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Acar Eser N, Serbest Ceylanoglu K, Malkoc Sen E. Evaluation of eyelid features' changes before and after COVID-19 pandemic amongst healthcare and home office workers. Int Ophthalmol 2024; 44:328. [PMID: 39023647 DOI: 10.1007/s10792-024-03246-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE To evaluate the eyelid features' changes after N95 face mask (FM) usage in healthcare workers through the new type of Coronavirus Disease 2019 (COVID-19) pandemic and make a comparison with home-office workers as a control group with a computer vision algorithm. MATERIALS AND METHODS Sixty healthcare workers and forty control participants with similar demographic features included. Standardized biometric photographs which were taken before and after the COVİD-19 pandemic, analyzed by the ImageJ program (NIH, Bethesda, Md.) software. The distances between the central light reflex on the cornea and the upper (UE) and lower eyelid (LE) were recorded as the marginal reflex distances. (MRD1, MRD2 respectively) Parameters of pretarsal show (PTS) of UE and brow pupil diameter (BPD) were analyzed for both of the eyes. RESULTS There were no significant differences among the groups' measurements before the COVID-19 pandemic. In healthcare workers' group after the pandemic, values of MRD1, PTS, BPD showed a significant decrease in their right eye (p = 0.001, p = 0.002, p = 0.001 respectively) and same values reduced in the left eyes as well when compared with pre-pandemic measurements. (p = 0.048, p = 0.001, p = 0.001 respectively) PTS and BPD values were decreased for both right and left eyes of the controls. (p = 0.044, p = 0.001 and p = 0.001, p = 0.001 respectively) MRD1 measurements after the pandemic showed no difference either in the right or left eyes of the control group after the pandemic. (p = 0.071 and p = 0.065 respectively). DISCUSSION Results showed that both BPD and PTS values decreased independently from the previous FM usage in both of the groups. Even though MRD1 values remained within the normal values, a significant decrease was detected in the healthcare workers group which suggested the cause was newly developed upper eyelid (UE) dermatochalasis after long hours of FM usage. Although it is hard to make a truly objective evaluation both usage of standardized biometric photographs and a computer-based measurement system makes the results reliable.
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Affiliation(s)
- Nazan Acar Eser
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
| | | | - Emine Malkoc Sen
- Department of Ophthalmology, Ankara Etlik City Hospital, Ankara, Turkey
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2
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Akūlova L, Paegle L, Mārtiņsone I, Vanadziņš I, Knudsen LE, Matisāne L. COVID-19 pandemic influence on perceived exposure to chemical substances in Latvia: data from a focus group discussion and the HBM4EU citizen survey. Front Public Health 2024; 12:1382368. [PMID: 38846609 PMCID: PMC11155454 DOI: 10.3389/fpubh.2024.1382368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction The COVID-19 pandemic has globally influenced the exposure of populations to chemical substances through various channels. This study aims to evaluate the tendencies of the use of chemical products in Latvia amidst the pandemic. Answers from 597 respondents (26.6% male, 73.4% female, mean age 46.0 ± 12.2) which were gathered as part of the HBM4EU (Human Biomonitoring Initiative) citizen survey and 8 focus group participants were used. Methods The study utilized data from the HBM4EU citizen survey and conducted focus group discussions to understand the impact of the COVID-19 pandemic on chemical product usage in Latvia. Survey responses were analyzed to identify changes in exposure to chemicals, particularly in relation to disinfection agents and household products. Results More than two-thirds of survey participants reported increased exposure to chemicals during the COVID-19 pandemic, mainly related to the use of disinfection agents and household products. About 2-in-5 (39.8%) of survey respondents considered that the COVID-19 pandemic has increased their interest in exposure to chemicals. The excessive use of disinfectant products is the main concern of citizens (mentioned by 66.7%, n = 389). Also, two focus group participants noted that the use of disinfectant products is too widespread and should be minimized. Discussion The findings suggest that the COVID-19 pandemic has not only increased the use of chemical products in Latvia but also promoted an interest in safe and healthy use of chemicals which could be useful to raise the awareness of the general public.
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Affiliation(s)
- Lāsma Akūlova
- Laboratory of Hygiene and Occupational Diseases, Institute of Occupational Safety and Environmental Health, Rīga Stradiņš University, Riga, Latvia
| | - Linda Paegle
- Laboratory of Hygiene and Occupational Diseases, Institute of Occupational Safety and Environmental Health, Rīga Stradiņš University, Riga, Latvia
| | - Inese Mārtiņsone
- Laboratory of Hygiene and Occupational Diseases, Institute of Occupational Safety and Environmental Health, Rīga Stradiņš University, Riga, Latvia
| | - Ivars Vanadziņš
- Institute of Occupational Safety and Environmental Health, Rīga Stradiņš University, Riga, Latvia
| | - Lisbeth E. Knudsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Linda Matisāne
- Institute of Occupational Safety and Environmental Health, Rīga Stradiņš University, Riga, Latvia
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3
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Kisielinski K, Hockertz S, Hirsch O, Korupp S, Klosterhalfen B, Schnepf A, Dyker G. Wearing face masks as a potential source for inhalation and oral uptake of inanimate toxins - A scoping review. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 275:115858. [PMID: 38537476 DOI: 10.1016/j.ecoenv.2023.115858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 04/12/2024]
Abstract
BACKGROUND From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins. METHODS A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation). RESULTS 24 studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO2. DISCUSSION Of course, masks filter larger dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary. CONCLUSION Undoubtedly, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins with health threatening and carcinogenic properties at population level with almost zero distance to the airways.
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Affiliation(s)
- Kai Kisielinski
- Social Medicine, Emergency Medicine and Clinical Medicine (Surgery), Private Practice, 40212 Düsseldorf, Germany.
| | - Stefan Hockertz
- Toxicology, Pharmacology, Immunology, tpi consult AG, Haldenstr. 1, CH 6340 Baar, Switzerland
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, 57078 Siegen, Germany
| | - Stephan Korupp
- Surgeon, Emergency Medicine, Private Practice, 52070 Aachen, Germany
| | - Bernd Klosterhalfen
- Institute of Pathology, Dueren Hospital, Roonstrasse 30, 52351 Dueren, Germany
| | - Andreas Schnepf
- Institute of Inorganic Chemistry, University of Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany
| | - Gerald Dyker
- Faculty of Chemistry and Biochemistry, Ruhr University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
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4
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Clynick M, Holness DL. New causes of occupational allergic contact dermatitis. Curr Opin Allergy Clin Immunol 2024; 24:51-57. [PMID: 38037883 DOI: 10.1097/aci.0000000000000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
PURPOSE OF REVIEW Occupational allergic contact dermatitis (OACD) is an important work-related skin disease. Information about the causative agents comes from many sources, including patch test databases, registries, case series and case reports. This review summarizes new information about common causative allergens and diagnosis. RECENT FINDINGS Common causes of OACD include rubber components, epoxies and preservatives. New exposure sources for these allergens continue to be described. Often these exposure sources are related to the changing world around us, such as allergens related to smartphones and technology, and personal protective equipment-related exposures during the COVID-19 pandemic. New allergens are also being described, some of which are related to known allergens (e.g. a new epoxy or acrylate component).Accurate diagnosis is critical to effective management of OACD, which may include removing the worker from exposure to the causative allergen. Safety data sheets may not contain complete information and patch testing with specialized series of allergens and workplace materials may be necessary. SUMMARY This review provides current evidence about causes of OACD and important aspects of diagnosis. This is important for clinical practice to ensure cases of OACD are not missed.
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Affiliation(s)
- Meghan Clynick
- Department of Medicine, St Michael's Hospital, Unity Health Toronto
- Department of Medicine
| | - Dorothy Linn Holness
- Department of Medicine, St Michael's Hospital, Unity Health Toronto
- Department of Medicine
- Dalla Lana School of Public Health, University of Toronto
- MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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5
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Jackson JM, Alexis A, Zirwas M, Taylor S. Unmet needs for patients with seborrheic dermatitis. J Am Acad Dermatol 2024; 90:597-604. [PMID: 36538948 DOI: 10.1016/j.jaad.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Seborrheic dermatitis (SD) is a common skin disease with signs and symptoms that may vary by skin color, associated medical conditions, environmental factors, and vehicle preference. Diagnosis of SD is based on presence of flaky, "greasy" patches, and/or thin plaques accompanied by erythema of the scalp, face, ears, chest, and groin and is associated with pruritus in many patients. The presentation may vary in different skin types and hyper- or hypopigmentation may occur, with or without erythema and minimal or no scaling. While the pathogenesis is not certain, 3 key factors generally agreed upon include lipid secretion by sebaceous glands, Malassezia spp. colonization, and some form of immunologic dysregulation that predisposes the patient to SD. Treatment involves reducing proliferation of, and inflammatory response to, Malassezia spp. Topical therapies, including antifungal agents and low potency corticosteroids, are the mainstay of treatment but may be limited by efficacy and side effects. Few novel treatments for SD are currently being studied; however, clinical trials assessing the use of topical phosphodiesterase-4 inhibitors have been completed. Improving outcomes in SD requires recognizing patient-specific manifestations/locations of the disease, including increased awareness of how it affects people of all skin types.
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Affiliation(s)
- J Mark Jackson
- University of Louisville, Division of Dermatology, Forefront Dermatology, Louisville, Kentucky.
| | | | - Matthew Zirwas
- Dermatologists of the Central States, Probity Medical Research, and Ohio University, Bexley, Ohio
| | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Lin RR, Lin DA, Maderal AD. Toxic Ingredients in Personal Care Products: A Dermatological Perspective. Dermatitis 2024; 35:121-131. [PMID: 38109205 DOI: 10.1089/derm.2023.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Environmental dermatology is the study of how environmental factors affect the integumentary system. The environment includes natural and built habitats, encompassing ambient exposure, occupational exposures, and lifestyle exposures secondary to dietary and personal care choices. This review explores common toxins found in personal care products and packaging, such as bisphenols, parabens, phthalates, per- and poly-fluoroalkyl substances, p-phenylenediamine, and formaldehyde. Exposure to these toxins has been associated with carcinogenic, obesogenic, or proinflammatory effects that can potentiate disease. In addition, these compounds have been implicated as endocrine-disrupting chemicals that can worsen dermatological conditions such as acne vulgaris, or dermatitis. Certain pollutants found in personal care products are not biodegradable and have the potential to bioaccumulate in humans. Therefore, even short-term exposure can cause long-lasting issues for communities. The skin is often the first point of contact for environmental exposures and serves as the conduit between environmental toxins and the human body. Therefore, it is important for dermatologists to understand common pollutants and their acute, subacute, and chronic impact on dermatological conditions to better diagnose and manage disease.
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Affiliation(s)
- Rachel R Lin
- From the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Deborah A Lin
- Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrea D Maderal
- Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, Miami, Florida, USA
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Kampf G. Effect of Face Masking on Transmission of SARS-CoV-2. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:175-199. [PMID: 39102197 DOI: 10.1007/978-3-031-61943-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
The efficacy of face masking for the public is not convincing to prevent the transmission of respiratory tract viruses such as SARS-CoV-2 when the criteria of evidence-based medicine are applied. This finding is mainly explained by the results from randomized-controlled trials (RCTs) when a high prevalence of the infection and a high compliance in mask wearing was assured. Throughout these studies no significant protective effect was observed. Observational studies with surgical masks describe a significant protective effect, but are prone to confounders such as physical distance. Respirators do not provide an additional health benefit compared to surgical or medical masks (RCTs). Community masks can even increase the risk of infection (RCTs). Based on the categories of evidence-based medicine, the efficacy results can best be categorized as conflicting evidence. Many relevant adverse events are described when masks are worn for hours such as dyspnea (12.2-52.8%), headache (3.9-73.4%), pruritus (0.0-60.0%), and skin reactions (0.0-85.0%). Their frequency is often higher with respirators. In future pandemics, masks should only be recommended or mandated for settings in which a clinically relevant health benefit can be expected, defined as the prevention of severe, critical or fatal disease, that clearly outweighs the expectable associated adverse reactions.
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Affiliation(s)
- Günter Kampf
- University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany.
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Chang X, Wang WX. Phthalate acid esters contribute to the cytotoxicity of mask leachate: Cell-based assay for toxicity assessment. JOURNAL OF HAZARDOUS MATERIALS 2023; 459:132093. [PMID: 37494796 DOI: 10.1016/j.jhazmat.2023.132093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/28/2023]
Abstract
After the COVID-19 outbreak, masks have become an essential part of people lives. Although several studies have been conducted to determine the release of hazardous substances from masks, how their co-presence poses a potential exposure risk to human health remains unexplored. In this study, we quantitatively compared the leaching of substances from six different common types of masks, including phthalate acid esters (PAEs), metals, and microplastics (MPs), and comprehensively evaluated the potential cytotoxicity of different leachates. MPs smaller than 3 µm were quantified by Py-GC-MS, and reusable masks showed greater releasing potentials up to 1504 µg/g. We also detected the prevalence of PAEs in masks, with the highest release reaching 42 μg/g, with dibutyl phthalate (DBP), diisobutyl phthalate (DiBP) and bis (2-ethylhexyl) phthalate (DEHP) being the predominant types. Moreover, the antimicrobial cloth masks released 173.0 µg of Cu or 4.5 µg of Ag, representing 2.7% and 0.04% of the original masks, respectively. Our cell-based assay results demonstrated for the first time that mask leachate induced nuclear condensation with DNA damage, and simultaneously triggered high levels of glutathione and reactive oxidative stress production, which exacerbated mitochondrial fragmentation, eventually leading to cell death. Combined with substance identification and correlation analysis, PAEs were found to be the contributors to cytotoxicity. Masks containing Cu or Ag led to acidification of lysosomes and alkalinization of cells. These results strongly suggested that the levels of PAEs in the production of regulatory masks should be strictly controlled.
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Affiliation(s)
- Xinyi Chang
- School of Energy and Environment and State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon, Hong Kong, China; Research Centre for the Oceans and Human Health, City University of Hong Kong Shenzhen Research Institute, Shenzhen 518057, China
| | - Wen-Xiong Wang
- School of Energy and Environment and State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon, Hong Kong, China; Research Centre for the Oceans and Human Health, City University of Hong Kong Shenzhen Research Institute, Shenzhen 518057, China.
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Luong Nguyen Dac T, Vu Thi Thuy T, Le Dang Mai A, Nguyen Thi Bich L, Huynh Thi Xuan T. Factors associated with mask-induced dermatosis and its impact on patients' quality of life. Dermatol Reports 2023; 15:9694. [PMID: 37822983 PMCID: PMC10563030 DOI: 10.4081/dr.2023.9694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 10/13/2023] Open
Abstract
The COVID-19 pandemic continues to have a significant impact on society, both physically and mentally. Mask use in public places has been made mandatory in many countries, as it is one of the most effective methods to prevent transmission of the virus. However, continuous mask usage has been associated with the emergence of various cutaneous diseases in the areas of contact with the mask. This study aimed to evaluate the effect of various cutaneous manifestations resulting from mask use on patients' quality of life through a questionnaire survey. This was a cross-sectional study conducted at a hospital from May to July 2022. Patients who had experienced skin symptoms related to mask use in the past or present were included in the study. Participants completed the questionnaire with informed consent. A total of 165 participants participated in the survey, with the most common complaint being itching (58.18%), followed by acne (52.73%). Itching was found to have the highest dermatology life quality index score. Patients with skin redness had a lower quality of life compared to those without it. Prolonged mask-wearing can result in skin diseases that can seriously impair patients' quality of life.
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10
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Beauchamp JD, Mayhew CA. Revisiting the rationale of mandatory masking. J Breath Res 2023; 17:042001. [PMID: 37548323 DOI: 10.1088/1752-7163/acdf12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/16/2023] [Indexed: 08/08/2023]
Abstract
In this perspective, we review the evidence for the efficacy of face masks to reduce the transmission of respiratory viruses, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and consider the value of mandating universal mask wearing against the widespread negative impacts that have been associated with such measures. Before the SARS-CoV-2 pandemic, it was considered that there was little to no benefit in healthy people wearing masks as prophylaxis against becoming infected or as unwitting vectors of viral transmission. This accepted policy was hastily reversed early on in the pandemic, when districts and countries throughout the world imposed stringent masking mandates. Now, more than three years since the start of the pandemic, the amassed studies that have investigated the use of masks to reduce transmission of SARS-CoV-2 (or other pathogens) have led to conclusions that are largely inconsistent and contradictory. There is no statistically significant or unambiguous scientific evidence to justify mandatory masking for general, healthy populations with the intention of lessening the viral spread. Even if mask wearing could potentially reduce the transmission of SARS-CoV-2 in individual cases, this needs to be balanced against the physical, psychological and social harms associated with forced mask wearing, not to mention the negative impact of innumerable disposed masks entering our fragile environment. Given the lack of unequivocal scientific proof that masks have any effect on reducing transmission, together with the evident harms to people and the environment through the use of masks, it is our opinion that the mandatory use of face masks in the general population is unjustifiable and must be abandoned in future pandemic countermeasures policies.
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Affiliation(s)
- Jonathan D Beauchamp
- Fraunhofer Institute for Process Engineering and Packaging IVV, Giggenhauser Str. 35, 85354 Freising, Germany
| | - Chris A Mayhew
- Institute for Breath Research, Leopold-Franzens-Universität, Innsbruck, Innrain 66, 6020 Innsbruck, Austria
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Tang H, Wang H, Hamblin MR, Jiang L, Zhou Y, Xu Y, Wen X. Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review. Front Public Health 2023; 11:1189190. [PMID: 37546301 PMCID: PMC10400336 DOI: 10.3389/fpubh.2023.1189190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD). Methods Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included. Discussion This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.
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Affiliation(s)
- Huimiao Tang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Lu Jiang
- Outpatient Department of West China Hospital, Sichuan University, Chengdu, China
| | - Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Ryu H, Kim YH. Measuring the quantity of harmful volatile organic compounds inhaled through masks. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 256:114915. [PMID: 37079939 PMCID: PMC10112860 DOI: 10.1016/j.ecoenv.2023.114915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
An increase in the concentration of environmental particulate matter and the spread of the COVID-19 virus have dramatically increased our time spent wearing masks. If harmful chemicals are released from these masks, there may be harmful effects on human health. In this study, the concentration of volatile organic compounds (VOCs) emitted from some commonly used masks was assessed qualitatively and quantitatively under diverse conditions (including different mask material types, time between opening the product and wearing, and mask temperature). In KF94 masks, 1-methoxy-2-propanol (221 ± 356 µg m-3), N,N-dimethylacetamide (601 ± 450 µg m-3), n-hexane (268 ± 349 µg m-3), and 2-butanone (160 ± 244 µg m-3) were detected at concentrations 22.9-147 times higher than those found in masks made from other materials, such as cotton and other functional fabrics. In addition, in KF94 masks, the total VOC (TVOC) released amounted to 3730 ± 1331 µg m-3, about 14 times more than that released by the cotton masks (267.5 ± 51.6 µg m-3). In some KF94 masks, TVOC concentration reached over 4000 µg m-3, posing a risk to human health (based on indoor air quality guidelines established by the German Environment Agency). Notably, 30 min after KF94 masks were removed from their packaging, TVOC concentrations decreased by about 80% from their initial levels to 724 ± 5.86 µg m-3; furthermore, 6 h after removal, TVOC concentrations were found to be less than 200 µg m-3. When the temperature of the KF94 masks was raised to 40 oC, TVOC concentrations increased by 119-299%. Since the types and concentrations of VOCs that will be inhaled by mask wearers vary depending on the mask use conditions, it is necessary to comply with safe mask wearing conditions.
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Affiliation(s)
- Hajoo Ryu
- Department of Environment and Energy, Jeonbuk National University, 567 Baekje-daero, Deokjin, Jeonju, Jeollabukdo 54896, Republic of Korea
| | - Yong-Hyun Kim
- Department of Environment and Energy, Jeonbuk National University, 567 Baekje-daero, Deokjin, Jeonju, Jeollabukdo 54896, Republic of Korea; School of Civil, Environmental, Resources and Energy Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin, Jeonju, Jeollabukdo 54896, Republic of Korea; Soil Environment Research Center, Jeonbuk National University, 567 Baekje-daero, Deokjin, Jeonju, Jeollabukdo 54896, Republic of Korea.
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Kaur A, Nixon R. Allergic contact dermatitis to mercaptobenzothiazole in N95 mask rubber straps in healthcare workers. Contact Dermatitis 2023. [PMID: 37080922 DOI: 10.1111/cod.14323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Affiliation(s)
- Amreeta Kaur
- Occupational Dermatology Research and Education Centre (ODREC), Skin Health Institute, Carlton, Victoria, Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre (ODREC), Skin Health Institute, Carlton, Victoria, Australia
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14
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Ma H, Shu Q, Li Z, Song X, Xu H. Formaldehyde aggravates allergic contact dermatitis by facilitating NLRP3 inflammasome activation in macrophages. Int Immunopharmacol 2023; 117:109904. [PMID: 36827924 DOI: 10.1016/j.intimp.2023.109904] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
Formaldehyde (FA) is known to be an environmental pollutant and contact sensitizer at 1 % or 2 % concentrations, which can induce inflammatory diseases such as allergic contact dermatitis (ACD). However, the aggravative effects of FA on ACD at legitimate low concentrations in cosmetics have not been studied. The activation of NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome in ACD was recently identified, and the inflammatory responses were attenuated by NLRP3 inhibition. Since non-cytotoxic concentrations of FA at 50 and 100 μM were found to reinforce inflammatory responses in macrophages, the 0.05 % low concentration of FA was applied to ACD mice induced by 2,4-dinitro-1-fluorobenzene. FA significantly exacerbated inflammatory responses and NLRP3 inflammasome activation, which was confirmed in RAW264.7 macrophages treated with FA at 50 and 100 μM in vitro. Induction of mitochondrial reactive oxygen species, the common activation signal for NLRP3 inflammasome, was also observed in FA-treated macrophages. Inhibition of NLRP3 by MCC950 significantly attenuated the NLRP3 inflammasome activation induced by 100 μM FA in vitro and alleviated FA-enhanced inflammatory responses in ACD mice. These results not only demonstrated that FA was able to aggravate the inflammatory responses of ACD by facilitating NLRP3 inflammasome activation in macrophages, which was likely to play important roles in FA-related sensitization, but also indicated that NLRP3 could be targeted to relieve FA-induced inflammation.
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Affiliation(s)
- Huijuan Ma
- Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, Shanghai Key Laboratory of New Drug Design, State Key Laboratory of Bioreactor Engineering, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Qi Shu
- Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, Shanghai Key Laboratory of New Drug Design, State Key Laboratory of Bioreactor Engineering, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Zhiming Li
- Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, Shanghai Key Laboratory of New Drug Design, State Key Laboratory of Bioreactor Engineering, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Xiaodong Song
- Medical Laboratory Department, Hua Shan Hospital North, Fudan University, Shanghai 201907, China
| | - Huan Xu
- Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, Shanghai Key Laboratory of New Drug Design, State Key Laboratory of Bioreactor Engineering, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China.
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15
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Sawada Y. Occupational Skin Dermatitis among Healthcare Workers Associated with the COVID-19 Pandemic: A Review of the Literature. Int J Mol Sci 2023; 24:ijms24032989. [PMID: 36769309 PMCID: PMC9918113 DOI: 10.3390/ijms24032989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
The skin is the outermost layer of the human body and is continually exposed to numerous external stimuli, which can cause unwanted skin irritation. Occupational skin diseases are the most prevalent form of work-related illness and are found in a variety of sectors, particularly healthcare. During the recent COVID-19 pandemic, healthcare professionals experienced a variety of unexpected, unusual occupational skin diseases associated with COVID-19-engaged employment. Because the clinical characteristics of these types of skin inflammation are unique, this review focuses on the characteristics of a large category of occupational workers, namely COVID-19-engaged healthcare professionals. Furthermore, we examined the potential pathogeneses of occupational skin disorders associated with COVID-19-engaged labor, as well as different preventative methods.
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Affiliation(s)
- Yu Sawada
- Department of Dermatology, University of Occupational and Environmental Health, 1-1, Iseigoaka, Yahatanishi-Ku, Kitakyushu 807-8555, Fukuoka, Japan
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16
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Wang C, Su ZH, He MJ. Dynamic variation and inhalation exposure of organophosphates esters and phthalic acid esters in face masks. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120703. [PMID: 36403876 PMCID: PMC9671703 DOI: 10.1016/j.envpol.2022.120703] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus pandemic (COVID-19) has posed a huge global health threat since December 2019. Wearing face masks is known as an effective measure for controlling the wide spread of COVID-19 and its variants. But on the other hand, face masks could be a potential source of organophosphate esters (OPEs) and phthalic acid esters (PAEs) as they are extensively added in masks. However, knowledge associated with the occurrence as well as inhalation risks of OPEs and PAEs in masks is limited. In this study, OPEs and PAEs were determined in different types of mask samples collected from the local market. OPEs and PAEs were detected in mask samples ranging from 36.7 to 855 ng/g, and from 251 to 3830 ng/g, respectively. Relatively lower OPEs and PAEs concentrations were observed in disposable mask for toddlers. Simulated inhalation experiment indicated that the mass loss of OPEs and PAEs was 136 and 3910 ng/mask in disposable masks, 71.9 and 763 ng/mask in disposable mask for toddlers, 924 and 1020 ng/mask in N95 mask after 12 h, respectively. Significantly negative correlations were exhibited between the decrement of OPEs in masks and the increment of OPEs in corresponding polyurethane foams (PUFs) during the course, elucidating OPEs released from masks could be well captured by PUFs. With regard to the variation over time, predominant OPE and PAE analogues showed semblable release and absorption tendency in mask and corresponding PUF. Inhalation exposure risk of OPEs and PAEs was estimated based on the increment of pollutants in PUF. The estimated daily intakes (EDIs), hazard index (HI) and carcinogenic risk (CR) were also calculated and they were within the threshold levels. This study provides the evidence of OPEs and PAEs releasing from the face masks during wearing and unveiled a potential source of OPEs and PAEs exposure to humans.
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Affiliation(s)
- Can Wang
- College of Resources and Environment, Southwest University, Chongqing, 400716, China
| | - Zi-Han Su
- College of Resources and Environment, Southwest University, Chongqing, 400716, China
| | - Ming-Jing He
- College of Resources and Environment, Southwest University, Chongqing, 400716, China; Chongqing Key Laboratory of Agricultural Resources and Environment, Chongqing, 400716, China.
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17
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Ganesapillai M, Mondal B, Sarkar I, Sinha A, Ray SS, Kwon YN, Nakamura K, Govardhan K. The face behind the Covid-19 mask - A comprehensive review. ENVIRONMENTAL TECHNOLOGY & INNOVATION 2022; 28:102837. [PMID: 35879973 PMCID: PMC9299984 DOI: 10.1016/j.eti.2022.102837] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/16/2022] [Accepted: 07/16/2022] [Indexed: 05/07/2023]
Abstract
The threat of epidemic outbreaks like SARS-CoV-2 is growing owing to the exponential growth of the global population and the continual increase in human mobility. Personal protection against viral infections was enforced using ambient air filters, face masks, and other respiratory protective equipment. Available facemasks feature considerable variation in efficacy, materials usage and characteristic properties. Despite their widespread use and importance, face masks pose major potential threats due to the uncontrolled manufacture and disposal techniques. Improper solid waste management enables viral propagation and increases the volume of associated biomedical waste at an alarming rate. Polymers used in single-use face masks include a spectrum of chemical constituents: plasticisers and flame retardants leading to health-related issues over time. Despite ample research in this field, the efficacy of personal protective equipment and its impact post-disposal is yet to be explored satisfactorily. The following review assimilates information on the different forms of personal protective equipment currently in use. Proper waste management techniques pertaining to such special wastes have also been discussed. The study features a holistic overview of innovations made in face masks and their corresponding impact on human health and environment. Strategies with SDG3 and SDG12, outlining safe and proper disposal of solid waste, have also been discussed. Furthermore, employing the CFD paradigm, a 3D model of a face mask was created based on fluid flow during breathing techniques. Lastly, the review concludes with possible future advancements and promising research avenues in personal protective equipment.
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Affiliation(s)
- Mahesh Ganesapillai
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Bidisha Mondal
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Ishita Sarkar
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Aritro Sinha
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Saikat Sinha Ray
- Department of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Republic of Korea
| | - Young-Nam Kwon
- Department of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Republic of Korea
| | - Kazuho Nakamura
- Faculty of Engineering, Division of Material Science and Chemical Engineering, Yokohama National University, Tokiwadai, Yokohama, Kanagawa 240-8501, Japan
| | - K Govardhan
- Department of Micro and Nano-Electronics, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
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18
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Li Y, Cary-Brown S, Ochapa M, Rostampour S, Hawkins AS. Mask wearing on an HBCU campus during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-7. [PMID: 36194436 DOI: 10.1080/07448481.2022.2123245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/16/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Objective: Young adults of age 18-29 years old account for the most COVID-19 cases in the US, and ethnic groups were affected disproportionately. Correctly wearing a face mask remains a critical intervention for COVID-19 mitigation. The study aimed to examine how well Historically Black Colleges and Universities (HBCUs) residents adhered to mask wearing during the pandemic. Methods: We conducted an observational study on an urban HBCU campus and the neighborhoods in Maryland for 13 weeks in spring 2021. Results: Of 1926 (1126 on campus; 800 off campus) persons observed, 89.8% wore masks, with 83.5% covering their mouths and noses. The HBCU campus showed better mask adherence than neighborhoods (92.0% vs. 86.7%). The most common improper mask wearing was nose out, followed by only-on-chin. Cloth and surgical masks were worn the most. Conclusion: The HBCU campus and neighborhood settings presented a high rate of facemask use during the pandemic.
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Affiliation(s)
- Yuejin Li
- Department of Biology, Morgan State University, Baltimore, Maryland, USA
| | - Sierra Cary-Brown
- Public Health Program, School of Community Health and Policy, Morgan State University, Baltimore, Maryland, USA
| | - Monica Ochapa
- Public Health Program, School of Community Health and Policy, Morgan State University, Baltimore, Maryland, USA
| | - Sara Rostampour
- Department of Biology, Morgan State University, Baltimore, Maryland, USA
| | - Anita Smith Hawkins
- Public Health Program, School of Community Health and Policy, Morgan State University, Baltimore, Maryland, USA
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19
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Guarneri F, Belloni Fortina A, Corazza M, Cristaudo A, Foti C, Parodi A, Pigatto P, Stingeni L, DE Pità O. Topical non-pharmacological treatment of eczema: an Italian consensus. Ital J Dermatol Venerol 2022; 157:402-413. [PMID: 36213968 DOI: 10.23736/s2784-8671.22.07283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Eczematous diseases (contact dermatitis, atopic dermatitis, hand eczema) are among the most frequent findings in dermatological clinical practice. A large body of evidence exists on structural and functional skin barrier damage in eczematous diseases, and on the importance of interventions aimed to repair such damage. While there is substantial agreement on pharmacological treatment, more sparse data are available on role, indications and usefulness of topical non-pharmacological treatments, despite significant research and progress in the composition and technology of emollients, cleansers and barrier creams significantly changed and expanded the functional activities of these products. This often leads to inadequate prescription and/or use, which increase individual and social costs of the disease and make the products useless or, in some cases, even counterproductive. This consensus document, discussed and compiled in a series of meetings by a group of Italian dermatologists experienced in the field of eczematous diseases, summarizes epidemiology and clinical features of the nosological entities of the "eczema family", illustrates the chemical/biochemical structure of emollients, cleansers and barrier creams, and aims to help physicians to exploit the full potential of available products, by providing a detailed but practical guide on characteristics, indications and correct use of non-pharmacological treatments currently available for eczematous diseases.
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Affiliation(s)
- Fabrizio Guarneri
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Caterina Foti
- Department of Biomedical Sciences and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Paolo Pigatto
- Unit of Dermatology, Department of Surgical and Odontoiatric Biomedical Sciences, Galeazzi IRCCS Orthopedic Institute, Milan, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ornella DE Pità
- Unit of Clinical Pathology, Inflammatory and Autoimmune Skin Diseases, Cristo Re Hospital, Rome, Italy
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20
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Kaur K, Gurnani B. Face mask - induced itching during the COVID-19 pandemic: Are we heading towards a silent epidemic? Indian J Ophthalmol 2022; 70:3152-3153. [PMID: 35918998 DOI: 10.4103/ijo.ijo_989_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kirandeep Kaur
- Pediatric and Squint Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Bharat Gurnani
- Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
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21
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Kong S, Mawhirt SL. Patch testing results in adult patients with dermatitis during the coronavirus disease 2019 pandemic. Ann Allergy Asthma Immunol 2022; 129:521-522. [PMID: 35858656 PMCID: PMC9288667 DOI: 10.1016/j.anai.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Stephanie Kong
- Department of Medicine, NYU Langone Hospital Long Island, Mineola, New York
| | - Stephanie L Mawhirt
- Department of Medicine, NYU Langone Hospital Long Island, Mineola, New York; NYU Long Island School of Medicine, Mineola, New York.
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22
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Bhattacharjee S, Bahl P, Chughtai AA, Heslop D, MacIntyre CR. Face masks and respirators: Towards sustainable materials and technologies to overcome the shortcomings and challenges. NANO SELECT 2022. [DOI: 10.1002/nano.202200101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shovon Bhattacharjee
- Biosecurity Program The Kirby Institute, Faculty of Medicine University of New South Wales Kensington Sydney Australia
- Department of Applied Chemistry and Chemical Engineering Faculty of Engineering and Technology Noakhali Science and Technology University Noakhali Bangladesh
| | - Prateek Bahl
- School of Mechanical & Manufacturing Engineering University of New South Wales Sydney Australia
| | - Abrar Ahmad Chughtai
- School of Population Health Faculty of Medicine University of New South Wales Kensington Sydney Australia
| | - David Heslop
- School of Population Health Faculty of Medicine University of New South Wales Kensington Sydney Australia
| | - C. Raina MacIntyre
- Biosecurity Program The Kirby Institute, Faculty of Medicine University of New South Wales Kensington Sydney Australia
- College of Public Service and Community Solutions and College of Health Solutions Arizona State University Tempe Arizona USA
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23
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Goller M, Dickel H, Nicolay JP. A case of immediate type allergy from polypropylene in a particle filter mask in a nurse. Contact Dermatitis 2022; 87:294-296. [PMID: 35522147 DOI: 10.1111/cod.14143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mara Goller
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef-Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany
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24
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Kawakami T, Obama T, Sakai S, Takagi M, Takahashi N, Oshima N, Tahara M, Ikarashi Y. Free formaldehyde in non-medical face masks purchased from the Japanese market since the COVID-19 outbreak. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2022; 57:193-197. [PMID: 35240932 DOI: 10.1080/10934529.2022.2047560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Since the Coronavirus Disease 2019 (COVID-19) pandemic began, people have been wearing face masks for many hours every day. As these face masks are in contact with the skin, it is important to pay more attention to their quality and safety. This study examined the concentration of free formaldehyde in 90 non-medical face masks and related products (33 nonwoven, 30 woven cloth, 12 polyurethane, and 15 related products) because formaldehyde is a common contact allergen in textile products. For products consisting of mixed materials, each material was sampled, resulting in 103 samples for analysis. Free formaldehyde (34-239 μg/g) was found in three cloth masks, which consisted of cotton and polyester, with antibacterial and antiviral labeling. It was confirmed that the detected formaldehyde originated from the mask-finishing treatment by a hydrochloric acid extraction discrimination test. These masks may elicit contact dermatitis if the consumers have already been sensitized to formaldehyde. However, the risk of contact dermatitis caused by formaldehyde in masks may be considered low since the frequency of formaldehyde detection in masks in Japan is low.
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Affiliation(s)
- Tsuyoshi Kawakami
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Tomoko Obama
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Shinobu Sakai
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Mihono Takagi
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Natsuko Takahashi
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Naohiro Oshima
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Maiko Tahara
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Yoshiaki Ikarashi
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
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25
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Goossens A, Aerts O. Contact allergy to and allergic contact dermatitis from formaldehyde and -releasers: A clinical review and update. Contact Dermatitis 2022; 87:20-27. [PMID: 35229319 DOI: 10.1111/cod.14089] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
This review aims to provide a clinically useful update regarding the role of formaldehyde (FA) and its five main releasers (FRs) quaternium-15, diazolidinyl urea, DMDM hydantoin, imidazolidinyl urea and 2-bromo-2-nitropropane-1,3-diol (bronopol) in contact allergy and allergic contact dermatitis. These ubiquitous preservatives are still often, and sometimes undeclared, present in cosmetics, pharmaceuticals, medical devices, household detergents and chemical (industrial) products. In Europe, the use of free FA and quaternium-15 in cosmetics is forbidden and contact allergy rates have been found to be stable to decreasing. However, FA/FRs still readily provoke localized (e.g., facial/hand), airborne and generalized dermatitis, and may also complicate atopic and stasis dermatitis, or result in nummular dermatitis. Seborrheic-, rosacea- and impetigo-like dermatitis have recently been reported. For a correct diagnosis, FA 2% aq. (0.60 mg/cm2 ) should be used, and particularly the FRs bronopol 0.5% pet. and diazolidinyl urea 2% should be patch tested separately in a baseline series. If sensitization to FA occurs, both FA and FRs should preferably be avoided, except perhaps for bronopol in case it tests negatively. If a patient reacts to one or more FRs (such as bronopol, or diazolidinyl/imidazolidinyl urea), but not to FA, then the specific FR(s) should be avoided. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- An Goossens
- Department of Dermatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, INFLA-MED Centre of Excellence, University of Antwerp, Antwerp, Belgium
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26
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Johansen JD, Bonefeld CM, Schwensen JFB, Thyssen JP, Uter W. Novel insights into contact dermatitis. J Allergy Clin Immunol 2022; 149:1162-1171. [PMID: 35183605 DOI: 10.1016/j.jaci.2022.02.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/04/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Abstract
Contact dermatitis is a common disease, caused by repeated skin contact to contact allergens or irritants, resulting in allergic contact dermatitis (ACD) and/or irritant contact dermatitis. Attempts have been made to identify biomarkers to distinguish irritant and allergic patch test reactions, which could aid diagnosis. Some promising candidates have recently been identified, but verification and validation in clinical cases still need to be done. New causes of ACD are constantly recognized. In this review, 10 new contact allergens from recent years, were identified, several relating to anti-age products. Frequent allergens causing considerable morbidity in the population such as the preservative methylisothiazolinone (MI) have been regulated in EU. A significant drop in cases has been seen, while high rates are still occurring in other areas such as North America. Other frequent causes are fragrance allergens especially widely used terpenes and acrylates used in medical devises for control of diabetes. These represent unsolved problems. Recent advances in immunology have opened for a better understanding of the complexity of contact dermatitis, especially ACD. The disease may be more heterogenous that previous understood with several subtypes. With the rapidly evolving molecular understanding of the disease, the potential for development of new drugs for personalized treatment of contact dermatitis is considerable.
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Affiliation(s)
- J D Johansen
- National Allergy Research Centre, Department of Skin and Allergy. Gentofte Hospital University of Copenhagen, 2900 Hellerup, Denmark.
| | - C M Bonefeld
- The LEO Foundation Skin Immunology Research Center, Department of Immunology & Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
| | - J F B Schwensen
- National Allergy Research Centre, Department of Skin and Allergy. Gentofte Hospital University of Copenhagen, 2900 Hellerup, Denmark
| | - J P Thyssen
- National Allergy Research Centre, Department of Skin and Allergy. Gentofte Hospital University of Copenhagen, 2900 Hellerup, Denmark
| | - W Uter
- Dept. of Medical Informatics, Biometry and Epidemiology, Univ. Erlangen / Nürnberg; Waldstr. 6 91054 Erlangen, GERMANY
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27
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Babino G, Argenziano G, Balato A. Impact in Contact Dermatitis during and after SARS-CoV2 Pandemic. CURRENT TREATMENT OPTIONS IN ALLERGY 2022; 9:19-26. [PMID: 35194543 PMCID: PMC8830973 DOI: 10.1007/s40521-022-00298-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 12/28/2022]
Abstract
Purpose of the review Due to the recent COVID-19 pandemic, several skin conditions have emerged due to the preventive measures adopted by both health care workers and the general population against SARS-CoV-2. Above all, wearing of personal protective equipment, frequent hand-washing and disinfecting of surfaces have resulted in an increased risk of irritant or allergic contact dermatitis. The aim of this review is to investigate contact dermatitis associated with COVID-19 pandemic period. Recent findings There is a real evidence of the rising prevalence of irritant and allergic contact dermatitis in response to the COVID-19 pandemic. The most commonly recorded symptoms are dryness, itch and redness of the skin. Nasal bridge, cheeks, forehead and hands represent the mainly affected skin sites. Summary Contact dermatitis lesions may appear as a result of various recommendations to prevent transmission of COVID-19. Procedures to alleviate pressure and friction, gentle skin care and adequate moisturizing, have been identified as important preventive strategies for contact dermatitis related to personal protective equipment and personal hygiene measures.
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Affiliation(s)
- Graziella Babino
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Anna Balato
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
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28
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Sarfraz Z, Sarfraz A, Sarfraz M, Felix M, Bernstein JA, Fonacier L, Cherrez-Ojeda I. Contact dermatitis due to personal protective equipment use and hygiene practices during the COVID-19 pandemic: A systematic review of case reports. Ann Med Surg (Lond) 2022; 74:103254. [PMID: 35039780 PMCID: PMC8755461 DOI: 10.1016/j.amsu.2022.103254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/31/2021] [Accepted: 01/06/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Prolonged use of personal protective equipment (PPE) may lead to contact dermatitis during the coronavirus disease 19 (COVID-19) pandemic. This paper aims to identify the causative factors of contact dermatitis from PPE and hygiene practices. METHODS The search was conducted adhering to PRISMA 2020 guidelines. A Delphi process was employed to ensure that the aims of this study were met. PubMed and Web of Science databases were systematically searched through September 12, 2021, using search terms: Contact dermatitis, case report, covid-19. The findings were tabulated as author/year, gender, age, presentation, cause, dermatological diagnosis, testing modality, provided treatment, symptom resolution (time in days), prognosis, and follow-up. RESULTS The mean age of all individuals was 29.75 years, with 75% females. All cases presented with erythema, with 62.5% reporting pruritus and 37.5% reporting burning facial symptoms. Surgical masks and hand-hygiene products (37.5%) were the most commonly reported causative agent with 25% due to KN95/FFP type 2 use. Allergic contact dermatitis (50%) and irritant contact dermatitis (25%) were common diagnoses. Treatments included creams, emollients, and desloratadine, with restriction of irritant-causing factors. The prognosis was generally good among the cases, with 62.5% presenting complete resolution within a week and 12.5% showing moderate improvement at the fourth month after discontinuing use. CONCLUSION This study finds pertinent links between PPE use and contact dermatitis during the COVID-19 pandemic. While many cases are bound to go underreported in literature, well-designed, large-scale studies in the future may help promote these associations in a more comprehensive manner.
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Affiliation(s)
| | | | | | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Jonathan A. Bernstein
- Department of Internal Medicine, University of Cincinnati College of Medicine, Ohio, USA
| | - Luz Fonacier
- Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA
- Department of Allergy, New York University Winthrop Hospital, Mineola, NY, USA
| | - Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
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29
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Wu P, Li J, Lu X, Tang Y, Cai Z. Release of tens of thousands of microfibers from discarded face masks under simulated environmental conditions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150458. [PMID: 34592275 PMCID: PMC9752784 DOI: 10.1016/j.scitotenv.2021.150458] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 05/03/2023]
Abstract
While mechanical abrasion by water and sediment is a primary and critical step in weathering process, the upsurge of discarded face masks will undoubtedly become a potential source of micro-/nanofibers owing to the spread of novel coronavirus (COVID-19) pneumonia. However, effects of mechanical abrasion on discarded face masks have neither been seriously addressed nor understood. Therefore, we conducted a simulated experiment to explore abundance, size distribution and morphology of microfibers released from common, surgical and face filtering piece (FFP) masks after mechanical abrasion. Technologies such as Fourier transform infrared spectrometry, fluorescence microscopy, scanning electron microscopy, and confocal laser scanning microscopy were used. Results showed that the abundance of released microfibers followed order of surgical > common > FFP in both water and sediment environments, and the maximum abundance reached 272 ± 12.49 items per square centimeter of mask (items·cm-2) after sediment abrasion. Taking surgical mask for further investigation, the length of released fiber was observed to vary from 47.78 μm to 3.93 mm, and 72.41-89.58% of the total number of released microfibers fell in the range of 0.1-1 mm. However, microfibers with a very small length (1-100 μm) can occupy 0.09-13.59% of the total number of released fibers in sediment environment. The roughness of fiber surface after sediment abrasion was successively increased. Furthermore, the morphology analysis showed significant changes with countless cracks and many prominent protrusions on fiber surface after sediment abrasion. The cracks and protrusions may further accelerate mask decomposition, thereby potentially resulting in the adsorption of other contaminants and the release of self-containing chemicals. This study provides a valuable database of microfibers released from discarded face masks at the primary but critical stage, and further contributes knowledge on environmental impact of discarded personal protective equipment due to COVID-19.
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Affiliation(s)
- Pengfei Wu
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China; State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR, PR China.
| | - Jiangpeng Li
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China; Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China.
| | - Xiao Lu
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China; Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China.
| | - Yuanyuan Tang
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China; Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China.
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR, PR China.
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30
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Kutralam-Muniasamy G, Pérez-Guevara F, Shruti VC. A critical synthesis of current peer-reviewed literature on the environmental and human health impacts of COVID-19 PPE litter: New findings and next steps. JOURNAL OF HAZARDOUS MATERIALS 2022; 422:126945. [PMID: 34449351 PMCID: PMC8372437 DOI: 10.1016/j.jhazmat.2021.126945] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 05/03/2023]
Abstract
Since the emergence of Coronavirus disease (COVID-19), the threat of plastic waste pollution has grown exponentially, with a strong attention on the environmental and human health consequences of millions of personal protective equipment (PPE) (e.g., face masks, shields, gloves, and wipes) being used and discarded. In response, a massive research effort has been launched to understand, characterize, and estimate the exposure risks of PPE associated contaminants. While the number of studies examining the impacts of PPE is increasing, this review aimed to provide a quick update on the research conducted to date of this topic, as well as to identify priorities for future research. Specifically, we analyzed recent global peer-reviewed articles on PPE to synthesize methods, control measures, and documented evidence to (1) investigate the discarded PPE in a variety of environments; (2) determine the microplastics discharge in the aquatic environment; (3) examine the intentionally or unintentionally added chemicals in the production of PPE; and (4) assess potential human health hazards and exposure pathways. Despite progress, more research is needed in the future to fully understand the chemical emissions from PPE degradation mechanisms (mechanical, chemical, and biological), as well as the magnitude and density of PPE pollution in the environment.
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Affiliation(s)
- Gurusamy Kutralam-Muniasamy
- Department of Biotechnology and Bioengineering, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Fermín Pérez-Guevara
- Department of Biotechnology and Bioengineering, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico; Nanoscience & Nanotechnology Program, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - V C Shruti
- Instituto Politécnico Nacional (IPN), Centro Mexicano para la Producción más Limpia (CMP+L), Av. Acueducto s/n, Col. Barrio la Laguna Ticomán, Del Gustavo A. Madero, C.P. 07340 Mexico.
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31
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Jemec Kokalj A, Dolar A, Drobne D, Marinšek M, Dolenec M, Škrlep L, Strmljan G, Mušič B, Škapin AS. Environmental hazard of polypropylene microplastics from disposable medical masks: acute toxicity towards Daphnia magna and current knowledge on other polypropylene microplastics. MICROPLASTICS AND NANOPLASTICS 2022; 2:1. [PMID: 35005629 PMCID: PMC8724753 DOI: 10.1186/s43591-021-00020-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/01/2021] [Indexed: 05/07/2023]
Abstract
The COVID-19 pandemic has increased the use of disposable plastics, including medical masks, which have become a necessity in our daily lives. As these are often improperly disposed of, they represent an important potential source of microplastics in the environment. We prepared microplastics from polypropylene medical masks and characterised their size, shape, organic chemical leaching, and acute toxicity to the planktonic crustacean Daphnia magna. The three layers of the masks were separately milled and characterised. Each of the inner frontal, middle filtering, and outer layers yielded different types of microplastics: fibres were obtained from the inner and outer layer, but irregular fragments from the middle layer. The shape of the obtained microplastics differed from the initial fibrous structure of the intact medical mask layers, which indicates that the material is deformed during cryo-milling. The chemical compositions of plastics-associated chemicals also varied between the different layers. Typically, the inner layer contained more chemicals related to antimicrobial function and flavouring. The other two layers also contained antioxidants and their degradation products, plasticisers, cross-linking agents, antistatic agents, lubricants, and non-ionic surfactants. An acute study with D. magna showed that these microplastics do not cause immobility but do physically interact with the daphnids. Further long-term studies with these microplastics are needed using a suite of test organisms. Indeed, studies with other polypropylene microplastics have shown numerous adverse effects on other organisms at concentrations that have already been reported in the environment. Further efforts should be made to investigate the environmental hazards of polypropylene microplastics from medical masks and how to handle this new source of environmental burden. PLEASE CHECK THE SI WORD DOCUMENT THE AUTHORS ARE NOT LISTED THERE I CANNOT EDIT THAT FILE PLEASE ADD THE AUTHORS SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s43591-021-00020-0.
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Affiliation(s)
- Anita Jemec Kokalj
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna pot 111, SI-1000 Ljubljana, Slovenia
| | - Andraž Dolar
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna pot 111, SI-1000 Ljubljana, Slovenia
| | - Damjana Drobne
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna pot 111, SI-1000 Ljubljana, Slovenia
| | - Marjan Marinšek
- Faculty of Chemistry and Chemical Technology, Chair of Materials and Polymer Science, University of Ljubljana, Večna pot 113, SI-1000 Ljubljana, Slovenia
| | - Matej Dolenec
- Department of Geology, Faculty of Natural Sciences and Engineering, University of Ljubljana, Aškerčeva 12, SI-1000 Ljubljana, Slovenia
| | - Luka Škrlep
- Slovenian National Building and Civil Engineering Institute, Dimičeva ulica 12, SI-1000 Ljubljana, Slovenia
| | - Gregor Strmljan
- Slovenian National Building and Civil Engineering Institute, Dimičeva ulica 12, SI-1000 Ljubljana, Slovenia
| | - Branka Mušič
- Slovenian National Building and Civil Engineering Institute, Dimičeva ulica 12, SI-1000 Ljubljana, Slovenia
| | - Andrijana Sever Škapin
- Slovenian National Building and Civil Engineering Institute, Dimičeva ulica 12, SI-1000 Ljubljana, Slovenia
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32
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Mohseni Afshar Z, Babazadeh A, Hasanpour A, Barary M, Sayad B, Janbakhsh A, Aryanian Z, Ebrahimpour S. Dermatological manifestations associated with COVID-19: A comprehensive review of the current knowledge. J Med Virol 2021; 93:5756-5767. [PMID: 34241899 PMCID: PMC8427109 DOI: 10.1002/jmv.27187] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Babak Sayad
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of MedicineBabol University of Medical SciencesBabolIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
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33
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Abdali S, Yu J. Occupational Dermatoses Related to Personal Protective Equipment Used During the COVID-19 Pandemic. Dermatol Clin 2021; 39:555-568. [PMID: 34556245 PMCID: PMC8165076 DOI: 10.1016/j.det.2021.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The recent coronavirus disease 2019 (COVID-19) pandemic has led to the dramatic increase in use of personal protective equipment (PPE) among health care providers and the general public. Herein the authors discuss the various occupational dermatoses including allergic and irritant contact dermatitis, acne, seborrheic dermatitis, and rosacea related to frequent handwashing, disinfecting of surfaces, and prolonged wear of various PPE including face masks, gloves, and gowns. The authors provide an overview of published PPE-associated occupational dermatoses during the COVID-19 pandemic and also discuss prevention strategies and treatment options to help patients with these complaints.
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Affiliation(s)
- Selli Abdali
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114, USA.
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34
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Kang SY, Chung BY, Kim JC, Park CW, Kim HO. Clinical manifestations and patch test results for facial dermatitis associated with disposable face mask use during the COVID-19 outbreak: A case-control study. J Am Acad Dermatol 2021; 85:719-721. [PMID: 34139295 PMCID: PMC8200325 DOI: 10.1016/j.jaad.2021.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Seok Young Kang
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - Bo Young Chung
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - Jin Cheol Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - Chun Wook Park
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - Hye One Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea.
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35
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Schwensen JF, Simonsen AB, Zachariae C, Johansen JD. Facial dermatoses in healthcare professionals induced by the use of protective masks during the COVID-19 pandemic. Contact Dermatitis 2021; 85:710-711. [PMID: 34296441 PMCID: PMC8444920 DOI: 10.1111/cod.13948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Jakob Fb Schwensen
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne Birgitte Simonsen
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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36
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Damiani G, Gironi LC, Pacifico A, Cristaudo A, Malagoli P, Allocco F, Bragazzi NL, Linder DM, Santus P, Buja A, Savoia P, Pigatto PD. Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort. Ital J Dermatol Venerol 2021; 156:220-225. [PMID: 33960753 DOI: 10.23736/s2784-8671.21.06895-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks increased in the general population. We aimed to quantify the prevalence of mask-related cutaneous side effects and the differences between CE and non-CE approved masks. METHODS In this multicenter prospective observational study conducted from March 20, 2020 to May 12, 2020(during and after quarantine), patients attending emergency departments for a dermatological consult were clinically assessed and their masks were inspected to detect CE marks and UNI (Italian National Unification Entity) norms. Patients with history of facial dermatoses or under current treatment for facial dermatoses were excluded. RESULTS We enrolled 412 patients (318 during quarantine and 94 after quarantine). CE-approved masks were observed 52.8% vs. 24.5%, whilst subsets of non-CE approved masks were 9.7% vs. 14.9% (Personal protective equipment (PPE)-masks), 16.4% vs. 12.8% (surgical masks [SM]), and 21.1% vs. 47.9%(non-PPE) and (non-SM masks), respectively during and after quarantine. Remarkably, non-CE-approved masks resulted in patients displaying a statistically significant higher incidence of facial dermatoses and irritant contact dermatitis compared to CE-approved masks, and these differences were mainly driven by non-PPE non-SM masks. Comparing quarantine and after quarantine periods, no statistically significant differences were found for CE-approved masks, whilst differences were detected in non-CE-approved masks regarding incidence of facial dermatoses (P<0.0001)and irritant contact dermatitis (P=0.0041). CONCLUSIONS Masks are essential to prevent COVID-19 but at the same time higher awareness regarding mask specifications should be promoted in the general population. Non-PPE and non-SM masks should undergo more rigorous testing to prevent the occurrence of cutaneous side effects and future patients' lawsuit damages.
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Affiliation(s)
- Giovanni Damiani
- Department of Clinical Dermatology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy - .,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy -
| | - Laura C Gironi
- Maggiore della Carità University Hospital, Novara, Italy
| | - Alessia Pacifico
- Department of Clinical Dermatology, IRCCS S. Gallicano Dermatological Institute, Rome, Italy
| | - Antonio Cristaudo
- Department of Clinical Dermatology, IRCCS S. Gallicano Dermatological Institute, Rome, Italy
| | - Piergiorgio Malagoli
- Unit of Dermatology, Hospital of San Donato Milanese, San Donato Milanese, Milan, Italy
| | | | - Nicola L Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON, Canada
| | - Dennis M Linder
- Department of Dermatology, University Hospital, Padua, Italy
| | - Pierachille Santus
- Respiratory Unit, Department of Biomedical And Clinical Sciences (DIBIC), University of Milan, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alessandra Buja
- Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Paolo Dm Pigatto
- Department of Clinical Dermatology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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37
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Holness DL. Occupational Dermatitis and Urticaria. Immunol Allergy Clin North Am 2021; 41:439-453. [PMID: 34225899 DOI: 10.1016/j.iac.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.
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Affiliation(s)
- Dorothy Linn Holness
- Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
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38
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Choi SY, Hong JY, Kim HJ, Lee GY, Cheong SH, Jung HJ, Bang CH, Lee DH, Jue MS, Kim HO, Park EJ, Ko JY, Son SW. Mask-induced dermatoses during the COVID-19 pandemic: a questionnaire-based study in 12 Korean hospitals. Clin Exp Dermatol 2021; 46:1504-1510. [PMID: 34081799 PMCID: PMC8239570 DOI: 10.1111/ced.14776] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.
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Affiliation(s)
- S Y Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - J Y Hong
- Department of Dermatology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
| | - H J Kim
- Department of Dermatology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - G-Y Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S H Cheong
- Department of Dermatology, Konyang University, Daejeon, Korea
| | - H J Jung
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - C H Bang
- Department of Dermatology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - D H Lee
- Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M-S Jue
- Department of Dermatology, Veterans Health Service Medical Center, Seoul, Korea
| | - H O Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - E J Park
- Department of Dermatology, College of Medicine, Hallym University, Seoul, Korea
| | - J Y Ko
- Department of Dermatology, Hanyang University College of Medicine and Hanyang University Seoul Hospital, Seoul, Korea
| | - S W Son
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
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39
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"Face mask dermatitis" due to compulsory facial masks during the SARS-CoV-2 pandemic: data from 550 health care and non-health care workers in Germany. Eur J Dermatol 2021; 31:199-204. [PMID: 33814358 PMCID: PMC8356539 DOI: 10.1684/ejd.2021.4007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background During the COVID-19 pandemic, wearing face masks is mandatory not only for health care workers (HCWs) but also for the general population in many countries around the globe. Objectives The aim of the study was to investigate the onset of adverse facial skin reactions due to compulsory face masks during the COVID-19 pandemic in HCWs and non-HCWs, and draw awareness of this new dermatological condition and its preventive measures. Materials & Methods A questionnaire was distributed to 550 patients and HCWs from the Department of Dermatology and Allergy of the University Hospital Munich (LMU), Germany. Participants were surveyed regarding mask type, duration of usage and adverse facial skin reactions. Information on symptoms and the use of skin care products and topical drugs were retrieved. Results The duration of wearing masks showed a significant impact on the prevalence of symptoms (p < 0.001). Type IV hypersensitivity was significantly more likely in participants with symptoms compared to those without symptoms (p = 0.001), whereas no increase in symptoms was observed in participants with atopic diathesis. HCWs used facial skin care products significantly more often than non-HCWs (p = 0.001). Conclusion Preventive and therapeutic measures should be established in order to avoid “face mask dermatitis”, especially for people with underlying risk factors.
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Weisshaar E, John SM. [Occupational dermatology-more relevant than ever]. Hautarzt 2021; 72:467-468. [PMID: 34061217 PMCID: PMC8167831 DOI: 10.1007/s00105-021-04823-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Elke Weisshaar
- Berufsdermatologie, Universitätshautklinik Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.
| | - Swen Malte John
- Abteilung Dermatologie, Umweltmedizin, Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland. .,Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Osnabrück, Deutschland.
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Lee EB, Lobl M, Ford A, DeLeo V, Adler BL, Wysong A. What Is New in Occupational Allergic Contact Dermatitis in the Year of the COVID Pandemic? Curr Allergy Asthma Rep 2021; 21:26. [PMID: 33779825 PMCID: PMC8006117 DOI: 10.1007/s11882-021-01000-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates. RECENT FINDINGS Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.
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Affiliation(s)
- Erica B Lee
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Marissa Lobl
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Aubree Ford
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Vincent DeLeo
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA.
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Dowdle TS, Thompson M, Alkul M, Nguyen JM, Sturgeon ALE. COVID-19 and dermatological personal protective equipment considerations. Proc (Bayl Univ Med Cent) 2021; 34:469-472. [PMID: 34219927 DOI: 10.1080/08998280.2021.1899730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Cutaneous injury and irritation among health care workers has substantially risen during the COVID-19 pandemic. In a field already laden with skin-induced injury and irritation due to high levels of handwashing and glove wearing, increases have been reported in handwashing-induced xerosis, irritant dermatitis, and contact dermatitis from N95 respirators and other surgical masks. Masks, goggles, face shields, and gloves all potentially create abrasions from long hours of use, leading to itching, pain, and aggravation of underlying skin conditions. Personal protective equipment (PPE)-related skin injury can be serious, and the American Academy of Dermatology has released recommendations on preventing and treating occupationally induced dermatologic conditions during the COVID-19 pandemic. These are reviewed and discussed in conjunction with overarching guidelines for mitigating the spread of the virus.
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Affiliation(s)
- Travis S Dowdle
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Mallory Thompson
- School of Medicine, Texas Christian University/University of North Texas Health Science Center, Fort Worth, Texas
| | - Mahmud Alkul
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Jeannie M Nguyen
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Ashley L E Sturgeon
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas
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43
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İnan Doğan E, Kaya F. Dermatological findings in patients admitting to dermatology clinic after using face masks during Covid-19 pandemia: A new health problem. Dermatol Ther 2021; 34:e14934. [PMID: 33751746 PMCID: PMC8206671 DOI: 10.1111/dth.14934] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/29/2020] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
In the present study, the purpose was to evaluate the presence of dermatological symptoms and the effects of mask use on existing dermatological diseases associated with face in patients admitting with any dermatological disease. The present study consisted of 150 patients, including 91 volunteering women and 59 men, admitting to our dermatology clinic with any dermatological symptoms. The presence of symptoms, such as itching, rash, drying and peeling, discomfort, redness, burning, pain, swelling, acne, oily skin symptoms because of mask use, and previous history of facial dermatological disease, whether this disease increased with the use of mask, were questioned. The diagnosis made after dermatological examination and the dermatological examination findings were evaluated with the results of the survey. The most common finding in all patients after mask use was itching with a rate of 64.7%. Similar rates were detected for other symptoms. A significant increase was detected in the severity of acneiform and inflammatory dermatosis after the use of masks (P < .05). Our study showed that long-term mask use caused primary skin symptoms, such as itching, redness, rash, dryness and peeling, burning, oily skin, and acne formation in individuals who have dermatological diseases, and also increased the existing dermatological facial diseases. Therefore, it should be recommended to use water-based moisturizers as it may have a barrier effect on the faces of individuals who use a face mask and have any facial dermatosis, and patients should be closely monitored for skin diseases on the face.
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Affiliation(s)
- Esra İnan Doğan
- Department of Dermatovenereology, Adıyaman University School of Medicine Faculty, Adıyaman, Turkey
| | - Ferit Kaya
- Department of Public Health, Adıyaman University School of Medicine Faculty, Adıyaman, Turkey
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44
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Damiani G, Gironi LC, Grada A, Kridin K, Finelli R, Buja A, Bragazzi NL, Pigatto PDM, Savoia P. COVID-19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi-center, real-life, telemedical, and observational prospective study. Dermatol Ther 2021; 34:e14848. [PMID: 33533563 PMCID: PMC7995182 DOI: 10.1111/dth.14848] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/09/2021] [Accepted: 01/27/2021] [Indexed: 02/06/2023]
Abstract
Masks are essential for COVID‐19 prevention, but recently they were suggested to modify cutaneous facial microenvironment and trigger facial dermatoses. To evaluate mask‐related rosacea and acne (maskne) in untreated patients during lockdown. In this multi‐center, real‐life, observational prospective study, we enrolled stable, untreated acne and rosacea patients that wore masks during lockdown at least 6 h/day. They underwent two teledermatological consultations, at the baseline and after 6 weeks. Clinical, pharmacological, and psychological data were recorded. A total 66 patients, 30 (median age: 34.0 [30.25‐29.75] yoa) with acne and 36 patients (median age: 48 [43‐54] years) with rosacea, were enrolled in this study. After 6 weeks of mask and quarantine, patients with acne displayed an increased Global Acne Grading Scale (GAGS) score in mask‐related areas (P < .0001). Likewise, after 6 weeks of mask and quarantine, patients with rosacea displayed a worsen in both physican (P < .0001) and patient (P < .0001) reported outcomes. Remarkably, patients reported also a statistically significant decrease in their quality of life (P < .0001). Masks appear to trigger both acne and rosacea flares. Additional studies are needed to generate evidence and inform clinical decision‐making.
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Affiliation(s)
- Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy.,Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | | | - Ayman Grada
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Alessandra Buja
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Nicola L Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Canada
| | - Paolo D M Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
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45
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Damiani G, Gironi LC, Kridin K, Pacifico A, Buja A, Bragazzi NL, Spalkowska M, Pigatto PDM, Santus P, Savoia P. Mask-induced Koebner phenomenon and its clinical phenotypes: A multicenter, real-life study focusing on 873 dermatological consultations during COVID-19 pandemics. Dermatol Ther 2021; 34:e14823. [PMID: 33527560 PMCID: PMC7995036 DOI: 10.1111/dth.14823] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022]
Abstract
During COVID-19 pandemic, wearing masks for prevention became mandatory but evidence suggest that is also detrimental for skin. Although facial dermatoses due to masks increase in both healthcare workers and general population, a pathogenetic hypothesis remains still elusive. We aimed to evaluate the prevalence of dermatological consultations due to Koebner triggered dermatoses In this prospective, multicenter, real life study carried out in Italy from March 11th to December 11th 2020 during COVID-19 pandemics, dermatological consultations (in-person and telemedicine) to study the prevalence of Koebner (KB) phenomenon due to masks were evaluated. Boyd and Nelder classification was adopted for Koebner phenomenon and Bizzozero's for KB intensity. A total of 229/873 (26.2%) dermatological consultations were KB triggered dermatoses and lesions were located in mask-covered ear area (76 [33.2%]), malar area (73 [31.8%]), perioral area (53 [23.1%]), and nose (27 [11.8%]). The first KB category grouped 142 patients (psoriasis, vitiligo, maskne, and mask rosacea), the second one 24 (warts, molluscum contagiosum, and impetigo), the third one 46 (atopic dermatitis), and the fourth one 17 (eczema). Among previously KB negative psoriatic patients that became KB positive, 9/13 (69.2%) had discontinued or modified the prescribed antipsoriatic treatment. Mask-related Koebner phenomenon is an important clinical sign to orient clinician's therapeutic protocols during COVID-19 pandemic, especially in patients with psoriasis.
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Affiliation(s)
- Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy.,Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | | | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Alessia Pacifico
- Clinical Dermatology Department, IRCCS S. Gallicano Dermatological Institute, Rome, Italy
| | - Alessandra Buja
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Magdalena Spalkowska
- Faculty of Medicine, Department of Dermatology, Jagellonian University Medical College, Krakow, Poland.,Department of Rheumatology and Immunology, University Hospital of Krakow, Krakow, Poland
| | - Paolo Daniele Maria Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milano, Italy
| | | | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
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46
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Antiseptic drugs and disinfectants with special scrutiny of COVID-19 pandemic related side effects. SIDE EFFECTS OF DRUGS ANNUAL 2021. [PMCID: PMC8488688 DOI: 10.1016/bs.seda.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This review covers publications during the period of January 2020 to December 2020 on adverse reactions to antiseptic drugs and disinfectants. Specific agents discussed are alcohols (ethanol, isopropanol), aldehydes (formaldehyde), guanidines (chlorhexidine, polyhexamethylene guanidine, and polyhexamethylene biguanidine), benzalkonium compounds, triclocarban, povidone-iodine, and sodium hypochlorite. No new data were identified for glutaraldehyde, cetrimide, ethylene oxide, tosylchloramide, triclosan, iodine, and phenolic compounds. The use of antiseptic drugs and disinfectants has been considerably increased during 2020 in a variety of medical and occupational settings, in commerce and gastronomy, as well as in the household, due to their antiviral properties against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the Coronavirus Disease 2019 (COVID-19) pandemic. Exposure was additionally increased by widespread misinformation on social media for non-evidence based disinfectant use, even including ingestion or injection, as well as by questionable practices such as environmental spraying or disinfectant gates. Irritant effects on the respiratory system, skin and eyes were the most common adverse reaction, while the widespread and sometimes excessive use led to increased reports of poisonings, as well as cases of disinfectant adulteration including dilution into ineffective concentrations or addition of toxic agents such as methanol.
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47
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Wilcha RJ. Does Wearing a Face Mask During the COVID-19 Pandemic Increase the Incidence of Dermatological Conditions in Health Care Workers? Narrative Literature Review. JMIR DERMATOLOGY 2021; 4:e22789. [PMID: 34028470 PMCID: PMC8104277 DOI: 10.2196/22789] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/21/2020] [Accepted: 04/17/2021] [Indexed: 12/24/2022] Open
Abstract
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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Affiliation(s)
- Robyn-Jenia Wilcha
- Faculty of Biology, Medicine and Health University of Manchester Manchester United Kingdom
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48
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Darlenski R, Kazandjieva J, Tsankov N. Prevention and occupational hazards for the skin during COVID-19 pandemic. Clin Dermatol 2020; 39:92-97. [PMID: 33972059 PMCID: PMC7833884 DOI: 10.1016/j.clindermatol.2020.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The life of medical specialists worldwide has dramatically changed due to the spread of the coronavirus disease 2019 (COVID-19) pandemic. Health care professionals (HCPs) have personally faced the outbreak by being on the first line of the battlefield with the disease and, as such, compose a significant number of people who have contracted COVID-19. We propose a classification and discuss the pathophysiology, clinical findings, and treatments and prevention of the occupational skin hazards COVID-19 poses to HCPs. The multivariate pattern of occupational skin diseases during the COVID-19 pandemic can be classified into four subgroups: mechanical skin injury, moisture-associated skin damage, contact reactions, and exacerbation of preexisting dermatoses. The clinical pattern is versatile, and the most affected skin sites were the ones in contact with the protective equipment. Dermatologists should recognize the plethora of HCPs’ occupational skin reactions that are occurring during the COVID-19 pandemic and implement treatment and preventive strategies.
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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.
| | - Jana Kazandjieva
- Department of Dermatology and Venereology, Medical University Sofia, Sofia, Bulgaria
| | - Nikolai Tsankov
- Department of Dermatology and Venereology, Acibadem City Clinic, Tokuda Hospital, Sofia, Bulgaria
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Di Altobrando A, La Placa M, Neri I, Piraccini BM, Vincenzi C. Contact dermatitis due to masks and respirators during
COVID
‐19 pandemic: What we should know and what we should do. Dermatol Ther 2020; 33:e14528. [DOI: 10.1111/dth.14528] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Ambra Di Altobrando
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology University of Bologna Bologna Italy
| | - Michelangelo La Placa
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology University of Bologna Bologna Italy
| | - Iria Neri
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology University of Bologna Bologna Italy
| | - Bianca Maria Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology University of Bologna Bologna Italy
| | - Colombina Vincenzi
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology University of Bologna Bologna Italy
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50
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Mawhirt SL, Frankel D, Diaz AM. Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers. Curr Allergy Asthma Rep 2020; 20:75. [PMID: 33047260 PMCID: PMC7549735 DOI: 10.1007/s11882-020-00974-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 01/08/2023]
Abstract
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. 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.
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Affiliation(s)
- Stephanie L Mawhirt
- Division of Allergy and Immunology, Department of Medicine, NYU Winthrop Hospital, 120 Mineola Blvd Suite 410, Mineola, New York, USA.
| | - David Frankel
- Division of Allergy and Immunology, Department of Medicine, NYU Winthrop Hospital, 120 Mineola Blvd Suite 410, Mineola, New York, USA
| | - Althea Marie Diaz
- Department of Medicine, 222 Station Plaza North, Suite 509, Mineola, New York, USA
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