, Singh M, Pawar M, Maheswari A. Retroauricular dermatitis with vehement use of ear loop face masks during COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:e549-e552. [PMID: 32491204 PMCID: PMC7300984 DOI: 10.1111/jdv.16692] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Bothra
- Department of Dermatology, Gauhati Medical College & Hospital, Guwahati, India
| | - S Das
- Department of Dermatology, Gauhati Medical College & Hospital, Guwahati, India
| | - M Singh
- Department of Dermatology, JK Medical College & LN Hospital, Bhopal, India
| | - M Pawar
- Department of Dermatology, MVP's Dr.M.V.P Medical College & Hospital & Research Centre, Nashik, India
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156
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Tang J, Zhang S, Chen Q, Li W, Yang J. Risk factors for facial pressure sore of healthcare workers during the outbreak of COVID-19. Int Wound J 2020; 17:2028-2030. [PMID: 32592509 PMCID: PMC7361841 DOI: 10.1111/iwj.13434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jieying Tang
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Shihong Zhang
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Qiang Chen
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Weiwei Li
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jianmin Yang
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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157
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Matusiak Ł, Szepietowska M, Krajewski P, Białynicki-Birula R, Szepietowski JC. Inconveniences due to the use of face masks during the COVID-19 pandemic: A survey study of 876 young people. Dermatol Ther 2020; 33:e13567. [PMID: 32410275 PMCID: PMC7273023 DOI: 10.1111/dth.13567] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/02/2020] [Accepted: 05/10/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Marta Szepietowska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Piotr Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | | | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
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158
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Yuan N, Yang WX, Lu JL, Lv ZH. Investigation of adverse reactions in healthcare personnel working in Level 3 barrier protection PPE to treat COVID-19. Postgrad Med J 2020; 97:351-354. [PMID: 32554543 PMCID: PMC7301344 DOI: 10.1136/postgradmedj-2020-137854] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/21/2020] [Accepted: 06/06/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE OF THE STUDY The aim of our study was to investigate potential adverse reactions in healthcare professionals working in Level 3 barrier protection personal protective equipment (L3PPE) to treat patients with COVID-19. STUDY DESIGN By using a convenience sampling approach, 129 out of 205 randomly selected healthcare professionals from the First Affiliated Hospital of Zhejiang University School of Medicine were invited to take part in a WeChat messaging app survey, Questionnaire Star, via a survey link. Healthcare personnel details were collected, including profession, years of professional experience and adverse reactions while wearing L3PPE. Survey results were divided by profession and years of professional experience; differences in adverse reactions were compared. RESULTS Among the 129 healthcare professionals surveyed, 21 (16.28%) were doctors and 108 (83.72%) were nurses. A total of 122 (94.57%) healthcare professionals experienced discomfort while wearing L3PPE to treat patients with COVID-19. The main reasons for adverse reactions and discomfort include varying degrees of adverse skin reactions, respiratory difficulties, heat stress, dizziness and nausea. Doctors had a lower incidence of rashes (χ2=4.519, p=0.034) and dizziness (χ2=4.123, p=0.042) when compared with nurses. Junior (8.5 years of experience or fewer) healthcare personnel also experienced a higher rate of heat stress when compared with senior personnel (more than 8.5 years greater) (χ2=5.228, p=0.022). CONCLUSION More attention should be offered to healthcare personnel wearing L3PPE to treat patients with COVID-19 because they are susceptible to developing adverse reactions.
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Affiliation(s)
- Niu Yuan
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wei-Xia Yang
- Department of Respiratory and Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jian-Li Lu
- Deparment of Orthopedics, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhang-Hong Lv
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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159
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Gheisari M, Araghi F, Moravvej H, Tabary M, Dadkhahfar S. Skin reactions to non-glove personal protective equipment: an emerging issue in the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:e297-e298. [PMID: 32302444 PMCID: PMC7264802 DOI: 10.1111/jdv.16492] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Gheisari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - F Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - H Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Tabary
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - S Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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160
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Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore) 2020; 99:e20603. [PMID: 32541493 PMCID: PMC7302613 DOI: 10.1097/md.0000000000020603] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/28/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022] Open
Abstract
In December 2019, a new coronavirus was found in Wuhan, Hubei Province, China, and spread rapidly throughout the country, attracting global attention. On February 11, the World Health Organization (WHO) officially named the disease caused by 2019-nCoV coronavirus disease 2019 (COVID-19). With the increasing number of cases, health care workers (HCWs) from all over China volunteered to work in Hubei Province. Because of the strong infectivity of COVID-19, HCWs need to wear personal protective equipment (PPE), such as N95 masks, latex gloves, and protective clothing. Due to the long-term use of PPE, many adverse skin reactions may occur. Therefore, the purpose of this study is to explore the adverse skin reactions among HCWs using PPE.Questionnaires were used for the research; a quantitative study was carried out to determine the incidence of adverse skin reactions among HCWs using PPE.A total of 61 valid questionnaires were collected. The most common adverse skin reactions among HCWs wearing N95 masks were nasal bridge scarring (68.9%) and facial itching (27.9%). The most common adverse skin reactions among HCWs wearing latex gloves were dry skin (55.7%), itching (31.2%), and rash (23.0%). The most common adverse skin reactions among HCWs wearing protective clothing were dry skin (36.1%) and itching (34.4%).When most HCWs wear PPE for a long period of time, they will experience adverse skin reactions. The incidence of adverse skin reactions to the N95 mask was 95.1%, that to latex gloves was 88.5%, and that to protective clothing was 60.7%.
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Affiliation(s)
- Kaihui Hu
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Jing Fan
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Xueqin Li
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Xin Gou
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
| | - Xinyuan Li
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
| | - Xiang Zhou
- Department of Urology, the First Affiliated Hospital, Chongqing Medical University
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
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161
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Hua W, Zuo Y, Wan R, Xiong L, Tang J, Zou L, Shu X, Li L. Short-term skin reactions following use of N95 respirators and medical masks. Contact Dermatitis 2020; 83:115-121. [PMID: 32406064 PMCID: PMC7272965 DOI: 10.1111/cod.13601] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 02/05/2023]
Abstract
Background In the context of the COVID‐19 pandemic, cases of adverse skin reactions related to the wearing of masks have been observed. Objectives To analyze the short‐term effects of N95 respirators and medical masks, respectively, on skin physiological properties and to report adverse skin reactions caused by the protective equipment. Methods This study used a randomized crossover design with repeated measurements. Twenty healthy Chinese volunteers were recruited. Skin parameters were measured on areas covered by the respective masks and on uncovered skin 2 and 4 hours after donning, and 0.5 and 1 hour after removing the masks, including skin hydration, transepidermal water loss (TEWL), erythema, pH, and sebum secretion. Adverse reactions were clinically assessed, and perceived discomfort and non‐compliance measured. Results Skin hydration, TEWL, and pH increased significantly with wearing the protective equipment. Erythema values increased from baseline. Sebum secretion increased both on the covered and uncovered skin with equipment‐wearing. There was no significant difference in physiological values between the two types of equipment. More adverse reactions were reported following a N95 mask use than the use of a medical mask, with a higher score of discomfort and non‐compliance. Conclusions This study demonstrates that skin biophysical characters change as a result of wearing a mask or respirator. N95 respirators were associated with more skin reactions than medical masks.
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Affiliation(s)
- Wei Hua
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China.,Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Ying Zuo
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Ruoyu Wan
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Lidan Xiong
- Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Jie Tang
- Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Lin Zou
- Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Shu
- Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Li Li
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China.,Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
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162
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Zuo Y, Hua W, Luo Y, Li L. Skin reactions of N95 masks and medial masks among health-care personnel: A self-report questionnaire survey in China. Contact Dermatitis 2020; 83:145-147. [PMID: 32297349 PMCID: PMC7262031 DOI: 10.1111/cod.13555] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/03/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Ying Zuo
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Hua
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China.,Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Yaxin Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Li
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China.,Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
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163
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Atzori L, Ferreli C, Atzori MG, Rongioletti F. COVID-19 and impact of personal protective equipment use: From occupational to generalized skin care need. Dermatol Ther 2020; 33:e13598. [PMID: 32415741 PMCID: PMC7267141 DOI: 10.1111/dth.13598] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Laura Atzori
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria G Atzori
- Dermatology Unit, San Francesco Hospital of Nuoro, Nuoro, Italy
| | - Franco Rongioletti
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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164
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Desai SR, Kovarik C, Brod B, James W, Fitzgerald ME, Preston A, Hruza GJ. COVID-19 and personal protective equipment: Treatment and prevention of skin conditions related to the occupational use of personal protective equipment. J Am Acad Dermatol 2020; 83:675-677. [PMID: 32416206 PMCID: PMC7228687 DOI: 10.1016/j.jaad.2020.05.032] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/08/2020] [Accepted: 05/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Seemal R Desai
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas; Innovative Dermatology, Plano, Texas.
| | - Carrie Kovarik
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bruce Brod
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - William James
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Ave Preston
- Department of Nursing, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - George J Hruza
- Department of Dermatology, Saint Louis University, St Louis, Missouri
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165
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Maliyar K, Sachdeva M, Mufti A, Yeung J. Reply to: "Skin damage among health care workers managing coronavirus disease 2019". J Am Acad Dermatol 2020; 83:e169-e170. [PMID: 32417418 PMCID: PMC7224676 DOI: 10.1016/j.jaad.2020.05.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Khalad Maliyar
- Faculty of Medicine, University of Toronto, Ontario, Canada
| | | | - Asfandyar Mufti
- Department of Dermatology, University of Toronto, Ontario, Canada
| | - Jensen Yeung
- Department of Dermatology, University of Toronto, Ontario, Canada.
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166
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Del Castillo Pardo de Vera JL, Reina Alcalde S, Cebrian Carretero JL, Burgueño García M. The preventive effect of hydrocolloid dressing to prevent facial pressure and facial marks during use of medical protective equipment in COVID-19 pandemic. Br J Oral Maxillofac Surg 2020; 58:723-725. [PMID: 32418763 PMCID: PMC7211666 DOI: 10.1016/j.bjoms.2020.04.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 12/19/2022]
Affiliation(s)
| | - S Reina Alcalde
- Intensive Care Unit, University Hospital Puerta de Hierro, Madrid, Spain.
| | - J L Cebrian Carretero
- Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid, Spain.
| | - M Burgueño García
- Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid, Spain.
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167
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Masood S, Tabassum S, Naveed S, Jalil P. COVID-19 Pandemic & Skin Care Guidelines for Health Care Professionals. Pak J Med Sci 2020; 36:S115-S117. [PMID: 32582327 PMCID: PMC7306944 DOI: 10.12669/pjms.36.covid19-s4.2748] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The Novel corona virus is bringing multiple challenges for health care professionals. Skin is the biggest organ and the first line of defense against different infections and external factors. Being the front line warriors, health care professionals are susceptible to various skin conditions due to prolonged use of personal protective equipment. These adverse skin conditions are redness, irritation, itching, contact dermatitis, and aggravation of underlying skin conditions like seborrheic dermatitis and acne vulgaris. In the current global situation, the potential incidence of such adverse dermatological effects does not in any manner cause the HCPs to deviate from the strict specific precautionary hygiene rules. These skin problems are manageable with the few precautionary measures. This article explores the different skin conditions that result from personal hygiene measures and usage of protective gear and will suggest some practical advice about how to manage and protect from these different adverse skin conditions.
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Affiliation(s)
- Sadia Masood
- Dr. Sadia Masood, MBBS, FCPS, MHPE. Assistant professor & Section Head Dermatology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Saadia Tabassum
- Dr. Saadia Tabassum, MBBS, FCPS Assistant Professor & Dermatology Program Director, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shaheen Naveed
- Dr. Shaheen Naveed, MBBS, FCPS. Assistant Professor Dermatology, Department of Dermatology, Liaquat National Hospital, Karachi, Pakistan
| | - Palwasha Jalil
- Palwasha Jalil, MBBS. Chief Resident Dermatology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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168
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Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T, Song J, Liu D, Chen L, Shi Y, Jiang S, Liu Q, Xie J, Chen H, Duan Y, Xia Y, Zhou Y, Mei Y, Zhou X, Wu J, Fang M, Meng Z, Li H. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol 2020; 183:190-192. [PMID: 32255197 PMCID: PMC7262186 DOI: 10.1111/bjd.19089] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P Lin
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - S Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Y Huang
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - L Li
- Department of Infection Management, Peking University First Hospital, Beijing, China
| | - J Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - T Lei
- Department of Dermatology and Venerology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - J Song
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - D Liu
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - L Chen
- Department of Dermatology, Wuhan First Hospital, Wuhan, Hubei, China
| | - Y Shi
- Department of Dermatology and Venerology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - S Jiang
- Department of Dermatology and Venerology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Q Liu
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - J Xie
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - H Chen
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Duan
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Xia
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Zhou
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Mei
- Department of Dermatology, Wuhan First Hospital, Wuhan, Hubei, China
| | - X Zhou
- Department of Dermatology, Wuhan First Hospital, Wuhan, Hubei, China
| | - J Wu
- Department of Dermatology, Wuhan First Hospital, Wuhan, Hubei, China
| | - M Fang
- Department of Dermatology, Xiaogan Central Hospital, Xiaogan, Hubei, China
| | - Z Meng
- Department of Dermatology, Renmin Hospital Hubei University of Medicine, Shiyan, Hubei, China
| | - H Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China
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169
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Yan Y, Chen H, Chen L, Cheng B, Diao P, Dong L, Gao X, Gu H, He L, Ji C, Jin H, Lai W, Lei T, Li L, Li L, Li R, Liu D, Liu W, Lu Q, Shi Y, Song J, Tao J, Wang B, Wang G, Wu Y, Xiang L, Xie J, Xu J, Yao Z, Zhang F, Zhang J, Zhong S, Li H, Li H. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020; 33:e13310. [PMID: 32170800 PMCID: PMC7228211 DOI: 10.1111/dth.13310] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 02/05/2023]
Abstract
Health professions preventing and controlling Coronavirus Disease 2019 are prone to skin and mucous membrane injury, which may cause acute and chronic dermatitis, secondary infection and aggravation of underlying skin diseases. This is a consensus of Chinese experts on protective measures and advice on hand‐cleaning‐ and medical‐glove‐related hand protection, mask‐ and goggles‐related face protection, UV‐related protection, eye protection, nasal and oral mucosa protection, outer ear, and hair protection. It is necessary to strictly follow standards of wearing protective equipment and specification of sterilizing and cleaning. Insufficient and excessive protection will have adverse effects on the skin and mucous membrane barrier. At the same time, using moisturizing products is highly recommended to achieve better protection.
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Affiliation(s)
- Yicen Yan
- Department of Dermatology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Xicheng District, Beijing, China
| | - Hui Chen
- Department of Dermatology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - Liuqing Chen
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei, People's Republic of China
| | - Bo Cheng
- Department of Dermatology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Ping Diao
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou District, Chengdu City, Sichuan Province, People's Republic of China
| | - Liyun Dong
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Xinghua Gao
- Department of Dermatology, Chinese Medical University First Hospital, Shenyang, Liaoning Province, People's Republic of China
| | - Heng Gu
- Hospital for Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, Jiangsu Province, People's Republic of China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Wuhua District, Kunming, Yunnan Province, People's Republic of China
| | - Chao Ji
- Department of Dermatology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Hongzhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Dongcheng District, Beijing, China
| | - Wei Lai
- Department of Dermatology, The Third Affiliated Hospital, Sun Yat-Sen University, Tianhe District, Guangzhou, Guangdong, China
| | - Tiechi Lei
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Li
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou District, Chengdu City, Sichuan Province, People's Republic of China
| | - Liuyi Li
- Department of Infection Control, Peking University First Hospital, Xicheng District, Beijing, China
| | - Ruoyu Li
- Department of Dermatology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Xicheng District, Beijing, China
| | - Dongxian Liu
- Department of Dermatology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - Wei Liu
- Department of Dermatology, Air Force General Hospital of PLA, Haidian District, Beijing, People's Republic of China
| | - Qianjin Lu
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Shi
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiquan Song
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan, Hubei Province, China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Baoxi Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Shijingshan District, Beijing, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Air Force Medical University of PLA, Xi'an, Shaanxi, China
| | - Yan Wu
- Department of Dermatology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Xicheng District, Beijing, China
| | - Leihong Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Xie
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan, Hubei Province, China
| | - Jinhua Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhirong Yao
- Department of Dermatology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Yangpu District, Shanghai, People's Republic of China
| | - Furen Zhang
- Shandong Academy of Medical Sciences, Ji'nan, Shandong Province, People's Republic of China
| | - Jianzhong Zhang
- Department of Dermatology, Peking University People's Hospital, Xicheng District, Beijing, People's Republic of China
| | - Shaomin Zhong
- Department of Dermatology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Xicheng District, Beijing, China
| | - Hengjin Li
- Department of Dermatology, Hainan Hospital of PLA General Hospital, Sanya, Hainan Province, China
| | - Hang Li
- Department of Dermatology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Xicheng District, Beijing, China
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Abstract
The world has changed dramatically since the COVID-19 pandemic began. In addition to our social, occupational, and personal lives, the new coronavirus also poses novel challenges for all physicians, including dermatologists. Several skin conditions have emerged, mainly as a result of prolonged contact with personal protective equipment and excessive personal hygiene. Pressure injury, contact dermatitis, itch, pressure urticaria, and exacerbation of preexisting skin diseases, including seborrheic dermatitis and acne, have been described. We have focused on the dermatologic aspects of the COVID-19 infection so that dermatologists are aware of the skin complications and preventive measures can be taken in the COVID-19 pandemic.
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Affiliation(s)
- Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic, Tokuda Hospital, Sofia, Bulgaria; Department of Dermatology and Venereology, Medical Faculty, Trakia University, Stara Zagora, Bulgaria.
| | - Nikolai Tsankov
- Department of Dermatology and Venereology, Acibadem City Clinic, Tokuda Hospital, Sofia, Bulgaria
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171
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Kantor J. Behavioral considerations and impact on personal protective equipment use: Early lessons from the coronavirus (COVID-19) pandemic. J Am Acad Dermatol 2020; 82:1087-1088. [PMID: 32171806 PMCID: PMC7156803 DOI: 10.1016/j.jaad.2020.03.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 11/02/2022]
Affiliation(s)
- Jonathan Kantor
- Department of Dermatology and Center for Global Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Florida Center for Dermatology, P.A., Saint Augustine, Florida.
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172
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Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, Panombualert S, Mairiang D, Saengnipanthkul S, Wichajarn K, Kiatchoosakun P, Kosalaraksa P. The Effects of the Face Mask on the Skin Underneath: A Prospective Survey During the COVID-19 Pandemic. J Prim Care Community Health 2020; 11:2150132720966167. [PMID: 33084483 PMCID: PMC7786409 DOI: 10.1177/2150132720966167] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The study aimed to explore the prevalence and possible risk factors to prevent the face mask related adverse skin reactions during the ongoing COVID-19 after a recommendation of face mask wearing for public use in Thailand. RESULTS The prevalence of face mask related adverse skin reactions was 454 cases (54.5%), of which acne was the most frequent (399; 39.9%), followed by rashes on the face (154; 18.4%), and itch symptoms (130; 15.6%). Wearing a surgical mask showed a higher risk of adverse skin reaction compared to a cloth mask, OR (95% CI) = 1.54 (1.16-2.06). A duration of face mask wearing of more than 4 hours/day and the reuse of face masks increased the risk of adverse skin reactions compared to changing the mask every day, adjusted OR(95% CI) = 1.96 (1.29-2.98), and 1.5 (1.11-2.02). CONCLUSION Suggestions were made for wearing a cloth mask in non-health care workers (HCW) to decrease the risk of face mask related adverse skin reactions. This suggestion could potentially help in decreasing the demand of surgical masks which should be reserved for the HCW population during the ongoing COVID-19 pandemic.
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173
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Oon HH, Wong SN, Aw DCW, Cheong WK, Goh CL, Tan HH. Acne Management Guidelines by the Dermatological Society of Singapore. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2019; 12:34-50. [PMID: 31531161 PMCID: PMC6715335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Due to the multiethnic patient population with varying skin types in Singapore, clinicians often find the management of acne in their patients to be challenging. The authors developed these guidelines to provide comprehensive advice on individualized acne treatment and to provide a reference guide for all doctors who treat patients of Asian descent. Unique features of acne in Singapore are highlighted. We address concerns such as diet, special population needs, and the benefits, side effects, risks, and cost-effectiveness of currently available acne treatments. These treatment guidelines outline recommendations for the diagnosis, grading, and treatment of children, adolescents, and adults with acne of varying severity, and include advice pertaining to the use of cosmeceuticals and management of scars.
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Affiliation(s)
- Hazel H Oon
- Drs. Oon and Goh are with the National Skin Centre in Singapore
- Dr. Wong is with Dr. SN Wong Skin, Hair, Nails & Laser Specialist Clinic in Singapore
- Dr. Aw is with Sengkang General Hospital in Singapore
- Dr. Cheong is with Specialist Skin Clinic and Associates in Singapore
- Dr. Tan is with Thomson Specialist Skin Centre in Singapore
| | - Su-Ni Wong
- Drs. Oon and Goh are with the National Skin Centre in Singapore
- Dr. Wong is with Dr. SN Wong Skin, Hair, Nails & Laser Specialist Clinic in Singapore
- Dr. Aw is with Sengkang General Hospital in Singapore
- Dr. Cheong is with Specialist Skin Clinic and Associates in Singapore
- Dr. Tan is with Thomson Specialist Skin Centre in Singapore
| | - Derrick Chen Wee Aw
- Drs. Oon and Goh are with the National Skin Centre in Singapore
- Dr. Wong is with Dr. SN Wong Skin, Hair, Nails & Laser Specialist Clinic in Singapore
- Dr. Aw is with Sengkang General Hospital in Singapore
- Dr. Cheong is with Specialist Skin Clinic and Associates in Singapore
- Dr. Tan is with Thomson Specialist Skin Centre in Singapore
| | - Wai Kwong Cheong
- Drs. Oon and Goh are with the National Skin Centre in Singapore
- Dr. Wong is with Dr. SN Wong Skin, Hair, Nails & Laser Specialist Clinic in Singapore
- Dr. Aw is with Sengkang General Hospital in Singapore
- Dr. Cheong is with Specialist Skin Clinic and Associates in Singapore
- Dr. Tan is with Thomson Specialist Skin Centre in Singapore
| | - Chee Leok Goh
- Drs. Oon and Goh are with the National Skin Centre in Singapore
- Dr. Wong is with Dr. SN Wong Skin, Hair, Nails & Laser Specialist Clinic in Singapore
- Dr. Aw is with Sengkang General Hospital in Singapore
- Dr. Cheong is with Specialist Skin Clinic and Associates in Singapore
- Dr. Tan is with Thomson Specialist Skin Centre in Singapore
| | - Hiok Hee Tan
- Drs. Oon and Goh are with the National Skin Centre in Singapore
- Dr. Wong is with Dr. SN Wong Skin, Hair, Nails & Laser Specialist Clinic in Singapore
- Dr. Aw is with Sengkang General Hospital in Singapore
- Dr. Cheong is with Specialist Skin Clinic and Associates in Singapore
- Dr. Tan is with Thomson Specialist Skin Centre in Singapore
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174
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Hsu LY. Respiratory precautions for MERS-CoV: acceptable risk-benefit determination. Singapore Med J 2014; 55:293. [DOI: 10.11622/smedj.2014075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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175
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Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al‐Ansary LA, Bawazeer GA, van Driel ML, Nair NS, Jones MA, Thorning S, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2011; 2011:CD006207. [PMID: 21735402 PMCID: PMC6993921 DOI: 10.1002/14651858.cd006207.pub4] [Citation(s) in RCA: 242] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections like influenza or severe acute respiratory syndrome pose a global threat. Antiviral drugs and vaccinations may be insufficient to prevent their spread. OBJECTIVES To review the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. SEARCH STRATEGY We searched The Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL 2010, Issue 3), which includes the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to October 2010), OLDMEDLINE (1950 to 1965), EMBASE (1990 to October 2010), CINAHL (1982 to October 2010), LILACS (2008 to October 2010), Indian MEDLARS (2008 to October 2010) and IMSEAR (2008 to October 2010). SELECTION CRITERIA In this update, two review authors independently applied the inclusion criteria to all identified and retrieved articles and extracted data. We scanned 3775 titles, excluded 3560 and retrieved full papers of 215 studies, to include 66 papers of 67 studies. We included physical interventions (screening at entry ports, isolation, quarantine, social distancing, barriers, personal protection, hand hygiene) to prevent respiratory virus transmission. We included randomised controlled trials (RCTs), cohorts, case-controls, before-after and time series studies. DATA COLLECTION AND ANALYSIS We used a standardised form to assess trial eligibility. We assessed RCTs by randomisation method, allocation generation, concealment, blinding and follow up. We assessed non-RCTs for potential confounders and classified them as low, medium and high risk of bias. MAIN RESULTS We included 67 studies including randomised controlled trials and observational studies with a mixed risk of bias. A total number of participants is not included as the total would be made up of a heterogenous set of observations (participant people, observations on participants and countries (object of some studies)). The risk of bias for five RCTs and most cluster-RCTs was high. Observational studies were of mixed quality. Only case-control data were sufficiently homogeneous to allow meta-analysis. The highest quality cluster-RCTs suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Benefit from reduced transmission from children to household members is broadly supported also in other study designs where the potential for confounding is greater. Nine case-control studies suggested implementing transmission barriers, isolation and hygienic measures are effective at containing respiratory virus epidemics. Surgical masks or N95 respirators were the most consistent and comprehensive supportive measures. N95 respirators were non-inferior to simple surgical masks but more expensive, uncomfortable and irritating to skin. Adding virucidals or antiseptics to normal handwashing to decrease respiratory disease transmission remains uncertain. Global measures, such as screening at entry ports, led to a non-significant marginal delay in spread. There was limited evidence that social distancing was effective, especially if related to the risk of exposure. AUTHORS' CONCLUSIONS Simple and low-cost interventions would be useful for reducing transmission of epidemic respiratory viruses. Routine long-term implementation of some measures assessed might be difficult without the threat of an epidemic.
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Affiliation(s)
- Tom Jefferson
- University of OxfordCentre for Evidence Based MedicineOxfordUKOX2 6GG
| | - Chris B Del Mar
- Bond UniversityCentre for Research in Evidence‐Based Practice (CREBP)University DriveGold CoastQueenslandAustralia4229
| | - Liz Dooley
- Bond UniversityFaculty of Health Sciences and MedicineGold CoastQueenslandAustralia4229
| | - Eliana Ferroni
- Regional Center for Epidemiology, Veneto RegionEpidemiological System of the Veneto RegionPassaggio Gaudenzio 1PadovaItaly35131
| | - Lubna A Al‐Ansary
- World Health OrganizationDepartment of Health Metrics and MeasurementGenevaSwitzerland
| | - Ghada A Bawazeer
- King Saud UniversityDepartment of Clinical Pharmacy, College of PharmacyP.O. Box 22452RiyadhSaudi Arabia11495
| | - Mieke L van Driel
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineBrisbaneQueenslandAustralia4029
- Ghent UniversityDepartment of Public Health and Primary CareCampus UZ 6K3, Corneel Heymanslaan 10GhentBelgium9000
| | - N Sreekumaran Nair
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) (Institution of National Importance Under Ministry of Health and Family Welfare, Government of India)Department of Medical Biometrics & Informatics (Biostatistics)4th Floor, Administrative BlockDhanvantri NagarPuducherryIndia605006
| | - Mark A Jones
- Bond UniversityInstitute for Evidence‐Based Healthcare11 University DriveRobinaGold CoastQueenslandAustralia4226
| | - Sarah Thorning
- Gold Coast Hospital and Health ServiceGCUH LibraryLevel 1, Block E, GCUHSouthportQueenslandAustralia4215
| | - John M Conly
- Foothills Medical Centre, Room 930, North Tower1403‐29th St NWCalgaryABCanadaT2N 2T9
- WHO. Infection Prevention and Control in Health CareDepartment of Global Alert and Response ‐ Health Security and EnvironmentOffice L420, 20, Avenue AppiaGenevaSwitzerlandCH‐1211
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176
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Duarte LRP, Miola CE, Cavalcante NJF, Bammann RH. [Maintenance status of N95 respirator masks after use in a health care setting]. Rev Esc Enferm USP 2011; 44:1011-6. [PMID: 21337784 DOI: 10.1590/s0080-62342010000400022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
With the purpose of assessing the damages to N95 respirator masks over time and to estimate their expiration after use in clinical practice, this study was based on the descriptive analysis of N95 cone-shaped masks collected by nursing assistants after one, five, 15, and 30 consecutive days of use. Personal identification marks were founds in every respirator already on the first day of use. From the fifth day onward, all masks presented some type of dirt while folds were observed in more than 80% of the devices. Internal stains and folds were more frequent among workers of the 12-hour shift in comparison to the 6-hour shift (p < 0.05). The percentage of misplaced respirators was 16.17% by day five and reached 38.93% by day thirty. Though there is no convenience in reusing N95 respirators, their expiration should not exceed 5 days of use.
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177
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Jefferson T, Del Mar C, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, van Driel ML, Nair S, Foxlee R, Rivetti A. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2010:CD006207. [PMID: 20091588 DOI: 10.1002/14651858.cd006207.pub3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections like influenza or severe acute respiratory syndrome pose a world-wide threat. Antiviral drugs and vaccinations may be insufficient to prevent catastrophe. OBJECTIVES To systematically review the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 2); MEDLINE (1966 to May 2009); OLDMEDLINE (1950 to 1965); EMBASE (1990 to May 2009); and CINAHL (1982 to May 2009). SELECTION CRITERIA We scanned 2958 titles, excluded 2790 and retrieved the full papers of 168 trials, to include 59 papers of 60 studies. We included any physical interventions (isolation, quarantine, social distancing, barriers, personal protection and hygiene) to prevent transmission of respiratory viruses. We included the following study designs: randomised controlled trials (RCTs), cohorts, case controls, cross-over, before-after, and time series studies. DATA COLLECTION AND ANALYSIS We used a standardised form to assess trial eligibility. RCTs were assessed by: randomisation method; allocation generation; concealment; blinding; and follow up. Non-RCTs were assessed for the presence of potential confounders, and classified into low, medium, and high risks of bias. MAIN RESULTS The risk of bias for the four RCTs, and most cluster RCTs, was high. The observational studies were of mixed quality. Only case-control data were sufficiently homogeneous to allow meta-analysis.The highest quality cluster RCTs suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Additional benefit from reduced transmission from children to other household members is broadly supported in results of other study designs, where the potential for confounding is greater. Six case-control studies suggested that implementing barriers to transmission, isolation, and hygienic measures are effective at containing respiratory virus epidemics. We found limited evidence that N95 respirators were superior to simple surgical masks, but were more expensive, uncomfortable, and caused skin irritation. The incremental effect of adding virucidals or antiseptics to normal handwashing to decrease respiratory disease remains uncertain. Global measures, such as screening at entry ports, were not properly evaluated. There was limited evidence that social distancing was effective especially if related to the risk of exposure. AUTHORS' CONCLUSIONS Many simple and probably low-cost interventions would be useful for reducing the transmission of epidemic respiratory viruses. Routine long-term implementation of some of the measures assessed might be difficult without the threat of a looming epidemic.
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Affiliation(s)
- Tom Jefferson
- Vaccines Field, The Cochrane Collaboration, Via Adige 28a, Anguillara Sabazia, Roma, Italy, 00061
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Jefferson T, Del Mar C, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, van Driel ML, Foxlee R, Rivetti A. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. BMJ 2009; 339:b3675. [PMID: 19773323 PMCID: PMC2749164 DOI: 10.1136/bmj.b3675] [Citation(s) in RCA: 186] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To review systematically the evidence of effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. DATA SOURCES Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without restrictions on language or publication. Data selection Studies of any intervention to prevent the transmission of respiratory viruses (isolation, quarantine, social distancing, barriers, personal protection, and hygiene). A search of study designs included randomised trials, cohort, case-control, crossover, before and after, and time series studies. After scanning of the titles, abstracts and full text articles as a first filter, a standardised form was used to assess the eligibility of the remainder. Risk of bias of randomised studies was assessed for generation of the allocation sequence, allocation concealment, blinding, and follow-up. Non-randomised studies were assessed for the presence of potential confounders and classified as being at low, medium, or high risk of bias. DATA SYNTHESIS 58 papers of 59 studies were included. The quality of the studies was poor for all four randomised controlled trials and most cluster randomised controlled trials; the observational studies were of mixed quality. Meta-analysis of six case-control studies suggested that physical measures are highly effective in preventing the spread of severe acute respiratory syndrome: handwashing more than 10 times daily (odds ratio 0.45, 95% confidence interval 0.36 to 0.57; number needed to treat=4, 95% confidence interval 3.65 to 5.52), wearing masks (0.32, 0.25 to 0.40; NNT=6, 4.54 to 8.03), wearing N95 masks (0.09, 0.03 to 0.30; NNT=3, 2.37 to 4.06), wearing gloves (0.43, 0.29 to 0.65; NNT=5, 4.15 to 15.41), wearing gowns (0.23, 0.14 to 0.37; NNT=5, 3.37 to 7.12), and handwashing, masks, gloves, and gowns combined (0.09, 0.02 to 0.35; NNT=3, 2.66 to 4.97). The combination was also effective in interrupting the spread of influenza within households. The highest quality cluster randomised trials suggested that spread of respiratory viruses can be prevented by hygienic measures in younger children and within households. Evidence that the more uncomfortable and expensive N95 masks were superior to simple surgical masks was limited, but they caused skin irritation. The incremental effect of adding virucidals or antiseptics to normal handwashing to reduce respiratory disease remains uncertain. Global measures, such as screening at entry ports, were not properly evaluated. Evidence was limited for social distancing being effective, especially if related to risk of exposure-that is, the higher the risk the longer the distancing period. CONCLUSION Routine long term implementation of some of the measures to interrupt or reduce the spread of respiratory viruses might be difficult. However, many simple and low cost interventions reduce the transmission of epidemic respiratory viruses. More resources should be invested into studying which physical interventions are the most effective, flexible, and cost effective means of minimising the impact of acute respiratory tract infections.
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Affiliation(s)
- Tom Jefferson
- Acute Respiratory Infections Group, Cochrane Collaboration, Rome, Italy.
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180
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Seet RCS, Lim ECH, Oh VMS, Ong BKC, Goh KT, Fisher DA, Ho KY, Yeoh KG. Readiness exercise to combat avian influenza. QJM 2009; 102:133-7. [PMID: 19073645 DOI: 10.1093/qjmed/hcn159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM To examine the readiness of our hospital for the potential pandemic threat of avian influenza, we developed and implemented simulation case scenarios in our hospital. METHODS Two volunteers, who assumed the identity of 'actual' patients, were trained to simulate acute respiratory symptoms following a visit to an avian influenza-affected area, and their identities and locations were kept confidential prior to the readiness exercise. A team of auditors was stationed at high-risk areas to assess adherence to the use of personal protective equipment (PPE) and infection control procedures. RESULTS A total of 324 healthcare workers and 84 administrators participated in this hospital-wide exercise. Following disclosure of their symptoms, the 'patients' were masked and isolated in negative-pressure rooms. A quarantine order was enforced on 38 inpatients and 45 healthcare workers who were present in the affected wards at the time of the exercise, which mandated the use of PPE. Although all affected healthcare workers were competent in the use of PPE, we observed breaches in PPE and isolation procedures in eight medical and nursing students, and 10 healthcare attendants. The exercise concluded after H5N1 tests returned negative. CONCLUSION We recommend the use of case simulation as an effective means of assessing potential breaches in infection control procedures.
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Affiliation(s)
- R C-S Seet
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
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Effect of surgical masks worn concurrently over N95 filtering facepiece respirators: extended service life versus increased user burden. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2008; 14:E19-26. [PMID: 18287908 DOI: 10.1097/01.phh.0000311904.41691.fd] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Growing concern over the availability of Respiratory protective devices (eg, filtering facepiece Respirators), in the face of the probable extreme demand brought on by a pandemic influenza, has prompted the suggestion that useful life of N95 filtering facepiece Respirator can be extended by the concurrent use of a surgical mask as an outer protective barrier over the Respirator. Personal protective equipment generally places a strain on the user, and the detrimental physiological and psychological burdens normally imposed by Respirator use could be magnified by the addition of an extra layer of protection such as a surgical mask. The issue of this potentially increased burden of the concurrent use of a surgical facemask with an N95 filtering facepiece Respirator is investigated to afford users the necessary information to make informed decisions Regarding the use of this Respiratory personal protective equipment in the face of large-scale outbreaks of Respiratory pathogens.
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