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Cleland JB, Greenzaid JD, Doerfler L, Ahn CS. Wait times for surgery of cutaneous malignancies following the COVID-19 pandemic: a retrospective cohort analysis. Arch Dermatol Res 2024; 316:452. [PMID: 38967839 DOI: 10.1007/s00403-024-03200-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/20/2024] [Accepted: 06/23/2024] [Indexed: 07/06/2024]
Affiliation(s)
- Jane B Cleland
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA
| | - Jonathan D Greenzaid
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA.
| | - Laura Doerfler
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA
| | - Christine S Ahn
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Díaz-Calvillo P, Muñoz-Barba D, Ureña-Paniego C, Maul LV, Cerminara S, Kostner L, Martínez López A, Arias-Santiago S. Effects of COVID-19 Pandemic on the Diagnosis of Melanoma and Keratinocyte Carcinomas: a Systematic Review and Meta-analysis. Acta Derm Venereol 2024; 104:adv19460. [PMID: 38483083 PMCID: PMC10953710 DOI: 10.2340/actadv.v104.19460] [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: 09/18/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024] Open
Abstract
Since December 2019, the COVID-19 pandemic has profoundly affected healthcare. The real effects of the COVID-19 pandemic on skin cancer are still unclear, more than 3 years later. This study aims to summarise the pandemic's impact on skin cancer diagnosis and outcome. A systematic review and meta-analysis was conducted, selecting studies comparing skin cancer diagnosis and prognosis post-pandemic with pre-pandemic data. A total of 27 papers were reviewed including 102,263 melanomas and 271,483 keratinocyte carcinomas. During the initial pandemic months (January-July 2020), melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries by 50.8%. Early pandemic tumours exhibited greater thickness and stage. In a long-term period beyond the initial months, melanoma surgeries decreased by 9.3%, keratinocyte carcinomas by 16.6%. No significant differences were observed in the Breslow thickness of melanomas after the start of the pandemic (mean difference 0.06, 95% confidence interval -0.46, 0.58). Melanomas operated on post-pandemic onset had an increased risk of ulceration (odds ratio 1.35, 95% confidence interval 1.22-1.50). Keratinocyte carcinomas showed increased thickness and worsened stage post-pandemic. However, studies included were mostly retrospective and cross-sectional, reporting diverse data. This review indicates that the pandemic likely caused delays in skin cancer diagnosis and treatment, potentially impacting patient outcomes.
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Affiliation(s)
- Pablo Díaz-Calvillo
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Daniel Muñoz-Barba
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Clara Ureña-Paniego
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Lara Valeska Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Sara Cerminara
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Lisa Kostner
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland.
| | - Antonio Martínez López
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Salvador Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Dermatology, University of Granada, Granada, Spain
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Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T224-T230. [PMID: 38185206 DOI: 10.1016/j.ad.2024.01.004] [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: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
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Affiliation(s)
- P Díaz-Calvillo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - A Martínez-López
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
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Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:224-230. [PMID: 37858857 DOI: 10.1016/j.ad.2023.10.003] [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: 07/19/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
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Affiliation(s)
- P Díaz-Calvillo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
| | - A Martínez-López
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Dermatology, University of Granada, Granada, Spain
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Benedetti S, Frosolini A, Catarzi L, Marsiglio A, Gennaro P, Gabriele G. Impact of the COVID-19 Pandemic on the Diagnosis and Management of Non-Melanoma Skin Cancer in the Head and Neck Region: A Retrospective Cohort Study. Healthcare (Basel) 2024; 12:501. [PMID: 38391876 PMCID: PMC10888473 DOI: 10.3390/healthcare12040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
The present study investigates the impact of the COVID-19 pandemic on the management of Non-Melanoma Skin Cancer (NMSC) in the head and neck region. Conducted at the University Hospital "Le Scotte" in Siena, Italy, the research includes 111 patients treated from 2018 to 2021. The study aims to understand how pandemic-related healthcare changes affected NMSC treatment, focusing on differences in diagnosis and management before and during the pandemic. Methods involved retrospective analysis of patient demographics, clinical characteristics, lesion details, and treatment modalities, using Jamovi software (version 1.6) for statistical analysis. Results revealed the scalp as the most common NMSC site, with Squamous Cell Carcinoma (SCC) being the predominant histotype. A significant rise in Basal Cell Carcinoma (BCC) cases and a reduction in surgery duration were noted during the pandemic. The shift to local anesthesia was more pronounced, reflecting the necessity to adapt to healthcare limitations. Despite the disruptions caused by the pandemic, there was no significant drop in NMSC cases, which is attributed to the noticeable nature of head and neck lesions. In conclusion, this study highlights that the COVID-19 pandemic significantly influenced surgical practices in NMSC management, emphasizing the need for effective healthcare strategies that balance quality patient care with public health safety measures.
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Affiliation(s)
- Simone Benedetti
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Andrea Frosolini
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lisa Catarzi
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Agnese Marsiglio
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Paolo Gennaro
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Guido Gabriele
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
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Meraya AM, Kashan Syed N, Syed MH, Yasmeen A, Alfaifi MH, Alfaifi AJ, Hurubi KY, Khobrani MA, Alhossan A. Impact of COVID-19 related movement restrictions on the follow-up care visits of adults with chronic conditions: A Saudi arabian survey study. Saudi Pharm J 2023; 31:101846. [PMID: 38033751 PMCID: PMC10682654 DOI: 10.1016/j.jsps.2023.101846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Aims Lockdown measures implemented during the initial phase of the pandemic resulted in the delay and disruption of healthcare utilization for individuals with chronic conditions. We aimed to evaluate the impact of COVID-19 movement restrictions on the follow-up care visits of individuals with chronic illnesses. We also assessed the possible reasons patients missed their follow-ups and the potential barriers impeding follow-up during the pandemic. Methods A total of 397 adults with pre-existing medical conditions participated in an online cross-sectional survey from October to December 2022. The study sample comprised 57 % females and 43 % males, with a mean age of 43 years. A 36-item online self-report survey was used for data collection.Results: Fifty-five percent of participants reported missing their follow-up during COVID-19 pandemic, and 14 % made emergency department visits due to their missed follow-up appointments. In addition, 24 % experienced complications due to their missed appointments. The mean score on the fear of COVID-19 scale was 17.8 ± 6.5 (SD). For the majority of participants (60 %), pandemic-related restrictions were the predominant barrier to their follow-up visits. Additionally, we found that as individuals' COVID-19 fear scores increased, the likelihood of missing a follow-up care visit also increased (AOR: 1.067; p-value = 0.001). However, participants who did not perceive COVID-19 pandemic-related restrictions as a barrier were less likely to miss their follow-up visits (AOR: 0.581; p-value = 0.031). Furthermore, those who understood the significance of follow-up care were less likely to miss any of their follow-up visits (AOR: 0.224; p-value < 0.001) than those who had limited understanding of its importance. Conclusion The results showed that pandemic-related movement restrictions negatively affected attendance at follow-up visits for people with pre-existing health conditions. Initiatives should therefore be undertaken during global public health emergencies to provide medical and psychological support to vulnerable and high-risk groups.
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Affiliation(s)
- Abdulkarim M. Meraya
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Nabeel Kashan Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Mamoon H. Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Ayesha Yasmeen
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Mohammed H. Alfaifi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Aseel J. Alfaifi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Khalid Y. Hurubi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Moteb A. Khobrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Saudi Arabia
| | - Abdulaziz Alhossan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Saudi Arabia
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Balchander D, Shorbaji K, Cabrera CI, Hoying D, Clancy K, Fowler N, Thuener JE, Lavertu P, Pan Q, Teknos TN, Rezaee RP, Li S, Tamaki A. Prognostic significance of time trends in treatment of head and neck squamous cell carcinoma. Am J Otolaryngol 2023; 44:103966. [PMID: 37481899 DOI: 10.1016/j.amjoto.2023.103966] [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: 03/10/2023] [Revised: 06/19/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To analyze the impact of demographic, clinical, and management variables on time to treatment initiation (TTI) and overall survival (OS). STUDY DESIGN Retrospective chart review. MATERIALS AND METHODS Medical records of patients diagnosed with head and neck cancer from 2018 to 2020 were reviewed. Univariate linear and Cox-regressions identified predictors of TTI and OS. Kaplan Meier (KM) curves assessed the difference in survival by diagnostic year and TTI. RESULTS 381 patients met eligibility criteria. Median TTI was 35.0 days (IQR: 25.0-49.0). Only 10.8 % of all patients reported any treatment delay, with TTI exceeding 90 days found in 3.7 % of patients. TTI increased with African American race (p = 0.02), ED referrals (p = 0.02), and direct admission status (p = 0.01). When compared to treatment with surgery alone, TTI was shorter in patients undergoing surgery with adjuvant radiation (p = 0.02), adjuvant chemoradiation (p = 0.04), and salvage surgery (p = 0.04). Univariate Cox-regressions found smoking (p = 0.01), direct admission status (p = 0.02), increased duration of symptoms (p = 0.02), placement of PEG tubes (p < 0.01) and tracheostomies (p < 0.01), combination treatment (p < 0.01), and surgery with adjuvant chemoradiation treatment (p = 0.01) to increase mortality risk. Disease characteristics, including tumor size (p < 0.01), presence of nodal disease (p = 0.02), and late-stage disease (p < 0.01), increased mortality risk. TTI and diagnostic year did not impact survival. CONCLUSIONS Our analysis determined several demographic, referral, and treatment factors impacted TTI. However, increased TTI did not impact survival. Characteristics consistent with advanced disease worsened OS. Despite the pandemic burden, patients diagnosed in 2020 showed no difference in short-term survival compared to prior years.
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Affiliation(s)
| | - Khaled Shorbaji
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Claudia I Cabrera
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David Hoying
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kate Clancy
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nicole Fowler
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jason E Thuener
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pierre Lavertu
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Quintin Pan
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Theodoros N Teknos
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rod P Rezaee
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Shawn Li
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Akina Tamaki
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Bowers JM, Seidenberg AB, Kemp JM. Skin Cancer Diagnosis Among People With Disabilities. Am J Prev Med 2023; 65:896-900. [PMID: 37062527 PMCID: PMC10576008 DOI: 10.1016/j.amepre.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION People with disabilities face unique challenges that may affect skin cancer prevention, diagnosis, and access to treatment. These challenges could be exacerbated by the COVID-19 pandemic. In 2022, the prevalence of self-reported skin cancer diagnoses, delayed medical care because of the coronavirus disease 2019 (COVID-19) pandemic, and skin cancer risk factors among people with disabilities were estimated. METHODS Data from the 2020 National Health Interview Survey (N=31,568 U.S. adults) were analyzed. Skin cancer diagnosis, age at the time of skin cancer diagnosis, skin cancer risk factors (e.g., sun protection), and delayed medical care because of the COVID-19 pandemic were included. Disability status was measured using the Washington Group Short Set on Functioning, which includes vision, hearing, mobility, communication, self-care, and cognitive disabilities. RESULTS Although 8.8% of U.S. adults reported having a disability, people with disabilities accounted for 14.7% of all self-reported skin cancer diagnoses, including 17.5% of melanoma diagnoses. Notably, people with disabilities were on average, older (mean age=59.8 years) than people without disabilities (mean age=46.8 years). Models that adjusted for age and other demographics revealed that people with disabilities had higher odds of delaying medical care because of the COVID-19 pandemic (OR=1.65, 95% CI=1.41, 1.94); people with disabilities reported being diagnosed with skin cancer later in life (age 61.5 vs 54.0 years; p<0.001) but had odds of reporting any skin cancer (OR=1.11, 95% CI=0.93, 1.32) or melanoma diagnosis (OR=1.33, 95% CI=0.95, 1.87) similar to those of people without disabilities. CONCLUSIONS Because of disability-related challenges, older age, and delaying medical care during the pandemic, people with disabilities may be at increased risk for inequitable skin cancer outcomes.
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Affiliation(s)
- Jennifer M Bowers
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD.
| | - Andrew B Seidenberg
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD; Truth Initiative Schroeder Institute, Washington, DC
| | - Jacqueline M Kemp
- Massachusetts Dermatology Associates, Beverly, MA; Department of Dermatology, Harvard Medical School, Boston, MA
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9
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Łaziński Ł, Koziej M, Antoszewski B, Fijałkowska M. Skin cancer occurrence: single-center experiences from period 2020-2022. POLISH JOURNAL OF SURGERY 2023; 96:26-30. [PMID: 38629283 DOI: 10.5604/01.3001.0053.9174] [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] [Indexed: 04/19/2024]
Abstract
<b><br>Introduction:</b> Skin cancers constitute a group of medical disorders remaining a field of interest for surgeons and dermatologists. Currently, this group is typically divided into malignant melanoma (MM) and keratinocyte cancers (KC).</br> <b><br>Aim:</b> The aim of this study is to analyze the cases of skin cancers treated in the Department of Plastic, Reconstructive, and Aesthetic Surgery in Lodz (Poland) during the COVID-19 pandemic (from 2020 to 2022) and then compare the results with the ones from the pre-pandemic period (from 2017 to 2019).</br> <b><br>Material and methods:</b> An analysis of histopathological files from the period between 2020 and 2022 was performed. It was based on the following criteria: sex, age, type of skin cancer, subtype of basal cell carcinoma (BCC), location, and dimensions of the tumor. The study sample consisted of 225 patients presenting 241 cases of skin cancers. There were 74 men and 151 women, with the mean age being 71.7.</br> <b><br>Results:</b> The most common skin cancer was BCC (175 cases, 72.6%) followed by SCC (59 cases, 24.5%), melanoma (5 cases, 2.1%), and other (2 cases, 0.8% - angiosarcoma and sweat gland carcinoma).</br> <b><br>Conclusions:</b> A marked reduction in the number of skin cancers detected during the pandemic period was reported on. Delay in the surgical treatment of skin tumors does not seem to affect the size of the removed lesion. Some models predicting that tumors would be larger after the confinement period are not applicable in reality. However, further investigations with larger samples from multiple centers are needed to confirm these findings and to work out standards on how to deal with healthcare crises in the future.</br>.
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Affiliation(s)
- Łukasz Łaziński
- Department of Plastic, Reconstructive and Aesthetic Surgery, Second Chair of Surgery Medical University of Lodz, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Bogusław Antoszewski
- Department of Plastic, Reconstructive and Aesthetic Surgery, Second Chair of Surgery Medical University of Lodz, Poland
| | - Marta Fijałkowska
- Department of Plastic, Reconstructive and Aesthetic Surgery, Second Chair of Surgery Medical University of Lodz, Poland
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Jović M, Marinković M, Suđecki B, Jurišić M, Bukumirić Z, Jovanović M, Stojičić M, Jeremić J. COVID-19 and Cutaneous Squamous Cell Carcinoma-Impact of the Pandemic on Unequal Access to Healthcare. Healthcare (Basel) 2023; 11:1994. [PMID: 37510435 PMCID: PMC10378852 DOI: 10.3390/healthcare11141994] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Most skin tumors are not fatal, but if not treated in a timely manner, they can lead to significant morbidity. Due to the COVID-19 pandemic and in order to create more capacities for the treatment of COVID-19-positive patients as well as to contain the spread of the virus, the healthcare system was reorganized worldwide, leading to decreased access to preventive screening programs. The aim of this study was to evaluate the impact of the pandemic on healthcare accessibility to cutaneous squamous cell carcinoma patients in Serbia. This retrospective study was conducted at the Clinic for Burns, Plastic, and Reconstructive Surgery, University Clinical Center of Serbia in Belgrade. Patient demographics and pathohistological findings of tumors of patients living in and outside the capital in the period before, during, and after the pandemic were compared. The two groups did not show any differences regarding the largest tumor diameter prior and during the pandemic; however, this difference became extremely noticeable after the pandemic (15 mm vs. 27 mm; p < 0.001). While cSCCs are commonly slow-growing tumors, the impact of the COVID-19 pandemic is not negligible. This study found a population at a significant risk of cSCC metastasis, with additional evidence likely to emerge in the upcoming years.
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Affiliation(s)
- Marko Jović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milana Marinković
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Branko Suđecki
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milana Jurišić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Zoran Bukumirić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute for Medical Statistics and Informatics, 11000 Belgrade, Serbia
| | - Milan Jovanović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milan Stojičić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Jelena Jeremić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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11
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Borg T, Eisold J, Miyanjo Y, Pappa E. The effect of COVID‐19 on surgical management of skin cancers of the head, face and neck in elderly patients. SKIN HEALTH AND DISEASE 2023; 3:e175. [PMID: 37025367 PMCID: PMC10071305 DOI: 10.1002/ski2.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 03/30/2023]
Abstract
Background The Corona Virus (COVID-19) has had a profound impact on healthcare systems worldwide, with interruptions to medical practices including the delivery of cancer treatment. Skin cancer is one of the leading causes of malignancy worldwide, with later stages of disease correlating to poorer prognosis. Immunocompromized and elderly patients represent populations that are at higher risk for adverse outcomes related to skin cancer, treatment delay and COVID-19 infection. Methodology Patients aged 65 and above who underwent surgical management of skin cancers from 31 January 2020 to 31 January 2021 were included in this study then compared with samples pre- and post-pandemic. Retrospective analysis was performed regarding: date of referral to date of surgery, skin cancer type, location of cancer, surgery performed, anaesthesia used, sutures used and outcomes. Data was compared to national guidelines. Results Five hundred and twenty skin cancers were included in this analysis, of which 340 were treated during the COVID-19 pandemic. Of the cohort treated during the pandemic, 44.2% (n = 111) received excision and direct closure, 13.1% (n = 33) underwent reconstruction by integra dermal substitute, 3.2% (n = 8) by split thickness skin graft, 6.4% (n = 16) by full thickness skin grafts and 33.1% (n = 83) by local flaps. Complete excision was achieved in 88.5% of cases (n = 301). The mean time from referral to surgery was 119 days. There were no deaths associated with COVID-19. Conclusion Safe and prompt treatment of head and neck skin cancers is achievable despite the COVID-19 pandemic. Measures to minimize infection risk include the use of teledermatology, reliable COVID-19 testing, Green Pathways and a reduction in the mean referral to surgery time.
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Affiliation(s)
| | | | - Yusuf Miyanjo
- Department of Oral and Maxillofacial SurgeryQueen's HospitalLondonUK
| | - Elena Pappa
- Department of Oral and Maxillofacial SurgeryQueen's HospitalLondonUK
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12
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Joulaei H, Foroozanfar Z, Ziaee A, Hooshyar D, Loolia M, Azadian F, Fatemi M. Delay in Regular Visits of Chronic Disease Patients and Its Associated Factors during the COVID-19 Pandemic. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:176-186. [PMID: 36895456 PMCID: PMC9989245 DOI: 10.30476/ijms.2022.93944.2529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 03/11/2023]
Abstract
Background Chronic patients need regular follow-ups. During the COVID-19 pandemic, these regular visits can be affected. The delay of chronic patients and its contributing factors in their periodic visits during the COVID-19 pandemic are examined here. Methods This cross-sectional study was conducted between February and June 2021, in Fars, Iran. Two hundred and eighty-six households with at least one chronic patient were recruited. Then, several trained questioners called the studied households and asked about the studied variables. The dependent variable was the number of delays in regular visits during the COVID-19 pandemic. The results were analyzed through Poisson regression by SPSS Statistics version 22 and GraphPad Prism software version 9. A significance level of 0.05 was considered for this study. Results Out of 286 households 113 (73.4%) fathers, 138 (70.1%) mothers, and 17 (58.6%) children in the households reported delayed referral. In fathers, referring to the health center was significantly associated with a decrease in the number of delays (P=0.033). The higher age of the householder (P=0.005), the higher number of children (P=0.043), and having a family physician (P=0.007) in the mothers' group, also the number of children in households (P=0.001) in the children group were significantly associated with increasing the number of delays. Conclusion COVID-19 pandemic not only creates direct harmful effects but also adversely affects people in danger of chronic diseases. Delays in follow-ups are taken into account as a major challenge during the COVID-19 pandemic. This issue is not limited to rural or urban residency.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Ziaee
- Department of Neuroscience, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Dariush Hooshyar
- Student Research Committee, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Fatemeh Azadian
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Fatemi
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Gil-Pallares P, Figueroa-Silva O, Gil-Pallares ME, Vázquez-Bueno JÁ, Piñeyro-Molina F, Monteagudo B, Heras-Sotos CDL. Did COVID-19 lockdown delay actually worsen melanoma prognosis? An Bras Dermatol 2023; 98:176-180. [PMID: 36567164 PMCID: PMC9729652 DOI: 10.1016/j.abd.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/17/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The COVID-19 lockdown possibly meant a delay in the diagnosis and treatment of melanoma and therefore, worsening its prognosis. This unique situation of diagnosis deferral is an exceptional opportunity to investigate melanoma biology. OBJECTIVES To evaluate the immediate and mid-term impact of diagnosis delay on melanoma. METHODS A retrospective observational study of melanoma diagnosed between March 14th 2019 and March 13th 2021. We compared the characteristics of melanomas diagnosed during the first 6-month period after the lockdown instauration and a second period after recovery of normal activity with the same periods of the previous year, respectively. RESULTS A total of 119 melanomas were diagnosed. There were no differences in age, sex, incidence, location, presence of ulceration or mitoses, and in situ/invasive melanoma rate (p>0.05). After the recovery of the normal activity, Breslow thickness increased in comparison with the previous year (2.4 vs 1.9mm, p<0.05) resulting in a significant upstaging according to the AJCC 8th ed. (p<0.05). STUDY LIMITATIONS The main limitation is that this is a single-center study. CONCLUSIONS The COVID-19 lockdown implied a diagnosis delay leading to a mid-term increase in Breslow thickness and an upstaging of invasive melanomas. However, the detection deferral did not result in a higher progression of in situ to invasive melanoma, in our sample.
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Affiliation(s)
- Pedro Gil-Pallares
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain.
| | - Olalla Figueroa-Silva
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | | | | | | | - Benigno Monteagudo
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
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14
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Toma AO, Prodan M, Reddyreddy AR, Seclaman E, Crainiceanu Z, Bloanca V, Bratosin F, Dumitru C, Pilut CN, Alambaram S, Vasamsetti NG, Decean L, Pricop M. The Epidemiology of Malignant Melanoma during the First Two Years of the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:305. [PMID: 36612627 PMCID: PMC9819675 DOI: 10.3390/ijerph20010305] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
It is hypothesized that the COVID-19 pandemic had a major impact on the epidemiology of malignant melanoma owing to diminished screening, diagnostic, and treatment capacities, resulting in a more advanced stage at initial presentation. The goal of this study is to undertake a systematic analysis of all epidemiological and clinical data on the trends and patient outcomes with malignant melanoma during the ongoing pandemic. Records were identified from PubMed, Cochrane, and Web of Science, selecting a total of 39 articles, narrative reviews, and editorial letters, following the PRISMA guidelines. The vast majority of the studies were published in Europe (28/39), and North America (7/39). A total of 99,860 patients were analyzed during 2020 and 2021 of the COVID-19 pandemic, and it was observed that malignant melanoma TNM staging increased significantly compared to the pre-pandemic period. Before the pandemic, 25.88% of patients had TNM stage II or above, compared to 36.25% during 2020-2021. During the COVID-19 pandemic, the malignant melanoma Breslow depth index grew from 1.59 mm before 2020 to 1.86 mm in 2020 and 2021. Patients decreased by 19.58% in 2020 and 2021 compared to pre-pandemic numbers. The patient-loss ratio indicated lower screening activity and patient addressability to dermatology and plastic surgery departments with skin cancer concerns during the COVID-19 pandemic. This systematic study shows that the identification and management of malignant melanoma during the COVID-19 pandemic faced major challenges which should alert medical systems to the high number of patients with advanced disease stages who may need emergency treatment and become incurable.
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Affiliation(s)
- Ana-Olivia Toma
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mihaela Prodan
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Akash Reddy Reddyreddy
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | - Edward Seclaman
- Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Center for Complex Networks Science, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Zorin Crainiceanu
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Vlad Bloanca
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ciprian Nicolae Pilut
- Kaloji Narayana Rao University of Health Sciences, Nizampura, Warangal, Telangana 506007, India
| | - Satish Alambaram
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | | | - Luminita Decean
- Faculty of General Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Strada Gheorghe Marinescu 38, 540139 Targu Mures, Romania
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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15
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Lee C, Witkowski A, Żychowska M, Ludzik J. The role of mobile teledermoscopy in skin cancer triage and management during the COVID-19 pandemic. Indian J Dermatol Venereol Leprol 2022; 89:347-352. [PMID: 36688890 DOI: 10.25259/ijdvl_118_2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/01/2022] [Indexed: 12/13/2022]
Abstract
The unprecedented onset of the COVID-19 crisis poses a significant challenge to all fields of medicine, including dermatology. Since the start of the coronavirus outbreak, a stark decline in new skin cancer diagnoses has been reported by countries worldwide. One of the greatest challenges during the pandemic has been the reduced access to face-to-face dermatologic evaluation and non-urgent procedures, such as biopsies or surgical excisions. Teledermatology is a well-integrated alternative when face-to-face dermatological assistance is not available. Teledermoscopy, an extension of teledermatology, comprises consulting dermoscopic images to improve the remote assessment of pigmented and non-pigmented lesions when direct visualisation of lesions is difficult. One of teledermoscopy's greatest strengths may be its utility as a triage and monitoring tool, which is critical in the early detection of skin cancer, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. Mobile teledermoscopy may act as a communication tool between medical practitioners and patients. By using their smartphone (mobile phone) patients can monitor a suspicious skin lesion identified by their medical practitioner, or alternatively self-detect concerning lesions and forward valuable dermoscopic images for remote medical evaluation. Several mobile applications that allow users to photograph suspicious lesions with their smartphones and have them evaluated using artificial intelligence technology have recently emerged. With the growing popularity of mobile apps and consumer-involved healthcare, this will likely be a key component of skin cancer screening in the years to come. However, most of these applications apply artificial intelligence technology to assess clinical images rather than dermoscopic images, which may lead to lower diagnostic accuracy. Incorporating the direct-to-consumer mobile dermoscopy model in combination with mole-scanning artificial intelligence as a mobile app may be the future of skin cancer detection.
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Affiliation(s)
- Claudia Lee
- Department of Medicine, University of California Riverside, Riverside, California, United States
| | - Alexander Witkowski
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
| | - Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Joanna Ludzik
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
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Beydoun HA, Beydoun MA, Alemu BT, Weiss J, Hossain S, Gautam RS, Zonderman AB. Determinants of COVID-19 Outcome as Predictors of Delayed Healthcare Services among Adults ≥50 Years during the Pandemic: 2006-2020 Health and Retirement Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12059. [PMID: 36231360 PMCID: PMC9566439 DOI: 10.3390/ijerph191912059] [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: 06/20/2022] [Revised: 08/16/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The coronavirus disease 19 (COVID-19) was declared a global pandemic on 11 March 2020. To date, a limited number of studies have examined the impact of this pandemic on healthcare-seeking behaviors of older populations. This longitudinal study examined personal characteristics linked to COVID-19 outcomes as predictors of self-reported delayed healthcare services attributed to this pandemic, among U.S. adults, ≥50 years of age. METHODS Secondary analyses were performed using cross-sectional data (1413 participants) and longitudinal data (2881 participants) from Health and Retirement Study (HRS) (2006-2018) linked to the 2020 HRS COVID-19 Project (57% female, mean age: 68 years). Demographic, socioeconomic, lifestyle and health characteristics were evaluated in relation to delayed overall, surgical and non-surgical healthcare services ("Since March 2020, was there any time when you needed medical or dental care, but delayed getting it, or did not get it at all?" and "What type of care did you delay") using logistic regression and Ensemble machine learning for cross-sectional data as well as mixed-effects logistic modeling for longitudinal data. RESULTS Nearly 32.7% delayed healthcare services, 5.8% delayed surgical services and 31.4% delayed non-surgical services. Being female, having a college degree or higher and 1-unit increase in depression score were key predictors of delayed healthcare services. In fully adjusted logistic models, a history of 1 or 2 cardiovascular and/or metabolic conditions (vs. none) was associated with 60-70% greater odds of delays in non-surgical services, with distinct findings for histories of hypertension, cardiovascular disease, diabetes and stroke. Ensemble machine learning predicted surgical better than overall and non-surgical healthcare delays. CONCLUSION Among older adults, sex, education and depressive symptoms are key predictors of delayed healthcare services attributed to the COVID-19 pandemic. Delays in surgical and non-surgical healthcare services may have distinct predictors, with non-surgical delays more frequently observed among individuals with a history of 1 or 2 cardiovascular and/or metabolic conditions.
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Affiliation(s)
- Hind A. Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA
| | - May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21225, USA
| | - Brook T. Alemu
- Health Sciences Program, School of Health Sciences, Western Carolina University, Cullowhee, NC 28723, USA
| | - Jordan Weiss
- Department of Demography, University of California Berkeley, Berkeley, CA 94720, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21225, USA
| | - Rana S. Gautam
- Department of Sociology and Human Services, University of North Georgia, Dahlonega, GA 30597, USA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21225, USA
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Micek A, Diehl K, Teuscher M, Schaarschmidt M, Sasama B, Ohletz J, Burbach G, Kiecker F, Hillen U, Harth W, Peitsch WK. Melanoma care during one year pandemic in Berlin: decreasing appointment cancellations despite increasing COVID-19 concern. J Dtsch Dermatol Ges 2022; 20:962-978. [PMID: 35665996 PMCID: PMC9348098 DOI: 10.1111/ddg.14799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 03/22/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES The COVID-19 pandemic poses a great challenge for cancer patients. Our aim was to assess its influence on treatment and appointments of melanoma patients after one year of pandemic. METHODS Melanoma patients treated in the Vivantes Skin Cancer Centre in Berlin, Germany completed a postal survey on pandemic-related alterations in melanoma care. Impact factors on changes of appointments were examined with descriptive analyses and multivariate logistic regression. Data after one year of pandemic were compared to those after its first wave. RESULTS Among 366 participants (57.7 % males; mean age 69.2 years, response rate: 36.1 %), 38 (10.1 %) reported postponed or missed appointments, mostly on their own demand (71.1 %) due to fear of COVID-19 (52.6 %). Current treatment was associated with a lower risk of changing appointments (Odds Ratio [OR]: 0.194, p = 0.002), higher age (OR: 1.037, p = 0.039), longer disease duration (OR: 1.007, p = 0.028), and higher school degree (OR: 2.263, p = 0.043) with higher probability. Among 177 patients currently receiving therapy, only 1.7 % experienced pandemic-related treatment alterations. Concern about COVID-19 was significantly higher after one year of pandemic than after its first wave, but the number of missed appointments was lower. CONCLUSIONS Pandemic-related changes were rare in our cohort and decreased over time despite increasing concern.
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Affiliation(s)
- Aleksandra Micek
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany,Faculty of Medicine, CharitéUniversity Medicine BerlinBerlinGermany
| | - Katharina Diehl
- Mannheim Institute of Public HealthSocial and Preventive MedicineMedical Faculty MannheimHeidelberg UniversityMannheimGermany,Department of Medical InformaticsBiometry and EpidemiologyFriedrich‐Alexander‐University Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Miriam Teuscher
- Department of Dermatology and PhlebologyVivantes Klinikum im FriedrichshainBerlinGermany
| | - Marthe‐Lisa Schaarschmidt
- Department of DermatologyVenereology and AllergologyUniversity Medical Center MannheimHeidelberg UniversityMannheimGermany
| | - Bianca Sasama
- Department of Dermatology and PhlebologyVivantes Klinikum im FriedrichshainBerlinGermany
| | - Jan Ohletz
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany
| | - Guido Burbach
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany
| | - Felix Kiecker
- Department of Dermatology and VenereologyVivantes Klinikum NeuköllnBerlinGermany
| | - Uwe Hillen
- Department of Dermatology and VenereologyVivantes Klinikum NeuköllnBerlinGermany
| | - Wolfgang Harth
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany
| | - Wiebke K. Peitsch
- Department of Dermatology and PhlebologyVivantes Klinikum im FriedrichshainBerlinGermany
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18
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Micek A, Diehl K, Teuscher M, Schaarschmidt ML, Sasama B, Ohletz J, Burbach G, Kiecker F, Hillen U, Harth W, Peitsch WK. Melanomversorgung während eines Jahres Pandemie in Berlin: abnehmende Terminstornierungen trotz zunehmender Besorgnis über COVID-19. J Dtsch Dermatol Ges 2022; 20:962-979. [PMID: 35881087 PMCID: PMC9350167 DOI: 10.1111/ddg.14799_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
HINTERGRUND UND ZIELE Die COVID-19-Pandemie stellt für Krebspatienten eine große Herausforderung dar. Unser Ziel war es, ihren Einfluss auf die Behandlung und auf Arzttermine von Melanompatienten nach einem Jahr Pandemie zu untersuchen. PATIENTEN UND METHODIK Melanompatienten, die im Vivantes Hauttumorzentrum in Berlin behandelt wurden, beantworteten eine postalische Umfrage zu Pandemie-bedingten Änderungen ihrer Melanomversorgung. Einflussfaktoren auf Terminänderungen wurden mit deskriptiven Analysen und multivariater logistischer Regression untersucht. Daten nach einem Jahr Pandemie wurden mit Daten nach der ersten Welle verglichen. ERGEBNISSE Von den 366 Teilnehmern (57,7 % Männer; Durchschnittsalter 69,2 Jahre, Rücklaufquote: 36,1 %) berichteten 38 (10,1 %) über verschobene oder verpasste Arzttermine, meist auf eigenen Wunsch (71,1 %) aus Angst vor COVID-19 (52,6 %). Eine aktuelle Therapie war mit einem geringeren Risiko, Termine zu verpassen, assoziiert (Odds Ratio [OR]: 0,194, p = 0,002), höheres Alter (OR: 1,037, p = 0,039), längere Krankheitsdauer (OR: 1,007, p = 0,028) und ein höherer Schulabschluss (OR: 2,263, p = 0,043) mit höherer Wahrscheinlichkeit. Von den 177 Patienten, die aktuell eine Therapie erhielten, erfuhren nur 1,7 % Pandemie-bedingte Behandlungsänderungen. Die Besorgnis über COVID-19 war nach einem Jahr Pandemie signifikant größer als nach der ersten Welle, die Zahl der verpassten Arzttermine jedoch niedriger. SCHLUSSFOLGERUNGEN Pandemie-bedingte Änderungen waren in unserer Kohorte selten und nahmen trotz zunehmender Besorgnis mit der Zeit ab.
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Affiliation(s)
- Aleksandra Micek
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin.,Medizinische Fakultät, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Katharina Diehl
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim.,Institut für Medizininformatik, Biometrie und Epidemiologie, Professur für Epidemiologie und Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Miriam Teuscher
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Marthe-Lisa Schaarschmidt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim
| | - Bianca Sasama
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Jan Ohletz
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Guido Burbach
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Felix Kiecker
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Uwe Hillen
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Wolfgang Harth
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 15] [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] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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20
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Silvia C, Denis C, Mario C, Luigi V, Federico T, Marcello C. Impact of COVID-19 Pandemic on Non-Melanoma Skin Cancer's Tumor Burden and Care: a Multi-Center Study based in Northern Italy. J Plast Reconstr Aesthet Surg 2022; 75:3616-3621. [PMID: 35918285 PMCID: PMC9217060 DOI: 10.1016/j.bjps.2022.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 05/09/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022]
Abstract
The brisk remodeling in healthcare delivery observed after the COVID-19 outbreak led us to evaluate how the pandemic affected non-melanoma skin cancer's (NMSC) care and tumor burden. To address this topic, we set up a retrospective real-life multi-center study based on the cities of Bergamo and Varese, whose provinces were the worst hit in Italy by the pandemic. We analyzed medical and pathological data from patients that underwent surgery in the two months preceding the outbreak in Italy and compared them to those who did in the corresponding bimester of the following year, reaching 214 patients and 274 lesions. We observed a considerable and significant increase in NMSC's diameter, as well as in the proportion of squamous cell carcinomas. Both the average waiting time to obtain an evaluation visit and the average time in the surgical waiting list was shorter after the COVID-19 outbreak: the reason is that we evaluated and operated near-exclusive patients affected by high-priority lesions, who benefited from “fast-track” referrals. Conversely, less-concerning lesions were, and still are, left on hold, until they will become advanced enough to be labeled as “urgent”. Plastic surgery departments should evade as soon as possible from this downward spiral, in order to provide our patients with timely cancer care and to be able to treat all plastic surgery-requiring pathologies.
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21
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Alam M, Etzkorn J, Albertini J, Bordeaux J, Council M, Maher I, Nehal K, Brodland D, Haas A, Kang B, Ibrahim S, Christensen R, Poon E, Worley B. Duration of Acceptable Delay Between the Time of Diagnosis and Treatment of Melanoma, Cutaneous Squamous Cell Carcinoma, and Basal Cell Carcinoma. J Eur Acad Dermatol Venereol 2022; 36:e460-e464. [DOI: 10.1111/jdv.17950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M. Alam
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago
- Department of Otolaryngology Feinberg School of Medicine Northwestern University Chicago
- Department of Surgery Feinberg School of Medicine Northwestern University Chicago
- Department of Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago
| | - J.R. Etzkorn
- Department of Dermatology Perelman School of Medicine University of Pennsylvania Philadelphia
| | - J.G. Albertini
- The Skin Surgery Center Winston‐Salem
- Wake Forest Department of Plastic and Reconstructive Surgery Wake Forest Baptist Health, Winston‐Salem
| | - J.S. Bordeaux
- Department of Dermatology Case Western Reserve University School of Medicine Cleveland
- University Hospitals Cleveland Medical Center Department of Dermatology Cleveland
| | - M.L. Council
- Division of Dermatology Center for Dermatologic and Cosmetic Surgery Washington University in Saint Louis Saint Louis
| | - I.A. Maher
- Department of Dermatology University of Minnesota Minneapolis
| | - K.S. Nehal
- Dermatology Service Memorial Sloan Kettering Cancer Center New York
| | - D.G. Brodland
- Zitelli & Brodland P.C. Skin Cancer Center Pittsburgh
- Departments of Dermatology, Otolaryngology, and Plastic Surgery University of Pittsburgh Pittsburgh
| | - A.F. Haas
- Sutter Health Department of Dermatology University of California‐Davis Sacramento
| | - B.Y. Kang
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago
| | - S.A. Ibrahim
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago
| | - R.E. Christensen
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago
| | - E. Poon
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago
| | - B. Worley
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago
- Florida Dermatology and Skin Cancer Centers Lake Wales
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22
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Seretis K, Boptsi E, Boptsi A, Lykoudis EG. The impact of treatment delay on skin cancer in COVID-19 era: a case-control study. World J Surg Oncol 2021; 19:350. [PMID: 34949189 PMCID: PMC8702374 DOI: 10.1186/s12957-021-02468-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background The outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period. Methods A comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019. Results Skin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap. Conclusion These results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided. Trial registration The study adhered to the STROBE statement for case-control studies.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece.
| | - Eleni Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
| | - Anastasia Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
| | - Efstathios G Lykoudis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
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23
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Conde-Taboada A, Iglesias-Puzas Á, Sirgado A, Campos L, Serrano I, López-Bran E. Influence of COVID-19 confinement on the size of malignant skin tumours surgically removed at a Spanish hospital. Clin Exp Dermatol 2021; 47:578-580. [PMID: 34610172 PMCID: PMC8653350 DOI: 10.1111/ced.14957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
The COVID‐19 pandemic required people to confine themselves to their homes where possible, and disrupted normal hospital activities. We examine whether this lockdown generated changes in the size of the tumours. We compared the dimensions of the surgically removed malignant skin tumours from the first 150 patients treated after the confinement ended in Spain (22 May 2020) with those of the last 150 patients to receive such treatment before the confinement began (13 March 2020). Data on tumour surface area were collected from pathology reports. Overall, no significant difference was seen in the tumour sizes. However, among men, the tumours removed after confinement were significantly larger (P < 0.05). Controversy exists over how the reduction in the number of tumours diagnosed during lockdowns might have influenced the characteristics of tumours. In this study, no overall difference was seen in the size of the tumours removed, although those removed from men after confinement were larger.
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Affiliation(s)
- A Conde-Taboada
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - Á Iglesias-Puzas
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - A Sirgado
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - L Campos
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - I Serrano
- Methodological Support Unit for Research, Hospital Clínico San Carlos, Madrid, Spain
| | - E López-Bran
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
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24
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Abstract
The COVID-19 pandemic has presented a unique set of challenges to cancer care centers around the world. Diagnostic and treatment delays associated with lockdown periods may be expected to increase the total number of avoidable skin cancer deaths. During this unprecedented time, dermatologists have been pressed to balance early surgical interventions for skin cancer with the risk of viral transmission. This article summarizes evidenced-based recommendations for the surgical management of cutaneous melanoma, keratinocyte cancer, and Merkel cell carcinoma during the COVID-19 pandemic. Additional long-term studies are required to determine the effect of COVID-19 on skin cancer outcomes.
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Affiliation(s)
- Sarem Rashid
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02466, USA; Boston University School of Medicine, Boston, MA, USA
| | - Hensin Tsao
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02466, USA.
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25
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Sun Q, McMahon DE, Ugwu-Dike PO, Sun Q, Tang K, Zhang H, Suchonwanit P, Oh CC, Chong AH, Willems A, Galván C, Dodiuk-Gad RP, Fantini F, Recalcati S, Avancini J, Miyamoto D, Sanches JA, Raboobee N, Bravo F, Freeman EE. How Coronavirus Disease 2019 Changed Dermatology Practice in 1 Year Around the World: Perspectives from 11 Countries. Dermatol Clin 2021; 39:639-651. [PMID: 34556253 PMCID: PMC8452267 DOI: 10.1016/j.det.2021.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Coronavirus disease 2019 (COVID-19) brought the world to its knees. As each nation grappled with launching an effective response while simultaneously minimizing repercussions on health care systems, economies, and societies, the medical and scientific landscape shifted forever. In particular, COVID-19 has challenged and transformed the field of dermatology and the way we practice. In this article, dermatologists from 11 countries share insights gained from local experience. These global perspectives will help provide a better framework for delivering quality dermatologic care and understanding how the field has evolved during this medical crisis.
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Affiliation(s)
- Qisi Sun
- Department of Dermatology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
| | - Devon E McMahon
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Pearl O Ugwu-Dike
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng Qu, Beijing Shi, China
| | - Keyun Tang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng Qu, Beijing Shi, China
| | - Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng Qu, Beijing Shi, China
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Thanon Rama VI, Khwaeng Thung Phaya Thai, Khet Ratchathewi, Krung Thep Maha Nakhon 10400, Thailand
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Outram Rd, Singapore 169608, Singapore
| | - Alvin H Chong
- Skin Health Institute, level 1/80 Drummond St, Carlton, VIC 3053, Australia; Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, University of Melbourne, Parkville, VIC 3010, Australia
| | - Anneliese Willems
- Skin Health Institute, level 1/80 Drummond St, Carlton, VIC 3053, Australia
| | - Cristina Galván
- Department of Dermatology, Hospital Universitario de Móstoles, Calle Río Júcar, S/N, 28935 Móstoles, Madrid, Spain
| | - Roni P Dodiuk-Gad
- Bruce Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, 3200003, Israel; Department of Dermatology, Emek Medical Center, Yitshak Rabin Boulevard 21, Afula, 1834111, Israel; Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Fabrizio Fantini
- Department of Dermatology, Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Via dell'Eremo, 9/11, 23900 Lecco LC, Italy
| | - Sebastiano Recalcati
- Department of Dermatology, Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Via dell'Eremo, 9/11, 23900 Lecco LC, Italy
| | - Joao Avancini
- Department of Dermatology, Hospital das Clínicas of the University of Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo-SP, 05403-000, Brazil
| | - Denise Miyamoto
- Department of Dermatology, Hospital das Clínicas of the University of Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo-SP, 05403-000, Brazil
| | - Jose A Sanches
- Department of Dermatology, Hospital das Clínicas of the University of Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo-SP, 05403-000, Brazil
| | - Noufal Raboobee
- Department of Dermatology, Westville Hospital, 7 Harry Gwala Rd, Westville, Durban, 3630, South Africa
| | - Francisco Bravo
- Department of Dermatology, Universidad Peruana Cayetano Heredia, Hospital Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres 15102, Peru; Department of Pathology, Universidad Peruana Cayetano Heredia, Hospital Cayetano Heredia, 1 CV Zac, Av. Honorio Delgado 262, San Martín de Porres 15102, Peru
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
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Gedeah C, Damsin T, Absil G, Somja J, Collins P, Rorive A, Marchal N, Seidel L, Nikkels AF. The impact of COVID-19 on the new diagnoses of melanoma. Eur J Dermatol 2021; 31:565-567. [PMID: 34642142 PMCID: PMC8572683 DOI: 10.1684/ejd.2021.4086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Christophe Gedeah
- Department of Dermatology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Thomas Damsin
- Department of Dermatology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Gilles Absil
- Department of Dermatology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Joan Somja
- Department of Dermatopathology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Patrick Collins
- Department of Dermatopathology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Andrée Rorive
- Department of Medical Oncology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Nathalie Marchal
- Department of Medical Oncology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Laurence Seidel
- Department of Biostatistics, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Arjen F. Nikkels
- Department of Dermatology, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
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27
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A Comparison of Diagnosed Skin Diseases between the Years with and without COVID-19 Pandemic. Medicina (B Aires) 2021; 57:medicina57080773. [PMID: 34440978 PMCID: PMC8399623 DOI: 10.3390/medicina57080773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objectives: The COVID-19 pandemic has a considerable influence on public health, either directly or indirectly. We investigated outpatient skin disease diagnoses at the dermatology clinic to determine the effect of the COVID-19 pandemic on these patients. Materials and Methods: We conducted a retrospective study using the International Codes of Diseases data from the outpatient department of Dermatology clinic, Vajira hospital, Navamindradhiraj University, Bangkok, Thailand from January 2019 to June 2021. Results: A total of 20,915 patients with 34,116 skin diagnoses were included in the study. The average weekly dermatologic clinic visits remained unchanged between the years with and without COVID-19 pandemic. While the percentage of xerosis cutis, other skin infections (syphilis and parasitic infections), hair and nail disorders, pigmentary disorders, benign skin tumors and drug eruptions were significantly decreased during the COVID-19 pandemic years, the percentage of other dermatitis, fungal and viral skin infections, acne, psoriasis, urticaria, vesiculobullous and autoimmune diseases were increased. Conclusion: The COVID-19 pandemic had a minimal effect on the average weekly skin clinic visits, but the diagnosed skin diseases pattern was affected. Knowing the pattern of skin diseases may help aid hospitals to better prepare for future pandemics in securing appropriate medications and supplies and training the medical teams.
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28
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Javor S, Sola S, Chiodi S, Brunasso AMG, Massone C. COVID-19-related consequences on melanoma diagnoses from a local Italian registry in Genoa, Italy. Int J Dermatol 2021; 60:e336-e337. [PMID: 33909286 PMCID: PMC8239777 DOI: 10.1111/ijd.15624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Sanja Javor
- Dermatology Unit, Galliera Hospital, Genoa, Italy
| | - Simona Sola
- Surgical Pathology, Galliera Hospital, Genoa, Italy
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