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Jimeno Ortega I, Stefanato CM. Telogen effluvium: a 360 degree review. Ital J Dermatol Venerol 2023; 158:457-466. [PMID: 38015483 DOI: 10.23736/s2784-8671.23.07579-5] [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: 11/29/2023]
Abstract
Telogen effluvium (TE) is one of the most common presentations of diffuse non-cicatricial alopecia and is generally self-limited. Multiple causes are associated with TE onset and its maintenance, with stress being felt the most common factor. The multifactorial etiologies involved in TE makes it a complex disorder to diagnose and treat often placing this entity into a "waste basket" diagnosis. By critically assessing the available scientific literature we aimed to review the multifaceted aspects of TE. Our objectives were to review the pathogenesis with the role of stress (including Coronavirus 19-associated TE), as well as to describe the main clinical findings, its differential diagnosis and the current knowledge on TE treatments along with the future treatment's insights.
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2
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Chávez-Chavira G. [Review of the post-COVID-19 syndrome associated to acute telogen effluvium]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:496-501. [PMID: 37540705 PMCID: PMC10521875 DOI: 10.5281/zenodo.8200471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/30/2023] [Indexed: 08/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has impacted our society in numerous ways. So far (November 2022) around 640 million SARS-CoV-2 infections have been confirmed worldwide. It is known that this disease has a main affection at the cardiopulmonary level, however, it affects almost all the organs and systems of the body, including the skin. Post-COVID-19 syndrome occurs in some patients, leaving significant sequelae that impact their quality of life. Among the most common sequelae are: cough, dyspnea, chronic fatigue, hyposmia and dysosmia. In addition to these, other sequelae not related to respiratory syndrome have been reported, such as hair loss, which has been observed in around 20% of post-COVID-19 patients, this could be attributable to acute telogen effluvium (TE). To date, no study has been conducted to determine the relationship of ET in those who have had COVID-19. Acute ET is defined as diffuse, non-scarring hair loss, usually self-limited, lasting for about 6 months. Within its etiology, severe systemic febrile illness, pregnancy, restrictive diets, severe stress and various drugs have been described. It seriously affects the quality of life of patients and is often associated with loss of confidence and low self-esteem.
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Affiliation(s)
- Grecia Chávez-Chavira
- Universidad Autónoma de Chihuahua, Facultad de Medicina y Ciencias Biomédicas, División de Investigación y Posgrado. Chihuahua, Chihuahua, MéxicoUniversidad Autónoma de ChihuahuaMéxico
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3
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Aryanian Z, Ehsani A, Razavi Z, Hamzelou S, Mohseni Afshar Z, Hatami P. The COVID-19 pandemic and its impact on esthetic dermatology. J Cosmet Dermatol 2022; 21:6557-6561. [PMID: 36106524 PMCID: PMC9538429 DOI: 10.1111/jocd.15386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Abstract
In general, the world population interest has increased for maintaining youthfulness and having better appearance since this leads to a better mental wellbeing and self-estimate. The coronavirus disease 2019 (COVID-19) pandemic has revolutionized every field of medicine. As every specialty has been affected by limitations caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this branch of medicine has also needed certain precautions for safer practice in the COVID era. With the global vaccination program against COVID-19, reports of some cutaneous reactions in patients have been undergone various esthetic procedures including filler or botox injection would be increasingly demonstrated. Although the end of pandemic was announced, the necessity of continuing COVID vaccination in future mandates gathering data regarding safety of vaccines. Herein, we presented a comprehensive review on various aspects of association between esthetic medicine or cosmetic dermatology and COVID-19.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Amirhooshang Ehsani
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zahra Razavi
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Shahin Hamzelou
- Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran
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4
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Sadeghi S, Amini Z, Goodarzi A. A Comparative Review on Mucocutaneous Reactions Caused by Covid-19 Infection versus Covid-19 Vaccination. Exp Dermatol 2022; 31:1122-1127. [PMID: 35657119 PMCID: PMC9348341 DOI: 10.1111/exd.14620] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/27/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
IMPORTANCE The prevalence and severity of mucocutaneous manifestations in Covid-19 infection are generally higher than those reported in Covid vaccines. Therefore, comparing the mucocutaneous reactions of the Covid-19 infection and vaccination is necessary to enhance our knowledge about such reactions and guide us to evaluate the risk of infection or vaccination. OBSERVATION A thorough literature search was conducted on PubMed, Google Scholar, and EBSCO (LISTA), and 2,069 articles were downloaded. After screening, 11 studies remained for the final review. The literature review revealed that the prevalence and severity of post-vaccine mucocutaneous adverse reactions have been less common compred to Covid-19 infection. Post-vaccine adverse reactions primarily occurred after the first dose administration and such reactions were manageable with antihistamines and corticosteroids administration. CONCLUSIONS AND RELEVANCE The current comparative analysis highlights the frequency and potential severity of mucocutaneous reactions due to Covid-19 infection and Covid-19 vaccination. It also affirmed that potentially critical (serious) mucocutaneous reactions are more likely to occur in Covid-19 infection compared to Covid vaccination. Moreover, post-vaccine reactions predominantly happened after the first dose and were reported to be non-life-threatening, self-manageable, and with a lower incidence of potentially critical events. It was also concluded that the incidence of mucocutaneous reactions decreased in the following doses. Hence, given the low rate of such reactions following Covid-19 vaccination, vaccines have a lower risk of mucocutaneous reactions occurrence than Covid-19 infection. Further, due to the limited number of studies, we recommend that large-scale trials evaluate such reactions comparing various types of Covid-19 vaccines in healthy individuals and those with autoimmune skin disorders.
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Affiliation(s)
- Sara Sadeghi
- Department of Pediatrics, Division of Dermatology, University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada.,Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zeynab Amini
- School of Biology and Environmental Science, Queensland University of Technology, Brisbane, Australia
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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5
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Nguyen B, Tosti A. Alopecia in COVID-19 Patients: Systematic Review and Meta-analysis. JAAD Int 2022; 7:67-77. [PMID: 35224518 PMCID: PMC8860672 DOI: 10.1016/j.jdin.2022.02.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 is associated with androgenetic alopecia (AGA), telogen effluvium (TE), and alopecia areata (AA). No studies have analyzed the aggregate data to date. Objective We conducted a systematic review to characterize the types, incidence, timing, and clinical outcomes of COVID-19–associated alopecia. Methods We searched PubMed/MEDLINE, Scopus, and Embase for articles published between November 2019 and August 2021 using the key words “alopecia” or “hair” and COVID-19–related search terms, identifying 41 original articles describing patients with alopecia and COVID-19. Results The current review included 1826 patients with alopecia and COVID-19 (mean age, 54.5 years; 54.3% male). The most common types of alopecia identified were AGA (30.7%, 86.4% male), TE (19.8%, 19.3% male), and AA (7.8%, 40.0% male). AGA preceded COVID-19 symptoms. TE was usually newly triggered by COVID-19 (93.6%). AA usually occurred in patients with preexisting disease (95.1%). Limitations Definitions of COVID-19 onset varied. Studies differed in methodology and were susceptible to reporting and sampling bias. Studies with large sample sizes may exert a disproportionate influence on data. Conclusion AGA may be a risk factor for severe COVID-19, whereas TE presents as a sequela of COVID-19. AA generally occurs as a relapse in patients with preexisting alopecia.
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6
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Erbaş GS, Botsali A, Erden N, Arı C, Taşkın B, Alper S, Vural S. COVID-19-related oral mucosa lesions among confirmed SARS-CoV-2 patients: a systematic review. Int J Dermatol 2022; 61:20-32. [PMID: 34549816 PMCID: PMC8652904 DOI: 10.1111/ijd.15889] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/31/2021] [Accepted: 08/16/2021] [Indexed: 02/05/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for coronavirus disease 2019 (COVID-19), which manifests as a flu-like respiratory infection affecting multiple organ systems, including the gastrointestinal system, central nervous system, cardiovascular system, skin, and mucosa. In this review, we investigated the literature on specific manifestations of COVID-19 in the oral mucosa. An online literature search in PubMed, Scopus, Google Scholar, and Medline was conducted to retrieve relevant studies on confirmed COVID-19 patients with oral mucosa findings published between December 31, 2019, and April 07, 2021. After an independent review by two authors, 39 articles considering 59 laboratory-confirmed cases of SARS-CoV-2 infection were included in the final analysis. The most common finding, reported in 29 patients (43.9%), was Kawasaki-like syndrome. In addition, oral ulcers including aphthous, hemorrhagic, and necrotic ulcers were reported in 24 patients (36.3%). Other lesions reported included pustules, macules, bullae, maculopapular enanthema, and erythema multiforme-like lesions. Concomitant skin lesions were present in 60.6% of patients. Fever was reported in 86.2% of patients. Forty-eight patients (76.1%) were hospitalized. Loss of taste and smell was present in 30.8% of the patients. A comprehensive understanding of the dermatologic manifestations of COVID-19 can improve and facilitate patient management and referrals.
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Affiliation(s)
- Gizem S. Erbaş
- School of MedicineTechnical University of MunichMunchenGermany
| | - Aysenur Botsali
- Department of DermatologyUniversity of Health Sciences, Gülhane Training and Research HospitalAnkaraTurkey
| | - Nihan Erden
- Koç University School of MedicineİstanbulTurkey
| | - Canan Arı
- Department of Dermatology and VenereologyAnkara Dışkapı Yıldırım Bayezit Eğitim ve Araştırma HospitalAnkaraTurkey
| | - Banu Taşkın
- Department of Dermatology and VenereologyKoç University School of MedicineİstanbulTurkey
| | - Sibel Alper
- Department of Dermatology and VenereologyKoç University School of MedicineİstanbulTurkey
| | - Secil Vural
- Department of Dermatology and VenereologyKoç University School of MedicineİstanbulTurkey
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7
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Elrobaa IH, New KJ. COVID-19: Pulmonary and Extra Pulmonary Manifestations. Front Public Health 2021; 9:711616. [PMID: 34650947 PMCID: PMC8505777 DOI: 10.3389/fpubh.2021.711616] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/30/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: The coronavirus disease-2019 (COVID-19) pandemic has been the most significant event in 2020, with ~86.8 million cases and 1.88 million deaths worldwide. It is a highly infectious disease, wherein the virus (severe acute respiratory syndrome coronavirus 2) rapidly multiplies and spreads to all parts of the body. Therefore, COVID-19 is not only respiratory disease but also a multisystem disease. Many people, including physicians, incorrectly believe that the disease affects only the respiratory tract. In this study, we aimed to describe COVID-19 manifestations and the underlying pathophysiology to provide the readers with a better understanding of this disease to achieve good management and to control the spread of this disease. Methods: Secondary data were obtained from PubMed, Google Scholar, and Scopus databases. The keywords used for the search were as follows: COVID-19, COVID-19 pulmonary manifestations, COVID-19 extra pulmonary manifestations, and pathophysiology of COVID-19. We collected secondary data from systemic reviews, metaanalyses, case series, and case reports in the form of public data that was published on websites of the government, medical corporations, medical peer-reviewed journals, and medical academies, all of which were indexed in PubMed, Google Scholar, or Scopus. Our questions were as follows: Is COVID-19 a respiratory disease only? and What are the extrapulmonary manifestations of COVID-19? Results: From our data, we found that a patient with COVID-19 may be either asymptomatic or symptomatic. Symptomatic cases may have either pulmonary or extrapulmonary manifestations. Pulmonary manifestations occur as mild, moderate, or severe cases. In mild and moderate cases, extrapulmonary manifestations such as gastroenteritis, fever, or vomiting may present alone. Some of these cases may be missed for diagnosis, and the patient may receive symptomatic treatment without a COVID-19 diagnosis, leading to increased spread of the infection. Extrapulmonary manifestations may occur in severe and critical cases as complications of severe infections (high viral overload) or the cytokine storm, such as in acute kidney injury (AKI), heart failure (HF), and venous thromboembolic (VTE) manifestation. Conclusion: COVID-19 is not a respiratory disease alone; rather, it is a multisystem disease. Pulmonary and extrapulmonary manifestations should be considered for early diagnosis and to control the spread of the infection.
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Affiliation(s)
- Islam H. Elrobaa
- Emergency Medicine Specialist in Hamad Medical Corporation, Qatar and Lecturer in Clinical Education Department, College of Medicine, Qatar University, Doha, Qatar
| | - Karl J. New
- Clinical Physiology, School of Health, Sport, and Professional Practice, Faculty of Life Science and Education, University of South Wales, Treforest, United Kingdom
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8
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Abstract
The emergence of the coronavirus disease 2019 pandemic has led to a change in the whole world order. The key actors and occupational groups most at risk during this period have been health care professionals. In this pandemic, we, as dermatologists, also have many responsibilities regarding patients, ourselves, and society. Dermatologists have to protect themselves, their families, and their patients while working in pandemic services and outpatient clinics, as well as in their practices. One of their roles is to inform the public about protective measures for cutaneous side effects associated with the intensive use of disinfectants and long-term use of masks. In hospitals, only emergency patients had been admitted for treatment in all units during the pandemic, and elective operations and procedures were delayed. In this context, it is very important to determine what procedures will be carried out during this period in the follow up and treatment of chronic dermatologic diseases, as well as what interventional and cosmetic procedures may performed. Guidelines issued by various medical societies have made valuable contributions. The benefits and associated issues of teledermatology have pros and cons. Finally, one of the issues to ponder in the long term seems to be how we should pursue online education.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Ataşehir Memorial Hospital, Istanbul, Turkey.
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Prof Dr Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden Academic Teaching Hospital of the Technical University, Freidrichstrasse, Dresden, Germany
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9
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Bhargava S, McKeever C, Sadoughifar R, Kroumpouzos G. Availability of personal protective equipment among dermatologists in the COVID-19 pandemic: Assessment and risk factors in a web-based, global study. Clin Dermatol 2021; 39:451-456. [PMID: 34518003 PMCID: PMC7849520 DOI: 10.1016/j.clindermatol.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: The availability of personal protective equipment (PPE) among dermatologists during the Coronavirus Disease 2019 (COVID-19) pandemic has not been studied. Methods: We have assessed PPE availability among dermatologists and relevant aspects of hospital service by surveying 733 dermatologists. Results: Considerable percentages of respondents had to purchase their own PPE (40.2%) and were not provided with it at the hospital (37.7%). Only 27% of respondents provided hospital service, and 18.4% were assigned to nondermatologic duty. A substantial percentage (64.4%) indicated the availability of hospital-issued management guidelines (HIMG) for COVID-19 patients. Nearly half of the survey participants (49.1%) responded that the health care system was not equipped for the pandemic. Purchasing one's own PPE was strongly associated with the private practice setting and continent, with the highest rates in Central and South America and in Europe (P < .001). PPE availability at a hospital was associated with 2 continents, with the highest rates in Europe and in North America (P < .001). In logistic regression, the most important factor reducing the odds ratio (OR) for purchasing their own PPE was HIMG for COVID-19 patients (OR, 0.55; 95% confidence interval [CI], 0.32-0.97). Respondents’ assessment that the health care system was equipped for COVID-19 was the most powerful increaser of OR for PPE availability (OR, 9.43; 95% CI, 5.37-16.56) followed by >1,000 COVID-19 cases in a participant's country. Conclusions: Substantial percentages of respondents had to purchase their own PPE and were not provided with it at the hospital. Strategies to increase PPE availability should be implemented by hospitals, industry, and government authorities.
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Affiliation(s)
| | - Charles McKeever
- Department of Dermatology, University of Panama Medical School and Social Security Hospital, Panama City, Panama
| | | | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School, Brown University, Providence, Rhode Island, USA.
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10
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Bhargava S, Negbenebor N, Sadoughifar R, Ahmad S, Kroumpouzos G. Global impact on dermatology practice due to the COVID-19 pandemic. Clin Dermatol 2021; 39:479-487. [PMID: 34518007 PMCID: PMC8043816 DOI: 10.1016/j.clindermatol.2021.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This contribution focuses on the effects of coronavirus disease 2019 (COVID-19) on dermatology practice. We discuss the impact on practice volume and procedures and on the considerable increase in teledermatology use. We also describe the important roles that dermatologists have played in enhancing infection prevention and on the frontline. During the crisis, dermatologists have faced the challenge of a shortage of resources, such as personal protective equipment, in the health care system. In addition, they have been involved in managing cutaneous manifestations related to COVID-19 and occupational disease caused by personal protective equipment. Dermatologists have made a diligent effort to identify melanoma and to ensure the treatment of high-risk skin cancers. Safety guidelines have been suggested to minimize the potential risks associated with the systemic use of immunosuppressant agents and immunomodulators in patients with severe inflammatory skin disease during the pandemic. Finally, social distancing necessitated that dermatology conferences take place virtually and teaching via e-learning increased.
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Affiliation(s)
| | - Nicole Negbenebor
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Serene Ahmad
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.
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11
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Wang JV, Munavalli GS, Zachary CB, Geronemus RG. Cosmetic Consumer Preferences During COVID-19 Pandemic: A New Normal? Dermatol Surg 2021; 47:1178-1180. [PMID: 33731565 DOI: 10.1097/dss.0000000000002969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York
| | - Girish S Munavalli
- Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, North Carolina
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12
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Etgu F, Onder S. Skin problems related to personal protective equipment among healthcare workers during the COVID-19 pandemic (online research). Cutan Ocul Toxicol 2021; 40:207-213. [PMID: 34047217 DOI: 10.1080/15569527.2021.1902340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Coronavirus disease-2019 (COVID-19) is a highly contagious infectious disease that first appeared in Wuhan, China, in December 2019. Health care workers (HCWs) are at increased risk of infection because the virus is highly contagious and can be transmitted by a variety of routes. Health care workers are required to use a variety of personal protective equipment (PPE) for prolonged hours and, as a result, they face varying degrees of cutaneous complications. METHODS We conducted a cross-sectional online questionnaire survey to investigate skin problems caused by the use of PPE and personal hygiene measures. We developed a survey with 32 questions using Google forms and distributed it via WhatsApp and Facebook groups. RESULTS A total of 1142 responses were obtained. Among the respondents, 88.1% reported adverse skin reactions due to PPE and personal hygiene measures. Female sex, working as a nurse, wearing PPE more than 6 h/day, and working more than 3 days/week increase the risk of PPE-related skin problems. CONCLUSION In this study, we highlighted skin problems related to PPE and found out risk factors for PPE-related skin problems.
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Affiliation(s)
- Fatma Etgu
- Department of Dermatology, Ordu University Educational and Research Hospital, Ordu, Turkey
| | - Sevda Onder
- Department of Dermatology, Ordu University, Ordu, Turkey
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13
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Mavi Yildiz A, Ucan Gunduz G, Yalcinbayir O, Acet Ozturk NA, Avci R, Coskun F. SD-OCT assessment of macular and optic nerve alterations in patients recovered from COVID-19. Can J Ophthalmol 2021; 57:75-81. [PMID: 34303641 PMCID: PMC8255111 DOI: 10.1016/j.jcjo.2021.06.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/29/2021] [Accepted: 06/28/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To quantify microstructutal alterations in the macula and peripapillary retinal nerve fibre layer (RNFL) in patients recovered from coronavirus disease 2019 (COVID-19) using spectral domain optic coherence tomography (SD-OCT). DESIGN Retrospective, observational. PARTICIPANTS This comparative, cross-sectional study included patients who recovered from COVID-19 (Group 1) and age- and sex-matched normal controls (Group 2). METHODS A comprehensive ophthalmic examination, including best-corrected visual acuity and biomicroscopic anterior and posterior segment examination was performed. SD-OCT analysis of the macula and peripapillary RNFL was obtained for each participant. In addition, patient demographics and comorbidities were recorded. RESULTS 238 eyes of 122 subjects (Group 1: n = 63; Group 2: n = 59) were included. The incidence of coexisting comorbidity was higher in Group 1 (n = 26/63, 41.3%) compared with Group 2 (n = 12/59, 20.3%) (p = 0.013). The central foveal thickness (CFT) was significantly higher in Group 1 (271.0±26.8 µm) than Group 2 (263.2±22.0 µm) (p = 0.015). The average outer nuclear layer (ONL) thickness at central fovea in Group 1 (85.4±13.3 µm) was significantly thicker than that in Group 2 (81.4±15.2 µm) (p = 0.035). The mean peripapillary RNFL thickness of Group 1 (102.6±8.8 µm) and Group 2 (100.9±8.3 µm) were similar (p = 0.145). The mean choroidal thickness of groups at the fovea and at 1500 µm nasal and temporal to the fovea were not significantly different (p > 0.05 for all). CONCLUSION Significant thickness alterations in individual retinal layers and CFT was detected in post-COVID-19 patients. The increase in CFT and ONL thickness might be attributed to direct infection or viral-induced inflammatory response of retina.
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Affiliation(s)
| | - Gamze Ucan Gunduz
- Bursa Uludag University School of Medicine, Department of Ophthalmology, Bursa, Turkey
| | - Ozgur Yalcinbayir
- Bursa Retina Eye Hospital, Department of Ophthalmology, Bursa, Turkey; Bursa Uludag University School of Medicine, Department of Ophthalmology, Bursa, Turkey
| | | | - Remzi Avci
- Bursa Retina Eye Hospital, Department of Ophthalmology, Bursa, Turkey
| | - Funda Coskun
- Bursa Uludag University School of Medicine, Department of Chest Diseases, Bursa, Turkey
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14
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Georgakopoulos JR, Mufti A, Vender R, Prajapati VH, Yeung J. Incidence and prognosis of COVID-19 in psoriasis patients on biologic therapy: a multicentre retrospective cohort study. J Eur Acad Dermatol Venereol 2021; 35:e485-e487. [PMID: 33872431 PMCID: PMC8250560 DOI: 10.1111/jdv.17279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/13/2021] [Indexed: 10/28/2022]
Affiliation(s)
- J R Georgakopoulos
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - A Mufti
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - R Vender
- Department of Dermatology, McMaster University, Hamilton, ON, Canada.,Dermatrials Research Inc. & Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | - V H Prajapati
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Community Pediatrics, Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Division of Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Dermatology Research Institute, Calgary, AB, Canada.,Skin Health & Wellness Centre, Calgary, AB, Canada.,Probity Medical Research Inc, Calgary, AB, Canada
| | - J Yeung
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Women's College Hospital, Toronto, ON, Canada.,Probity Medical Research Inc, Waterloo, ON, Canada
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15
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Bhargava S, McKeever C, Kroumpouzos G. Impact of COVID-19 pandemic on dermatology practices: Results of a web-based, global survey. Int J Womens Dermatol 2021; 7:217-223. [PMID: 33072835 PMCID: PMC7550183 DOI: 10.1016/j.ijwd.2020.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 12/14/2022] Open
Abstract
The spectrum and magnitude of changes in dermatology practice induced by the COVID-19 pandemic have not been adequately studied. OBJECTIVE This study aimed to assess the immediate and long-term effects of the pandemic on dermatology practice on a large scale, including the clinical activity of participants, frequency and types of procedures used, and teledermatology (TD) use. METHODS This web-based, global survey included 733 dermatologists. The primary outcomes are percentages of respondents providing in-person consultations, hospital service, and TD and performing procedures. Factors in logistic regression models that may influence the odds ratio (OR) for TD use during pandemic and for future use also were analyzed. RESULTS The percentages of respondents providing in-person consultations (46.6% vs. 100% before the pandemic) and hospital service (27% vs. 52.8% before the pandemic) as well as performing procedures (25.6% vs. 100% before the pandemic) decreased, whereas practicing TD increased three-fold (75.2% vs. 26.1% before the pandemic) during the pandemic (p < .001 for each). Practice location was associated with TD use during the pandemic and with its expected use in the future (p < .001 for both), with North American respondents indicating the highest use. TD use during the pandemic showed a positive correlation with TD use before the pandemic, performing procedures and, more specifically, with biopsies of suspicious pigmented lesions during the pandemic (p < .001 for each). TD use before the pandemic was the most powerful predictor of TD use during the pandemic (OR: 16.47; 95% confidence interval, 7.12-38.06). More than two third of participants (68.6%) expect to use TD in the future. The factor with the largest increase in OR on the expectation of future TD use was >1000 COVID-19 cases in the country (OR: 3.80; 95% confidence interval, 2.33-6.21). CONCLUSION This survey indicates a profound immediate effect of the pandemic on dermatology practice. The pandemic appears to have substantially contributed to an increased use of TD in the long run.
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Affiliation(s)
- Shashank Bhargava
- Department of Dermatology, R.D. Gardi Medical College, Ujjain, India
| | - Charles McKeever
- Department of Dermatology, University of Panama Medical School and Social Security Hospital, Panama City, Panama
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
- Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil
- GK Dermatology, PC, S Weymouth, MA, United States
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16
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Amato M, Eissa A, Rosiello G, Farinha R, Piazza P, Sighinolfi MC, Rocco B, Bianchi G, Micali S, Mottrie A, Puliatti S. Diagnostic bias during the COVID-19 era: COVID-19 or renal abscess? Urologia 2021; 88:218-222. [PMID: 33550944 PMCID: PMC7873619 DOI: 10.1177/0391560321993592] [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] [Indexed: 11/16/2022]
Abstract
Introduction: The Coronavirus disease-2019 (COVID-19) has been declared as a pandemic in March 2020 by the World Health Organization (WHO). Since then, this pandemic has dramatically affected the entire world, even radically influencing the way patients are framed at triage. Symptoms and tests in most cases lead to a correct diagnosis; however, error may be around the corner. Case report: A 60 years old patient was referred with weight loss, fatigue and mild fever for 3 weeks as he was working in a COVID-19 ward. After a positive swab and chest CT scan, he was admitted in the hospital and treated as mild COVID-19 patient. A CT scan performed after the patient was discharged revealed a renal lesion misidentified as a tumor then clarified to be an abscess which retrospectively appears to be the main cause of his symptoms. Conclusion: Clinicians should consider other life-threatening disease in the differential diagnosis of patients presenting with similar symptoms to minimize mistakes and avoid further unnecessary investigations.
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Affiliation(s)
- Marco Amato
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Urology, OLV, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Ahmed Eissa
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.,Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Giuseppe Rosiello
- Department of Urology, OLV, Aalst, Belgium.,ORSI Academy, Melle, Belgium.,Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Rui Farinha
- Department of Urology, OLV, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Pietro Piazza
- Department of Urology, OLV, Aalst, Belgium.,ORSI Academy, Melle, Belgium.,Department of Urology, University of Bologna, Bologna, Italy
| | | | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giampaolo Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alexandre Mottrie
- Department of Urology, OLV, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Urology, OLV, Aalst, Belgium.,ORSI Academy, Melle, Belgium
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17
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Amato M, Eissa A, Puliatti S, Secchi C, Ferraguti F, Minelli M, Meneghini A, Landi I, Guarino G, Sighinolfi MC, Rocco B, Bianchi G, Micali S. Feasibility of a telementoring approach as a practical training for transurethral enucleation of the benign prostatic hyperplasia using bipolar energy: a pilot study. World J Urol 2021; 39:3465-3471. [PMID: 33538866 PMCID: PMC7859466 DOI: 10.1007/s00345-021-03594-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 01/08/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction Telementoring is one of the applications of telemedicine capable of bringing highly experienced surgeons to areas lacking expertise. In the current study, we aimed to assess a novel telementoring application during the learning curve of transurethral enucleation of the prostate using bipolar energy (TUEB). Material and methods A telementoring system was developed by our engineering department. This application was used to mentor ten prospective cases of TUEB performed by an expert endourologist (novice to the TUEB). A questionnaire was filled by the operating surgeon and the mentor to provide subjective evaluation of the telementoring system. Finally, the outcomes of these patients were compared to a control group consisting of ten consecutive patients performed by the mentor. Results Ten consecutive TUEB were performed using this telementoring application. Delayed and interrupted connection were experienced in two and one patients, respectively; however, their effect was minor, and they did not compromise the safety of the procedure. None of the patients required conversion to conventional transurethral resection of the prostate. Only one patient in our series experienced grade IIIb complication. Conclusion The telementoring application for TUEB is promising. It is a simple and low-cost tool that could be a feasible option to ensure patients’ safety during the initial phase of the learning curve without time and locations constraints for both the mentor and the trainee; However, it should be mentioned that telementoring cannot yet replace the traditional surgical training with the mentor and trainee being in the operative room. Further studies are required to confirm the current results Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03594-9.
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Affiliation(s)
- Marco Amato
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.,ORSI Academy, Melle, Belgium
| | - Ahmed Eissa
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.,Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.,ORSI Academy, Melle, Belgium.,Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium
| | - Cristian Secchi
- Department of Sciences and Methods for Engineering (DISMI), University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Federica Ferraguti
- Department of Sciences and Methods for Engineering (DISMI), University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Marco Minelli
- Department of Sciences and Methods for Engineering (DISMI), University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Isotta Landi
- Department of Psychology and Cognitive Sciences, University of Trento, Royereto, Italy
| | - Giulio Guarino
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Maria Chiara Sighinolfi
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Giampaolo Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.
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18
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Psychological and professional impact of COVID-19 lockdown on French dermatologists: Data from a large survey. Ann Dermatol Venereol 2021; 148:101-105. [PMID: 33589284 PMCID: PMC7843100 DOI: 10.1016/j.annder.2021.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/12/2020] [Accepted: 01/05/2021] [Indexed: 11/20/2022]
Abstract
AIM To evaluate the extent to which COVID-19-related lockdown affected dermatologists. METHODS An anonymous online survey was proposed to all French dermatologists and dermatology residents to assess the impact of COVID-19 lockdown on their professional activity, their level of stress and their psychological state, as well as their coping strategies. RESULTS Exactly 800 dermatologists completed the survey. The respondents noted changes in behaviour in their professional and personal environment. The number of cancelled or rescheduled appointments was very high, with a huge financial impact for private practitioners. Stigmatisation was also reported. Anxiety and a feeling of increased stress were very frequent. Increased substance use was also reported. CONCLUSION The impact of the COVID-19 pandemic and lockdown was significant for French dermatologists, with risks to their own health, profound changes in their practice, and financial and psychological impact, but also the development of new consultation and evaluation strategies to improve their work-life balance.
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19
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Patrick MT, Zhang H, Wasikowski R, Prens EP, Weidinger S, Gudjonsson JE, Elder JT, He K, Tsoi LC. Associations between COVID-19 and skin conditions identified through epidemiology and genomic studies. J Allergy Clin Immunol 2021; 147:857-869.e7. [PMID: 33485957 PMCID: PMC7825803 DOI: 10.1016/j.jaci.2021.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) is commonly associated with skin manifestations, and may also exacerbate existing skin diseases, yet the relationship between COVID-19 and skin diseases remains unclear. Objective By investigating this relationship through a multiomics approach, we sought to ascertain whether patients with skin conditions are more susceptible to COVID-19. Methods We conducted an epidemiological study and then compared gene expression across 9 different inflammatory skin conditions and severe acute respiratory syndrome coronavirus 2–infected bronchial epithelial cell lines, and then performed a genome-wide association study transdisease meta-analysis between COVID-19 susceptibility and 2 skin diseases (psoriasis and atopic dermatitis). Results Skin conditions, including psoriasis and atopic dermatitis, increase the risk of COVID-19 (odds ratio, 1.55; P = 1.4 × 10−9) but decrease the risk of mechanical ventilation (odds ratio, 0.22; P = 8.5 × 10−5). We observed significant overlap in gene expression between the infected normal bronchial epithelial cells and inflammatory skin diseases, such as psoriasis and atopic dermatitis. For genes that are commonly induced in both the severe acute respiratory syndrome coronavirus 2 infection and skin diseases, there are 4 S100 family members located in the epidermal differentiation complex, and we also identified the “IL-17 signaling pathway” (P = 4.9 × 10−77) as one of the most significantly enriched pathways. Furthermore, a shared genome-wide significant locus in the epidermal differentiation complex was identified between psoriasis and severe acute respiratory syndrome coronavirus 2 infection, with the lead marker being a significant expression quantitative trait locus for S100A12 (P = 3.3 × 10−7). Conclusions Together our findings suggest association between inflammatory skin conditions and higher risk of COVID-19, but with less severe course, and highlight shared components involved in anti–COVID-19 immune response.
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Affiliation(s)
- Matthew T Patrick
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Mich.
| | - Haihan Zhang
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Mich
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Mich
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Mich
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Mich; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Mich
| | - Kevin He
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Mich
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Mich; Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Mich; Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, Mich.
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20
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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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21
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Moreno-Arrones OM, Lobato-Berezo A, Gomez-Zubiaur A, Arias-Santiago S, Saceda-Corralo D, Bernardez-Guerra C, Grimalt R, Fernandez-Crehuet P, Ferrando J, Gil R, Hermosa-Gelbard A, Rodrigues-Barata R, Fernandez-Nieto D, Merlos-Navarro S, Vañó-Galván S. SARS-CoV-2-induced telogen effluvium: a multicentric study. J Eur Acad Dermatol Venereol 2020; 35:e181-e183. [PMID: 33220124 PMCID: PMC7753386 DOI: 10.1111/jdv.17045] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/29/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022]
Affiliation(s)
- O M Moreno-Arrones
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcala, Madrid, Spain.,Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - A Lobato-Berezo
- Servicio Dermatología, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - A Gomez-Zubiaur
- Servicio Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain.,Unidad de Tricología, Instituto Médico Ricart, Madrid, Spain
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - D Saceda-Corralo
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcala, Madrid, Spain.,Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | | | - R Grimalt
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), Spain
| | - P Fernandez-Crehuet
- Dermatology Department, Clinica Fernández-Crehuet and Hospital Universitario Reina Sofia, Córdoba, Spain
| | - J Ferrando
- Honorary Professor of Dermatology, University of Barcelona, Barcelona, Spain
| | - R Gil
- Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcala, Madrid, Spain.,Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - R Rodrigues-Barata
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcala, Madrid, Spain.,Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcala, Madrid, Spain
| | - S Merlos-Navarro
- Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - S Vañó-Galván
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcala, Madrid, Spain.,Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
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22
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Andina D, Belloni-Fortina A, Bodemer C, Bonifazi E, Chiriac A, Colmenero I, Diociaiuti A, El-Hachem M, Fertitta L, van Gysel D, Hernández-Martín A, Hubiche T, Luca C, Martos-Cabrera L, Maruani A, Mazzotta F, Akkaya AD, Casals M, Ferrando J, Grimalt R, Grozdev I, Kinsler V, Morren MA, Munisami M, Nanda A, Novoa MP, Ott H, Pasmans S, Salavastru C, Zawar V, Torrelo A. Skin manifestations of COVID-19 in children: Part 3. Clin Exp Dermatol 2020; 46:462-472. [PMID: 33207021 PMCID: PMC7753282 DOI: 10.1111/ced.14483] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022]
Abstract
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial
recognized symptoms were respiratory, sometimes culminating in severe respiratory distress
requiring ventilation, and causing death in a percentage of those infected. As time has
passed, other symptoms have been recognized. The initial reports of cutaneous
manifestations were from Italian dermatologists, probably because Italy was the first
European country to be heavily affected by the pandemic. The overall clinical
presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in
adults as do the cutaneous manifestations of childhood. In this review, we summarize the
current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough
and critical review of articles published in the literature and from the personal
experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss
one of the first and most widespread cutaneous manifestations of COVID‐19, chilblain‐like
lesions, and in Part 2 we expanded to other manifestations, including erythema multiforme,
urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome. In this part of
the review, we discuss the histological findings of COVID‐19 manifestations, and the
testing and management of infected children for both COVID‐19 and any other pre‐existing
conditions. Click here for the corresponding questions to this CME article.
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Affiliation(s)
- D Andina
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Belloni-Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - C Bodemer
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - E Bonifazi
- Dermatologia Pediatrica Association, Bari, Italy
| | - A Chiriac
- Nicolina Medical Center, Iasi, Romania
| | - I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Fertitta
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - D van Gysel
- Department of Pediatrics, O. L. Vrouw Hospital, Aalst, Belgium
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - T Hubiche
- Department of Dermatology, Université Côte d'Azur, Nice, France
| | - C Luca
- Nicolina Medical Center, Iasi, Romania
| | - L Martos-Cabrera
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, SPHERE-INSERM1246, CHRU Tours, Tours, France
| | - F Mazzotta
- Dermatologia Pediatrica Association, Bari, Italy
| | - A D Akkaya
- Department of Dermatology, Ulus Liv Hospital, Istanbul, Turkey
| | - M Casals
- Department of Dermatology, Hospital Universitari de Sabadell, Barcelona, Spain
| | - J Ferrando
- Department of Dermatology, Hospital Clìnic, Barcelona, Spain
| | - R Grimalt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - I Grozdev
- Department of Dermatology, Children's University Hospital Queen Fabiola, Brussels, Belgium
| | - V Kinsler
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - M A Morren
- Pediatric Dermatology Unit, Department of Pediatrics and Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Munisami
- Department of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute Of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - M P Novoa
- Department of Dermatology, Hospital San Jose, Bogota, Colombia
| | - H Ott
- Division of Pediatric Dermatology, Children's Hospital Auf der Bult, Hannover, Germany
| | - S Pasmans
- Erasmus MC University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - V Zawar
- Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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23
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Varghese PM, Tsolaki AG, Yasmin H, Shastri A, Ferluga J, Vatish M, Madan T, Kishore U. Host-pathogen interaction in COVID-19: Pathogenesis, potential therapeutics and vaccination strategies. Immunobiology 2020; 225:152008. [PMID: 33130519 PMCID: PMC7434692 DOI: 10.1016/j.imbio.2020.152008] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/09/2020] [Accepted: 08/16/2020] [Indexed: 02/07/2023]
Abstract
The current coronavirus pandemic, COVID-19, is the third outbreak of disease caused by the coronavirus family, after Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. It is an acute infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This severe disease is characterised by acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulation dysfunction, and multiple organ dysfunction syndromes. Currently, no drugs or vaccines exist against the disease and the only course of treatment is symptom management involving mechanical ventilation, immune suppressants, and repurposed drugs. The severe form of the disease has a relatively high mortality rate. The last six months have seen an explosion of information related to the host receptors, virus transmission, virus structure-function relationships, pathophysiology, co-morbidities, immune response, treatment and the most promising vaccines. This review takes a critically comprehensive look at various aspects of the host-pathogen interaction in COVID-19. We examine the genomic aspects of SARS-CoV-2, modulation of innate and adaptive immunity, complement-triggered microangiopathy, and host transmission modalities. We also examine its pathophysiological impact during pregnancy, in addition to emphasizing various gaps in our knowledge. The lessons learnt from various clinical trials involving repurposed drugs have been summarised. We also highlight the rationale and likely success of the most promising vaccine candidates.
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Affiliation(s)
- Praveen Mathews Varghese
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, London, United Kingdom; School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Anthony G Tsolaki
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, London, United Kingdom
| | - Hadida Yasmin
- Immunology and Cell Biology Laboratory, Department of Zoology, Cooch Behar Panchanan Barma University, Cooch Behar, West Bengal, India
| | - Abhishek Shastri
- Central and North West London NHS Foundation Trust, London, United Kingdom
| | - Janez Ferluga
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, London, United Kingdom
| | - Manu Vatish
- Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Oxford University Hospital, Oxford, OX3 9DU, United Kingdom
| | - Taruna Madan
- Department of Innate Immunity, ICMR - National Institute for Research in Reproductive Health, J.M. Street, Parel, Mumbai, Maharashtra, India
| | - Uday Kishore
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, London, United Kingdom.
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Cho SI, Kim YE, Jo SJ. Association of COVID-19 with skin diseases and relevant biologics: a cross-sectional study using nationwide claim data in South Korea. Br J Dermatol 2020; 184:296-303. [PMID: 32875557 PMCID: PMC9213995 DOI: 10.1111/bjd.19507] [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] [Received: 07/23/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023]
Abstract
Background As the coronavirus disease 2019 (COVID‐19) pandemic has spread, information about COVID‐19 and skin disease or related biologics is still lacking. Objectives To identify the association between COVID‐19 and skin diseases or biologics. Methods A nationwide claim dataset relevant to COVID‐19 in South Korea was analysed. This dataset included insurance claim data before and during COVID‐19 treatment and clinical outcomes. Claim data related to skin diseases and relevant biologics were analysed to determine the association of COVID‐19 with skin diseases and relevant biologics. Results The dataset contained a total of 234 427 individuals (111 947 male and 122 480 female) who underwent COVID‐19 testing. Of them, 7590 (3·2%) were confirmed as having COVID‐19, and 227 (3·0%) confirmed patients died. Among various skin diseases and biologics, no significant increase in the presence of specific skin diseases or exposure to biologics was observed in the COVID‐19‐positive group, even after adjusting for or matching covariates. The presence of skin diseases and exposure to biologics also did not seem to affect clinical outcomes including mortality. Conclusions Underlying skin diseases did not appear to increase susceptibility to COVID‐19 or mortality from COVID‐19. Considering the risks and benefits, biologics for dermatological conditions might be continuously used during the COVID‐19 pandemic.
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Affiliation(s)
- S I Cho
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Y E Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - S J Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
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25
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Leis M, Fleming P, Lynde CW. Impacts of COVID-19 on Dermatologic Practice, Disease Presentation, and Immunomodulator Prescriptions. J Cutan Med Surg 2020; 25:106-108. [PMID: 32936028 DOI: 10.1177/1203475420960437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Maria Leis
- 12366 Faculty of Medicine, University of Toronto, ON, Canada
| | - Patrick Fleming
- 12366 Division of Dermatology, University of Toronto, ON, Canada.,The Lynde Institute of Dermatology, Markham, ON, Canada
| | - Charles W Lynde
- 12366 Division of Dermatology, University of Toronto, ON, Canada.,The Lynde Institute of Dermatology, Markham, ON, Canada
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