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Jackson JM, Alexis A, Zirwas M, Taylor S. Unmet needs for patients with seborrheic dermatitis. J Am Acad Dermatol 2024; 90:597-604. [PMID: 36538948 DOI: 10.1016/j.jaad.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Seborrheic dermatitis (SD) is a common skin disease with signs and symptoms that may vary by skin color, associated medical conditions, environmental factors, and vehicle preference. Diagnosis of SD is based on presence of flaky, "greasy" patches, and/or thin plaques accompanied by erythema of the scalp, face, ears, chest, and groin and is associated with pruritus in many patients. The presentation may vary in different skin types and hyper- or hypopigmentation may occur, with or without erythema and minimal or no scaling. While the pathogenesis is not certain, 3 key factors generally agreed upon include lipid secretion by sebaceous glands, Malassezia spp. colonization, and some form of immunologic dysregulation that predisposes the patient to SD. Treatment involves reducing proliferation of, and inflammatory response to, Malassezia spp. Topical therapies, including antifungal agents and low potency corticosteroids, are the mainstay of treatment but may be limited by efficacy and side effects. Few novel treatments for SD are currently being studied; however, clinical trials assessing the use of topical phosphodiesterase-4 inhibitors have been completed. Improving outcomes in SD requires recognizing patient-specific manifestations/locations of the disease, including increased awareness of how it affects people of all skin types.
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Affiliation(s)
- J Mark Jackson
- University of Louisville, Division of Dermatology, Forefront Dermatology, Louisville, Kentucky.
| | | | - Matthew Zirwas
- Dermatologists of the Central States, Probity Medical Research, and Ohio University, Bexley, Ohio
| | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Bergman MS, Grinshpun SA, Yermakov MV, Zhuang Z, Vollmer BE, Yoon KN. Fit evaluation of NIOSH approved N95 filtering facepiece respirators with various skin protectants: A pilot study. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:365-372. [PMID: 37319423 PMCID: PMC10591668 DOI: 10.1080/15459624.2023.2226180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Widespread disease outbreaks can result in prolonged wear times of National Institute for Occupational Safety and Health Approved N95 filtering facepiece respirators by healthcare personnel. Prolonged wear times of these devices can cause the development of various adverse facial skin conditions. Healthcare personnel have been reported to apply "skin protectants" to the face to reduce the pressure and friction of respirators. Because tight-fitting respirators rely on a good face seal to protect the wearer, it is important to understand if the fit is affected when skin protectants are used. This laboratory pilot study included 10 volunteers who performed quantitative fit tests to evaluate respirator fit while wearing skin protectants. Three N95 filtering facepiece respirator models and three skin protectants were evaluated. Three replicate fit tests were performed for each combination of subject, skin protectant (including a control condition of no protectant), and respirator model. Fit Factor (FF) was affected differently by the combination of the protectant type and respirator model. The main effects of the protectant type and respirator model were both significant (p < 0.001); additionally, their interaction was significant (p = 0.02), indicating FF is affected by the combined effects of the protectant type and respirator model. Compared to the control condition, using a bandage-type or surgical tape skin protectant decreased the odds of passing the fit test. Using a barrier cream skin protectant also decreased the odds of passing the fit test across all models compared to the control condition; however, the probability of passing a fit test was not statistically significantly different from the control condition (p = 0.174). These results imply that all three skin protectants reduced mean fit factors for all N95 filtering facepiece respirator models tested. The bandage-type and surgical tape skin protectants both reduced fit factors and passing rates to a greater degree than the barrier cream. Respirator users should follow respirator manufacturers' guidance on the use of skin protectants. If a skin protectant is to be worn with a tight-fitting respirator, the fit of the respirator should be evaluated with the skin protectant applied before use in the workplace.
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Affiliation(s)
- Michael S. Bergman
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Washington, District of Columbia, USA
| | - Sergey A. Grinshpun
- Department of Environmental Health, Center for Health-Related Aerosol Studies, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael V. Yermakov
- Department of Environmental Health, Center for Health-Related Aerosol Studies, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ziqing Zhuang
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Washington, District of Columbia, USA
| | - Brooke E. Vollmer
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Washington, District of Columbia, USA
| | - Katherine N. Yoon
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Washington, District of Columbia, USA
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Kumar P, Jain M, Amirthavaali G, Mishra TS, Sasmal PK, Lubaib K, Gond PK, Sarthak S. Impact of personal protective equipment on patient safety and health care workers. Med J Armed Forces India 2023; 79:531-538. [PMID: 37719904 PMCID: PMC10499652 DOI: 10.1016/j.mjafi.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/03/2021] [Indexed: 02/06/2023] Open
Abstract
Background The study aims to assess the effect of personal protective equipment (PPE) on the physical and psychological well-being of health care workers (HCWs) and its impact on patient safety. Methods After ethical approval, a 14-point questionnaire was circulated offline and online among the HCWs of ours institute, who were involved in performing invasive procedures while wearing a PPE. The responses were analysed using the SPSS software version 26. Results Of 198 responses, the mean duration of PPE use was 4.6 ± 1.52 h. Seventy percent of respondents suggested <4 h of continuous use of PPE. Seventy-seven percent found difficulties during the procedures while wearing PPE and agreed to errors while performing a procedure. Poor visibility (95.5%), fogging (84.9%), communication difficulty (75.3%), sweating (74.2%), posture-related discomfort (56.1%) and poor concentration (51%) were major causes. Anxiety (39.9%) and fear of spreading an infection to the family (42.9%) were major psychological effects. Eighty percent of HCWs raised concern over the quality of PPE, N95 mask and eye protector. The HCWs felt the need to improve the quality of PPEs, use extra padding around the ears, sealing the N95 mask with adhesive tape, besides using sign language for communication for more safety. Fifty percent graded the procedure-related difficulty level >6 on a Likert scale of 1-10. Conclusion PPE-related discomfort is common among the HCWs and could contribute to errors during an invasive procedure. Efforts to alleviate the physical and psychological well-being of the HCWs will be essential for reducing procedural error while wearing a PPE.
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Affiliation(s)
- Pankaj Kumar
- Associate Professor (General Surgery), AIIMS, Bhubaneswar, India
| | - Mantu Jain
- Associate Professor (Orthopedic Surgery), AIIMS, Bhubaneswar, India
| | | | | | | | - K.P. Lubaib
- Resident (Orthopedic Surgery), AIIMS, Bhubaneswar, India
| | - Preeti K. Gond
- Resident (Orthopedic Surgery), AIIMS, Bhubaneswar, India
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Tang H, Wang H, Hamblin MR, Jiang L, Zhou Y, Xu Y, Wen X. Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review. Front Public Health 2023; 11:1189190. [PMID: 37546301 PMCID: PMC10400336 DOI: 10.3389/fpubh.2023.1189190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD). Methods Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included. Discussion This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.
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Affiliation(s)
- Huimiao Tang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Lu Jiang
- Outpatient Department of West China Hospital, Sichuan University, Chengdu, China
| | - Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Smulders M, van Dijk LNM, Song Y, Vink P, Huysmans T. Dense 3D pressure discomfort threshold (PDT) map of the human head, face and neck: A new method for mapping human sensitivity. APPLIED ERGONOMICS 2023; 107:103919. [PMID: 36375219 DOI: 10.1016/j.apergo.2022.103919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/22/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
When designing wearables that interface with the human head, face and neck, designers and engineers consider human senses, ergonomics and comfort. A dense 3D pressure discomfort threshold map could be helpful, but does not exist yet. Differences in pressure discomfort threshold for areas of the head, neck and face were recorded, to create a 3D pressure discomfort threshold map. Between 126 and 146 landmarks were placed on the left side of the head, face and neck of twenty-eight healthy participants (gender balanced). The positions of the landmarks were specified using an EEG 10-20 system-based landmark-grid on the head and a self-developed grid on the face and neck. A 3D scan was made to capture the head geometry and landmark coordinates. In a randomised order, pressure was applied on each landmark with a force gauge until the participant indicated experiencing discomfort. By interpolating all collected pressure discomfort thresholds based on their corresponding 3D coordinates, a dense 3D pressure discomfort threshold map was made. A relatively low-pressure discomfort threshold was found in areas around the nose, neck front, mouth, chin-jaw, cheek and cheekbone, possibly due to the proximate or direct location of nerves, blood veins and soft (muscular) tissue. Medium pressure discomfort was found in the neck back, forehead and temple regions. High pressure discomfort threshold was found in the back of the head and scalp, where skin is relatively thin and closely supported by bone, making these regions interesting for mounting or resting head, face and neck related equipment upon.
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Affiliation(s)
- M Smulders
- Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628CE, Delft, the Netherlands.
| | - L N M van Dijk
- Crescent Medical B.V., Vlamingstraat 72A, 2611KZ, Delft, the Netherlands
| | - Y Song
- Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628CE, Delft, the Netherlands.
| | - P Vink
- Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628CE, Delft, the Netherlands.
| | - T Huysmans
- Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628CE, Delft, the Netherlands; Imec-Vision Lab, Department of Physics, University of Antwerp, Universiteitsplein 1, B-2610, Antwerp, Belgium.
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Factors Participating in the Occurrence of Inflammation of the Lips (Cheilitis) and Perioral Skin. COSMETICS 2023. [DOI: 10.3390/cosmetics10010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Lip inflammation may manifest as mainly reversible cheilitis, mainly irreversible, or cheilitis connected to dermatoses or systemic diseases. Therefore, knowing a patient’s medical history is important, especially whether their lip lesions are temporary, recurrent, or persistent. Sometimes temporary contributing factors, such as climate and weather conditions, can be identified and avoided—exposure to extreme weather conditions (e.g., dry, hot, or windy climates) may cause or trigger lip inflammation. Emotional and psychological stress are also mentioned in the etiology of some lip inflammations (e.g., exfoliative cheilitis) and may be associated with nervous habits such as lip licking. To better manage cheilitis, it is also helpful to look for potential concomitant comorbidities and the presence of related diseases/conditions. Some forms of cheilitis accompany dermatologic or systemic diseases (lichen, pemphigus or pemphigoid, erythema multiforme, lupus, angioedema, xerostomia, etc.) that should be uncovered. Occasionally, lip lesions are persistent and involve histological changes: actinic cheilitis, granulomatous cheilitis, glandular cheilitis, and plasmacellular cheilitis. Perioral skin inflammation with simultaneous perioral dermatitis can have various causes: the use of corticosteroids and cosmetics, dysfunction of the skin’s epidermal barrier, a contact reaction to allergens or irritants (e.g., toothpaste, dental fillings), microorganisms (e.g., Demodex spp., Candida albicans, fusiform bacteria), hormonal changes, or an atopic predisposition. Epidermal barrier dysfunction can worsen perioral dermatitis lesions and can also be related to secondary vitamin or mineral deficiencies (e.g., zinc deficiency), occlusive emollient use, sunscreen use, or excessive exposure to environmental factors such as heat, wind, and ultraviolet light. Current trends in research are uncovering valuable information concerning the skin microbiome and disruption of the epidermal barrier of persons suffering from perioral dermatitis. Ultimately, an effective approach to patient management must take all these factors and new research into account.
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Jain VM, Parihar SRS, Acharya S, Acharya S. Effects of wearing personal protective equipment (PPE) and its role in affecting the work efficiency of dentists during the COVID-19 pandemic. Work 2023; 76:3-10. [PMID: 36872823 DOI: 10.3233/wor-220083] [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: 03/03/2023] Open
Abstract
BACKGROUND The risk of exposure to COVID-19 infection through droplets/aerosol in dental clinics has renewed focus on the utility and possible adverse effects of using personal protective equipment (PPE) on dentists. OBJECTIVE To obtain information from a cross-section of dentists regarding their PPE usage and to evaluate the possible risk factors that can influence their work efficiency. METHODS A 31-item cross-sectional survey with a structured multiple-choice questionnaire was designed. Social media and emails were used to circulate the questionnaire among dental professionals worldwide. A total of 317 respondents returned the completed forms. RESULTS A total of 184 (55%) participants reported getting soaking wet while wearing PPE at the end of the working hours (approximately eight hours of working). Many respondents (n = 286, 90%) reported that the use of PPE resulted in reduced visibility of the operating field. The majority of respondents (84%) felt that their overall work efficiency had reduced after using PPE. Binary logistic regression had shown that two significant factors that were associated with reduced work efficiency included, pre-existing systemic illness and getting soaking wet from wearing a PPE. CONCLUSION Definite protocols should be introduced that mandate the doffing of PPE for every patient, in a separate well-ventilated area where the skin can recuperate from the heat and pressure points caused by the PPE. Dentists should take greater care in choosing the appropriate PPE to prevent exacerbation of pre-existing illnesses, which may reduce their work efficiency.
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Affiliation(s)
- Vedushi M Jain
- Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | | | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
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Choe A, Kwon Y, Shin YE, Yeom J, Kim J, Ko H. Adaptive IR- and Water-Gating Textiles Based on Shape Memory Fibers. ACS APPLIED MATERIALS & INTERFACES 2022; 14:55217-55226. [PMID: 36448211 DOI: 10.1021/acsami.2c15974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Thermoregulation is an essential function of the human body for adapting to the surrounding temperature. Stimuli-responsive smart textiles can provide effective protection of the human skin temperature from a continuously changing environment. Herein, we develop a smart textile based on shape memory polymer (SMP) fibers for adaptive regulation of IR and water transmission on human skin. An SMP textile is fabricated with hierarchical micro/nanoporous structures to enhance thermal insulation performance, and silver nanowires are coated on one side to provide asymmetric IR reflectivity and hydrophilicity. The porous SMP textile shows great tunability of thermal insulation and asymmetric wettability by deformation and recovery of the shape and structure in response to stimuli. The degree of thermal insulation is controlled by 65.7% of the original value, and the surface temperature of the SMP textile on a hot plate is successfully controlled in the IR images due to adaptive IR reflectivity. Additionally, the directional transportation of water droplets can be switched on/off according to the shape of the SMP textiles, which can be employed for sweat removal from the human skin. This IR- and water-gating smart textile can provide a feasible strategy for protecting the human skin from external environmental changes.
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Affiliation(s)
- Ayoung Choe
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City 44919, Republic of Korea
| | - Yeju Kwon
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City 44919, Republic of Korea
| | - Young-Eun Shin
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City 44919, Republic of Korea
| | - Jeonghee Yeom
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City 44919, Republic of Korea
| | - Jeeyoon Kim
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City 44919, Republic of Korea
| | - Hyunhyub Ko
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City 44919, Republic of Korea
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Srinivas CR, Sethy M. Occupational Dermatoses. Indian Dermatol Online J 2022; 14:21-31. [PMID: 36776171 PMCID: PMC9910518 DOI: 10.4103/idoj.idoj_332_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/30/2022] Open
Abstract
Occupational skin diseases (OSDs) are one of the major problems in working life. Among occupational diseases, 30-45% are skin diseases. Contact dermatitis accounts for the greatest part (95%) of OSDs. It adversely affects the quality of life of workers. Classification of OSD is too difficult as there are geographical variations in the occupational groups affected. However, commonly affected occupational groups are agricultural workers, healthcare workers, construction workers, metal workers, cleaners, housekeepers, food handlers, hairdressers, beauticians, and mechanics. Because of the unorganized workplace, lack of a proper notification system for occupational dermatoses, and under-reporting of cases, there is a paucity of information regarding the magnitude of the problem of OSD in India. Although in India many studies have been conducted on individual small occupational groups, data on the complete epidemiology of OSD is limited. In this article, we have tried to compile the common OSDs in various occupations.
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Affiliation(s)
- Chakravarthi R. Srinivas
- Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Mitanjali Sethy
- Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Mitanjali Sethy, Assistant Professor, Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar - 751 024, Odisha, India. E-mail:
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Alamawi HO, Alruwaili MS, Alswayed SK, Alhumaidi WA, Aldabali SO, Alfalah HA. Mask-Induced Facial Dermatoses in the Saudi Arabian Population During the COVID-19 Pandemic: A Cross-Sectional Study. Cureus 2022; 14:e31151. [DOI: 10.7759/cureus.31151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2022] [Indexed: 11/08/2022] Open
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The prevalence of facial pressure injuries among nurses during COVID-19 pandemic and its relationship to COVID-19 infection. J Tissue Viability 2022; 31:699-706. [PMID: 36195528 PMCID: PMC9526514 DOI: 10.1016/j.jtv.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/12/2022] [Accepted: 09/25/2022] [Indexed: 02/04/2023]
Abstract
AIM The aim of this study was to investigate the prevalence of facial pressure injuries related to personal protective equipment use in nurses and the relationship with getting COVID-19 infection. DESIGN The study used descriptive and correlational online survey design. METHODS Nurses in Turkey were recruited via an electronic link sent to their social media platforms (e.g., Facebook, Instagram, Twitter), WhatsApp, and e-mail during the study: March-April 2021. Of them, 603 participants completed the survey form from all over Turkey. RESULTS/FINDINGS Facial pressure injuries develop in nurses due to use of personal protective equipment. The rates of facial pressure injuries were higher in the nurses who were younger (p=0.002) and those who had less experience years (p=0.005) than the other nurses. The statistically significant variables were determined as age, status of using face shield, status of wearing overalls and status of wearing shoe covers (p<0.05). We determined that facial pressure injuries were not significantly associated with getting COVID-19 infection (p>0,05). CONCLUSIONS This study showed that facial pressure injuries associated with personal protective equipment use among nurses, who work on the frontlines in the COVID-19 pandemic period, is highly prevalent. Experiencing facial pressure injuries did not have a significant effect on the participants' statuses of getting infected with COVID-19. Providing training in health institutions may present an effective strategy in lowering problems.
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Alizadeh N, Darjani A, Rafiei R, Gharaeinejad K, Eftekhari H, Bahrami E, Rafiei E. Dermatologic problems associated with personal protective equipment in health-care workers managing COVID-19 patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:80. [PMID: 36438073 PMCID: PMC9693753 DOI: 10.4103/jrms.jrms_921_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/23/2022] [Accepted: 07/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The safety of health-care workers (HCWs) during the COVID-19 pandemic is a major concern worldwide. Dermatological problems due to personal protective equipment are annoying issues. We aimed to evaluate dermatological adverse events following the use of these protections in HCWs managing COVID-19 patients. MATERIALS AND METHODS One hundred and fifty-six workers managing COVID-19 patients were enrolled in this cross-sectional study. We conducted face-to-face interviews to collect the data and focused mainly on protection type and mucocutaneous symptoms with new onset or exaggeration after this equipment. RESULTS Dermatological problems following protective equipment usage occurred mainly during the 1st week (65.4%). The most common site of skin involvement was the nose (82.7%) and the most frequent visible complaints were the pressure effect and erythema on the nose in 80.8% and 57.7% of cases, respectively. There was a significant association between mask type and facial skin problems (P < 0.001). The main symptoms were itching (21.8% scalp, 39.1% face and body) and burning sensation (14.1% scalp, 23.7% face and body). Skin desquamation (37.2%) and dorsal hand dermatitis (41.66%) were significantly more frequent in atopic participants (P = 0.02 and P = 0.01, respectively). Hand involvement was significantly associated with frequency of hand washing (odds ratio = 1.97, 95% confidence interval = 1.04-3.74, P = 0.03). CONCLUSION We found that skin problems related to protective equipment were common and frequently located on the face mainly due to facial masks. These complications should be prevented by proper use of this equipment.
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Affiliation(s)
- Narges Alizadeh
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Darjani
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Rana Rafiei
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran,Address for correspondence: Dr. Rana Rafiei, Department of Dermatology, Skin Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rana Rafiei, Rasht, Iran. E-mail:
| | - Kaveh Gharaeinejad
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Hojat Eftekhari
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Bahrami
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
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Rathi SK, Dsouza JM. Maskne: A New Acne Variant in Covid-19 Era. Indian J Dermatol 2022; 67:552-555. [PMID: 36865865 PMCID: PMC9971751 DOI: 10.4103/ijd.ijd_1054_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
"Maskne" has been one of the negative spinoffs of the universally acceptable and effective role of face mask in containing the ongoing pandemic of SARS-CoV-2 virus or COVID 19. Several factors contribute to its aetiopathogenesis including heat, humidity, mechanical friction and microbiome dysbiosis in a complex interplay under the occlusive area of the mask. Clinically, the morphology is not very different from acne vulgaris with comedones and inflammatory acne, but in a characteristic distribution over a roughly circular area of face covered by mask. Since the use of face masks is likely to continue in the near future, measures like wearing a comfortably fitting mask of appropriate fabric, using disposable masks, increasing mask-free period when at safer places, avoiding unnecessary use of personal care products over the occluded skin, proper and gentle cleaning of the affected areas, intermittent mopping off of the excessive sebum and sweat and use of specific, topical and systemic therapy could help in its resolution.
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Affiliation(s)
- Sanjay K. Rathi
- From the Dr. Rathi's Skin Clinic, Siliguri, West Bengal, India
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14
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Valk B, Ivanov NN, Nahhas A, Corwin K, Hansen K, Globerson J, LaCasse A, Corser W, Sikorski L. Mask-related skin changes among healthcare workers in a community-based hospital. J Osteopath Med 2022; 122:609-615. [PMID: 36028224 DOI: 10.1515/jom-2022-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/04/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT During the COVID-19 pandemic, dermatologists within the Beaumont Farmington Hills' Dermatology program noticed an increase in conditions associated with mask wearing, such as "maskne" (acne in a mask distribution, thought to be caused by mask wearing), as well as worsening of previously diagnosed dermatologic conditions. OBJECTIVES The goal of our study was to explore various factors that impacted mask-related skin changes and how these skin changes affected quality of life. METHODS A cross-sectional study was performed. The primary 10-item survey instrument administered was the Dermatology Life Quality Index (DLQI). Respondents were asked a series of 10 additional questions concerning the degree to which abnormal mask-related skin conditions affect their skin symptoms, possible embarrassment/self-consciousness, and perceived impact of mask-related skin changes. A series of descriptive statistics, cross-tabulation charts, and graphical examinations of data was utilized to evaluate sample subgroup and outcome distributional patterns. Pearson r bivariate correlation coefficients between possible collinear predictive measures on the primary study outcome were calculated. A series of simple inferential chi-squared (Χ2) tests of independence were also conducted. RESULTS A total of 370 out of 430 (86.0%) Beaumont Health employees noticed some degree of skin changes since the work-hours face mask requirement was instituted, while 378 out of 430 (87.9%) felt that their skin was better when not wearing a mask. The majority of respondents, 283 (65.8%), reported having at least a little symptomatic skin (i.e., itchy, painful, sore, stinging) during the prior week. Furthermore, 72.3% reported that they were at least a little embarrassed or self-conscious of their skin. Chi-squared analysis of composite DLQI score categories by the number of types of masks utilized (Pearson X2=19.0, df=8, p=0.015), and some degree of symptomatic skin (Pearson X2=156.4, df=4, p<0.001) were found to be statistically significant. CONCLUSIONS A large number of healthcare workers are affected by mask-related skin changes. Further research should be directed at better understanding how skin changes associated with mask wearing impact one's quality of life and mental health.
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Affiliation(s)
- Brittany Valk
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Nedyalko N Ivanov
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Amanda Nahhas
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Katie Corwin
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Katrina Hansen
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Jeff Globerson
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Annette LaCasse
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - William Corser
- Michigan State University Statewide Campus System, East Lansing, MI, USA
| | - Lynn Sikorski
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
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15
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Justin LYS, Yew YW. Facial Dermatoses Induced by Face Masks: A Systematic Review and Meta-Analysis of Observational Studies. Contact Dermatitis 2022; 87:473-484. [PMID: 35980367 PMCID: PMC9539048 DOI: 10.1111/cod.14203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 12/04/2022]
Abstract
The use of masks for infection control was common in the COVID‐19 pandemic. As numerous cross‐sectional studies have suggested a link between the use of such masks and various facial dermatoses, a systematic review and meta‐analysis of published studies was conducted to evaluate this association, as well as potential risk factors for the development of such facial dermatoses. Observational studies were searched for in MEDLINE, EMBASE and the Cochrane Central Register. Thirty‐seven observational studies with a total of 29 557 study participants were identified. This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) 2020 checklist and quality was assessed via the Newcastle‐Ottawa Quality Assessment Scale., Overall prevalence of facial dermatoses was 55%. Individually, acne, facial dermatitis, itch and pressure injuries were consistently reported as facial dermatoses, with a pooled prevalence of 31%, 24%, 30% and 31%, respectively. Duration of mask‐wear was the most significant risk factor for the development of facial dermatoses (95% CI: 1.31–1.54, p < 0.001). Overall, facial dermatoses associated with mask wear are common, and consist of distinct entities. They are related to duration of use. Appropriate and tailored treatment is important to improve the outcomes for these affected patients.
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Affiliation(s)
- Lim Yi Shen Justin
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Tan Tock Seng Hospital, Singapore
| | - Yik Weng Yew
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,National Skin Centre, Singapore
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16
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Cretu S, Dascalu M, Salavastru CM. Acne care in health care providers during the
COVID
‐19 pandemic: A national survey. Dermatol Ther 2022; 35:e15753. [PMID: 36190007 PMCID: PMC9538804 DOI: 10.1111/dth.15753] [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: 05/15/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Abstract
The medical face mask, widely used by health care providers (HCPs) during the COVID‐19 pandemic, is reported to be associated with adverse reactions, among which acne is one of the most common. This study aims to evaluate treatment strategies employed by HCPs affected by acne in association with prolonged medical face mask use, their openness towards accessing telemedicine as a patient, and other lifestyle factors with potential influence on the evolution of their acne. Our online‐based cross‐sectional survey was distributed between December 17, 2020, and February 17, 2021, and targeted HCPs from different medical centers in Romania. From the n = 134 respondents, 50% reported current acne lesions and 56.7% required treatment. Of the latter, 65.8% self‐medicated and 34.2% sought medical advice. The most common treatment associations between anti‐acne topical products were: retinoids and salicylic acid (18.18%; n = 8), retinoids and benzoyl peroxide (13.64%; n = 6), salicylic acid and benzoyl peroxide (13.64%; n = 6), and azelaic acid together with salicylic acid (9.09%; n = 4). The health care provider responders were reluctant to use telemedicine, as only 14.2% participants were open to telemedicine. Our results suggest inadequate management of acne in HCPs using medical face masks. As with other occupational hazards and proper usage of personal protective equipment, HCPs should receive adequate screening, training, and treatment for this condition.
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Affiliation(s)
- Stefana Cretu
- “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
- Dermatology Research Unit Colentina Clinical Hospital Bucharest Romania
| | - Mihai Dascalu
- Department of Computer Science Polytechnic University of Bucharest Romania
| | - Carmen Maria Salavastru
- “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
- Pediatric Dermatology Department Colentina Clinical Hospital Bucharest Romania
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17
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Al Zaabi A, Abdelhadi S, Ruszczak Z. Personal protective equipment-related dermatoses in COVID-19 frontline health workers. A lesson learned from 1-year single center in the UAE. Dermatol Ther 2022; 35:e15624. [PMID: 35674680 PMCID: PMC9347744 DOI: 10.1111/dth.15624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
Since COVID‐19 was declared a pandemic in March 2020, frontline health care workers wear personal protective equipment (PPE, surgical masks, N95 or similar respirators, gloves, goggles, face shields, and gowns). Alcohol‐based sanitizers and wipes were recommended. Such measures lead to disruption of the natural skin habitat and skin barrier and various cutaneous reactions. The aim was to assess the prevalence and characteristics of PPE‐related dermatoses among health care workers in Sheikh Khalifa Medical City (SKMC), a COVID‐19 facility, Abu Dhabi, United Arab Emirates. We conducted a voluntary, cross‐sectional anonymous survey among first‐line health care workers addressing types of PPE used, dermatoses classified as PPE related, and factors that influence them. Facial, nasal, and hand dermatoses were the most prevalent with 40.2%, 19.9%, and 14.1%, respectively. The changes are primarily attributed to surgical masks, N‐95 masks, and gloves. The shift duration is a contributing factor correlating with the severity of skin damage. Results of this study encouraged decision makers to recognize PPE‐related dermatoses as a continuously growing burden, reorganized the shift duration and PPE exposure, animated the personal to apply preventive measures, and promoted the well‐being of medical professionals in new waves of the pandemic.
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Affiliation(s)
- Amna Al Zaabi
- Division of Dermatology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Shaden Abdelhadi
- Division of Dermatology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.,Division of Dermatology and Division of Pediatric Dermatology, Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.,College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Zbigniew Ruszczak
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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18
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Nyberg A, Rajaleid K, Demmelmaier I. The Work Environment during Coronavirus Epidemics and Pandemics: A Systematic Review of Studies Using Quantitative, Qualitative, and Mixed-Methods Designs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116783. [PMID: 35682365 PMCID: PMC9180570 DOI: 10.3390/ijerph19116783] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/05/2023]
Abstract
We aimed to provide an overview of how work environment and occupational health are affected, and describe interventions designed to improve the work environment during epidemics and pandemics. The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) were followed. The databases Cinahl, Medline, PsycInfo, and Web of Science were searched for population: working population; exposure: coronavirus epidemic or pandemic; and outcome: work environment, in articles published until October 2020. Quality assessment was based on a modified version of the Mixed Methods Appraisal Tool (MMAT). After deduplication 3711 articles remained, of which 530 were selected for full-text screening and 119 for quality assessment. After the exclusion of studies that were low quality, 95 remained, of which 85 focused on healthcare personnel and 10 on employees in other industries; 73 used quantitative methods and 22 used qualitative or mixed methods; the majority were based on cross-sectional data. Healthcare staff experienced increased job demands, poor leadership, and lack of resources (personal protective equipment, personnel, and competence). High demands and work with infected patients were associated with negative mental health outcomes. There was a lack of studies assessing interventions, studies from industries other than healthcare, and studies of high quality.
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Affiliation(s)
- Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
- Correspondence: ; Tel.: +46-8-708-234318
| | - Kristiina Rajaleid
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
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19
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Manookian A, Dehghan Nayeri N, Shahmari M. Physical problems of prolonged use of personal protective equipment during the COVID-19 pandemic: A scoping review. Nurs Forum 2022; 57:874-884. [PMID: 35575417 PMCID: PMC9347983 DOI: 10.1111/nuf.12735] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
Background It is widely believed that using personal protective equipment (PPE) provides high levels of protection for healthcare workers (HCWs) in the fight against coronavirus disease (COVID‐19). However, the long‐term use of PPE is inconvenient for HCWs and may cause physical discomfort. These factors could result in poor compliance and disrupt the health and safety of HCWs, which may negatively affect the patient's safety. Objective This study aimed to investigate the literature for the purpose of collecting convincing evidence of HCWs' physical problems associated with PPE use during the COVID‐19 pandemic. Methods This scoping review was conducted using PubMed, Embase, ProQuest, Science Direct, Springer, Biomed Central, and Google Scholar to identify the related literature. Results HCWs have experienced various physical disorders including skin, respiratory, musculoskeletal, nervous, urinary, and circulatory system problems that are associated with PPE in various body systems. Among these, skin problems were the most frequent physical problems. Conclusions The literature demonstrated the adverse impacts of using PPE on HCWs. Therefore, healthcare policymakers should take the appropriate measures to improve the work environment during the COVID‐19 pandemic, which could consequently prevent and mitigate the adverse effects of using PPE.
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Affiliation(s)
- Arpi Manookian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,USERN Care (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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20
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Cosansu NC, Yuksekal G, Kutlu O, Umaroglu M, Yaldız M, Dikicier BS. The Change in The Frequency and Severity of Facial Dermatoses and Complaints in Healthcare Workers During the COVID-19. J Cosmet Dermatol 2022; 21:3200-3205. [PMID: 35509253 PMCID: PMC9347995 DOI: 10.1111/jocd.15044] [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: 01/18/2022] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022]
Abstract
Background The coronavirus disease 2019 (COVID‐19) pandemic has led to a dramatic increase in the use of personal protective equipment (PPE). However, the increased use of PPEs may lead to facial skin complaints. Aims This survey study aims to evaluate the effect of the COVID‐19 pandemic on facial dermatoses and complaints. Methods A total of 1017 volunteers (age 18–60 years), consisting of healthcare workers, participated in the study. In the present study, healthcare professionals were screened for facial dermatoses and complaints between 1 and 15 April 2021 with an online survey. Results The vast majority of the survey were women (82.4%) and between 26 and 35 years old (49.2%). The most new‐onset facial complaints were acne (25.3%) and lip dryness (29.2%). Along with the pandemic, 50.9% of patients with seborrheic dermatitis had an increase in lesions. Another remarkable result was a 60.5% increase in acne complaints. Moreover, the rate of exacerbations of rosacea, melasma, and lip dryness was increased after the COVID‐19 pandemic (39.1%, 22.0%, and 42.7%, respectively). Exacerbations of seborrheic dermatitis, acne, and lip dryness have occurred more frequently in females when compared to males (p < 0.001). Conclusions The current pandemic has had serious impacts on facial dermatoses which had to be managed carefully. Compared to the pre‐pandemic period, there was a significant increase in the frequency and severity of complaints in facial dermatoses related to PPE. If the complaints that may develop due to PPE are known in advance, their development can be prevented by taking precautions against them.
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Affiliation(s)
- Nur Cihan Cosansu
- Sakarya University, Education and Research Hospital, Department of Dermatology, Sakarya, Turkey
| | - Gulcan Yuksekal
- Yenikent State Hospital, Department of Dermatology, Sakarya, Turkey
| | - Omer Kutlu
- Tokat Gaziosmanpaşa University, School of Medicine, Department of Dermatology and Venereology
| | - Mutlu Umaroglu
- Sakarya University, Sakarya Medical Faculty, Department of Biostatistics, Sakarya, Turkey
| | - Mahizer Yaldız
- Sakarya University, Education and Research Hospital, Department of Dermatology, Sakarya, Turkey
| | - Bahar Sevimli Dikicier
- Sakarya University, Education and Research Hospital, Department of Dermatology, Sakarya, Turkey
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21
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Stiger I. Protecting yourself from PPE skin injuries. Nursing 2022; 52:45-47. [PMID: 35452041 DOI: 10.1097/01.nurse.0000827144.89703.c9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
ABSTRACT Nurses are wearing personal protective equipment (PPE) for extended periods while providing patient care during the ongoing COVID-19 pandemic. This article identifies dermatologic issues of extended PPE use, explores the risks of injury, and offers prevention strategies.
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Affiliation(s)
- Ivan Stiger
- Ivan Stiger is a doctoral student at Loma Linda University - School of Nursing in Loma Linda, Calif
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22
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Kunstler B, Newton S, Hill H, Ferguson J, Hore P, Mitchell BG, Dempsey K, Stewardson AJ, Friedman D, Cole K, Sim MR, Ferguson B, Burns P, King N, McGloughlin S, Dicks M, McCarthy S, Tam B, Hazelton B, McGurgan C, McDonald S, Turner T. P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects. Infect Dis Health 2022; 27:81-95. [PMID: 35151628 PMCID: PMC8769935 DOI: 10.1016/j.idh.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective equipment (PPE), including surgical masks and P2/N95 respirators, to prevent infection while treating patients. However, the comparative effectiveness of respirators and masks in preventing SARS-CoV-2 infection and the likelihood of experiencing adverse events (AEs) with wear are unclear. METHODS Searches were carried out in PubMed, Europe PMC and the Cochrane COVID-19 Study Register to 14 June 2021. A systematic review of comparative epidemiological studies examining SARS-CoV-2 infection or AE incidence in HCWs wearing P2/N95 (or equivalent) respirators and surgical masks was performed. Article screening, risk of bias assessment and data extraction were duplicated. Meta-analysis of extracted data was carried out in RevMan. RESULTS Twenty-one studies were included, with most having high risk of bias. There was no statistically significant difference in respirator or surgical mask effectiveness in preventing SARS-CoV-2 infection (OR 0.85, [95%CI 0.72, 1.01]). Healthcare workers experienced significantly more headaches (OR 2.62, [95%CI 1.18, 5.81]), respiratory distress (OR 4.21, [95%CI 1.46, 12.13]), facial irritation (OR 1.80, [95%CI 1.03, 3.14]) and pressure-related injuries (OR 4.39, [95%CI 2.37, 8.15]) when wearing respirators compared to surgical masks. CONCLUSION The existing epidemiological evidence does not enable definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection. Healthcare workers wearing respirators may be more likely to experience AEs. Effective mitigation strategies are important to ensure the uptake and correct use of respirators by HCWs.
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Affiliation(s)
- Breanne Kunstler
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Melbourne, VIC, 3800, Australia.
| | - Skye Newton
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - Hayley Hill
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - John Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, NSW, 2310, Australia
| | - Phillipa Hore
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Brett G. Mitchell
- The University of Newcastle, School of Nursing and Midwifery, Level 9, 77a Holden St, Gosford Hospital, Gosford, NSW, Australia, 2250
| | - Kathy Dempsey
- The Clinical Excellence Commission, 1 Reserve Road, St Leonards, NSW, Australia, 2065
| | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, 85 Commercial Rd, Melbourne, VIC, Australia, 3004
| | - Deborah Friedman
- Deputy Chief Health Officer, Victorian Department of Health Melbourne, VIC, Australia, 3004
| | - Kate Cole
- Cole Health Pty Ltd, Balmain, NSW, Australia, 2041
| | - Malcolm R. Sim
- Monash Centre for Occupational & Environmental Health (MonCOEH), School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC, Australia, 3004
| | - Bridget Ferguson
- Central Queensland University, School of Nursing, Midwifery and Social Sciences; 554-700 Yaamba Rd, Norman Gardens, QLD, 4701, Australia
| | - Penelope Burns
- Academic Unit of General Practice, ANU Medical School, The Australian National University, Building 4, Hospital Road, Garran, ACT, 2605, Australia
| | - Nicole King
- North Shore Private Hospital, 3 Westbourne St, St Leonard's, 2065, Australia
| | - Steven McGloughlin
- Alfred Health and School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia, 3004
| | - Melanie Dicks
- Ernst & Young, 121 Marcus Clarke Street, Canberra, ACT, Australia, 2601
| | - Sally McCarthy
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Barry Tam
- Health Infrastructure NSW, 60 Day Road, Cheltenham, NSW, 2119, Australia
| | - Briony Hazelton
- PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA, Australia, 6009
| | - Cherylynn McGurgan
- Royal Melbourne Hospital Emergency Department, 300 Grattan Street, Parkville, VIC, Australia, 3050
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Tari Turner
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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23
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Aryanian Z, Balighi K, Hatami P, Afshar ZM, Mohandesi NA. The role of SARS-CoV-2 infection and its vaccines in various types of hair loss. Dermatol Ther 2022; 35:e15433. [PMID: 35266262 PMCID: PMC9111640 DOI: 10.1111/dth.15433] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022]
Abstract
The prevalence of hair loss has increased during COVID‐19. In this study, we review the current literature on incidence and characteristics of various types of COVID‐19‐related and COVID‐19‐vaccine‐ related hair loss including telogen effluvium, alopecia areata, friction alopecia and anagen effluvium. Regarding most of them, the more severe the infection, the more profound and prolonged the course of alopecia. However, the most important issue is reassuring the patients of the non‐serious nature of this complication, since psychological support is the most important factor in the earlier resolution of the condition.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, School of Medicine Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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24
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Resuello TEM, Puyat MCA. Mask-induced facial dermatoses during the COVID-19 pandemic: A cross-sectional study in a tertiary medical center in the Philippines. JAAD Int 2022; 7:121-123. [PMID: 35291232 PMCID: PMC8913279 DOI: 10.1016/j.jdin.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tina Elaine M. Resuello
- Correspondence to: Tina Elaine M. Resuello, MD, Department of Dermatology, Rizal Medical Center, Pasig Boulevard, Pasig 1600, Philippines
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25
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Althobaiti HM, Althobaiti H, Khan M, Alsatti H, Samarkandy SJ. The Association Between Facial Dermatosis and Face-Mask Wearing During COVID-19 in Saudi Arabia. Cureus 2022; 14:e22265. [PMID: 35350501 PMCID: PMC8933262 DOI: 10.7759/cureus.22265] [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] [Accepted: 02/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background: During the coronavirus pandemic of 2019, there has been an upsurge in the number of reported cases of facial dermatosis caused by face masks wearing within the general population. Face mask-induced facial dermatosis has been investigated previously in healthcare workers without involving the general population. However, as a precautionary measure against the coronavirus disease 2019 (COVID-19) pandemic, wearing a face mask has become mandatory for the general population, similar to healthcare workers. Objective: To measure the prevalence of COVID-19 pandemic-induced facial dermatosis. Also, to determine the type of face mask used that causes the most facial dermatosis and the association between prolonged usage of face masks and facial dermatosis in Western Saudi Arabia's population. Methods: The study covers the Western region of Saudi Arabia. A self-administered Google survey was shared on social media. The study used prior surveys from similar studies. The data collection included participants’ demographic information, pre-existing skin conditions, mask type, and mask-related skin conditions. The data were analyzed using the statistical package for the social sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY). Results: The median age was 30 years (interquartile range {IQR} 23-43). Females represented 65.5% of our sample. Face mask-wearing was associated with skin changes in 41.7% of the population. The most common skin condition associated with mask use was pimples and pustules representing 28.7%, of which the most common site was on the cheeks 31.4%. Acne vulgaris was the most common pre-existing skin condition, affecting 8.7% of the total population. Of the total, 46.2% experienced an exacerbation of their pre-existing skin condition with or after wearing masks. Skin changes were significantly associated with skin type and duration of wearing the mask (P<0.001). Conclusion: The prevalence of facial mask-induced facial dermatosis is 41.7% of the general population in which surgical mask was responsible for most cases. In addition, there is a strong association between the duration of wearing the mask and facial dermatosis.
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Babino G, Argenziano G, Balato A. Impact in Contact Dermatitis during and after SARS-CoV2 Pandemic. CURRENT TREATMENT OPTIONS IN ALLERGY 2022; 9:19-26. [PMID: 35194543 PMCID: PMC8830973 DOI: 10.1007/s40521-022-00298-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 12/28/2022]
Abstract
Purpose of the review Due to the recent COVID-19 pandemic, several skin conditions have emerged due to the preventive measures adopted by both health care workers and the general population against SARS-CoV-2. Above all, wearing of personal protective equipment, frequent hand-washing and disinfecting of surfaces have resulted in an increased risk of irritant or allergic contact dermatitis. The aim of this review is to investigate contact dermatitis associated with COVID-19 pandemic period. Recent findings There is a real evidence of the rising prevalence of irritant and allergic contact dermatitis in response to the COVID-19 pandemic. The most commonly recorded symptoms are dryness, itch and redness of the skin. Nasal bridge, cheeks, forehead and hands represent the mainly affected skin sites. Summary Contact dermatitis lesions may appear as a result of various recommendations to prevent transmission of COVID-19. Procedures to alleviate pressure and friction, gentle skin care and adequate moisturizing, have been identified as important preventive strategies for contact dermatitis related to personal protective equipment and personal hygiene measures.
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Affiliation(s)
- Graziella Babino
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Anna Balato
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
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Joshi A, Rathi SK. Koebner Phenomenon and Pseudo-Koebner Phenomenon Due to Disposable Surgical Masks in the Covid Era. Indian J Dermatol 2022; 67:197-199. [PMID: 36092199 PMCID: PMC9455128 DOI: 10.4103/ijd.ijd_496_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Arun Joshi
- From the Consultant Dermatologist, Department of Dermatology, Farwania Hospital, Farwania, Kuwait
| | - Sanjay K. Rathi
- Consultant Dermatologist, Dr Rathi Skin Clinic, Siliguri, West Bengal, India E-mail:
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Rivers JK, Arlette JP, DeKoven J, Guenther LC, Muhn C, Richer V, Rosen N, Tremblay JF, Wiseman MC, Zip C, Zloty D. Skin care and hygiene among healthcare professionals during and after the SARS-CoV-2 pandemic. SAGE Open Med 2021; 9:20503121211062795. [PMID: 34917384 PMCID: PMC8669117 DOI: 10.1177/20503121211062795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 pandemic has necessitated enhanced protection against viral transmission among healthcare professionals, particularly relating to handwashing and personal protective equipment. Some of these requirements may persist for years to come. They bring associated concerns around skin hygiene and general care, with damage to the face and hands now a well-documented consequence among healthcare professionals. This review assesses optimal skin care during the severe acute respiratory syndrome coronavirus 2 pandemic and in the "new normal" that will follow, identifies current knowledge gaps, and provides practical advice for the clinical setting. Regular, systematic hand cleaning with soap and water or an alcohol-based hand rub (containing 60%-90% ethanol or isopropyl alcohol) remains essential, although the optimal quantity and duration is unclear. Gloves are a useful additional barrier; further studies are needed on preferred materials. Moisturization is typically helpful and has proven benefits in mitigating damage from frequent handwashing. It may be best practiced using an alcohol-based hand rub with added moisturizer and could be particularly important among individuals with pre-existing hand dermatoses, such as psoriasis and eczema. Face moisturization immediately prior to donning a mask, and the use of dressings under the mask to reduce friction, can be helpful dermatologically, but more work is required to prove that these actions do not affect seal integrity. Nonetheless, such measures could play a role in institutional plans for mitigating the dermatologic impact of transmission control measures as we exit the pandemic.
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Affiliation(s)
- Jason K Rivers
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Pacific Derm, Vancouver, BC, Canada
| | - John P Arlette
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Joel DeKoven
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lyn C Guenther
- Division of Dermatology, Western University, London, ON, Canada
- Guenther Research Inc., London, ON, Canada
| | - Channy Muhn
- Division of Dermatology, Department of Medicine, McMaster University, Hamilton, ON, Canada
- Dermetics, Burlington, ON, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Pacific Derm, Vancouver, BC, Canada
| | | | | | - Marni C Wiseman
- Section of Dermatology, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Skinwise Dermatology, Winnipeg, MB, Canada
| | | | - David Zloty
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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Skiveren JG, Ryborg MF, Nilausen B, Bermark S, Philipsen PA. Adverse skin reactions among health care workers using face personal protective equipment during the coronavirus disease 2019 pandemic: A cross-sectional survey of six hospitals in Denmark. Contact Dermatitis 2021; 86:266-275. [PMID: 34865243 PMCID: PMC9302995 DOI: 10.1111/cod.14022] [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: 08/12/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Health care workers (HCWs) report frequent adverse skin reactions (ASRs) due to face personal protective equipment (F-PPE) use during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES To describe self-reported ASRs among HCWs using F-PPE; investigate background factors, such as chronic skin diseases and skin types (dry, oily, combination, sensitive), and determine whether HCWs took preventive methods against ASRs. METHODS An online questionnaire was distributed to 22 993 HCWs at hospitals. RESULTS The prevalence of ASRs was 61.9% based on 10 287 responders. Different types of F-PPE caused different reactions. The most common ASRs from surgical masks were spots and pimples (37.2%) and from FFP3 masks was red and irritated skin (27.3%). A significantly higher proportion of HCWs with chronic skin diseases had ASRs (71.6%) than those without chronic skin diseases (59.7%) (P < .001). Some skin types were more prone to ASRs (sensitive skin [78.8%] vs dry skin [54.3%]; P = .001). HCWs using F-PPE for >6 hours versus <3 hours per day had a four times higher ASR risk (P = <.001). Nearly all HCWs used preventive and/or counteractive methods (94.2%). CONCLUSIONS It is important to consider background factors, such as chronic skin diseases and skin types, to prevent and counteract ASRs due to F-PPE use. HIGHLIGHTS Daily long-term use of face protective equipment increased the risk of adverse skin reaction by four times. Health care workers (HCWs) with chronic skin diseases had significantly more skin reactions than those without. Sensitive skin types were more prone to skin reactions. The skin reactions were higher in HCWs in intensive care units than HCWs in in-patient clinics.
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Affiliation(s)
- Jette G Skiveren
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Malene F Ryborg
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Britt Nilausen
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Susan Bermark
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Peter A Philipsen
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
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Shah P, Luximon Y. Assessment of pressure sensitivity in the head region for Chinese adults. APPLIED ERGONOMICS 2021; 97:103548. [PMID: 34391990 DOI: 10.1016/j.apergo.2021.103548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 07/04/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
Measurement of pressure threshold has found its applications in the fields of medical sciences and product design. Hence it has been a profound area of research interest for several decades. However, hardly any detailed investigation has been undertaken to measure the pressure threshold in the head region. In this study, Pressure Discomfort Threshold (PDT) and Pressure Pain Threshold (PPT) were measured for two hundred eighteen healthy Chinese adults at seventy-six anatomical locations, and further statistical analyses were performed on the acquired data to understand the relationship between different demographic parameters. The results suggest that the pressure sensitivity is low in the vertex region, moderate in the forehead and temporal area, and high in the facial and nasal region. From this study, pressure sensitivity maps were developed for PDT and PPT for Chinese adults. The measured pressure threshold data showed no significant relationship with age and Body Mass Index (BMI).
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Affiliation(s)
- Parth Shah
- School of Design, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.
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Villar RC, Nashwan AJ, Mathew RG, Mohamed AS, Munirathinam S, Abujaber AA, Al‐Jabry MM, Shraim M. The lived experiences of frontline nurses during the coronavirus disease 2019 (COVID-19) pandemic in Qatar: A qualitative study. Nurs Open 2021; 8:3516-3526. [PMID: 33949145 PMCID: PMC8242704 DOI: 10.1002/nop2.901] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
AIM This study aims to explore the lived experiences of frontline nurses providing nursing care for COVID-19 patients in Qatar. DESIGN Qualitative, Phenomenological. METHODS Nurses were recruited from a designated COVID-19 facility using purposive and snowball sampling. The participants were interviewed face-to-face using semi-structured interview questions from 6 September-10 October 2020. The interviews were transcribed and analyzed using Colaizzi's phenomenological method. RESULT A total of 30 nurses were interviewed; (76.7%) were deployed for >6 months. Three major themes were drawn from the analysis: (a) Challenges of working in a COVID-19 facility (subthemes: working in a new context and new working environment, worn out by the workload, the struggle of wearing protective gear, fear of COVID-19, witnessing suffering); (b) Surviving COVID-19 (subthemes: keeping it safe with extra measures, change in eating habits, teamwork and camaraderie, social support); and (c) Resilience of Nurses (subthemes: a true calling, a sense of purpose).
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Affiliation(s)
- Ralph C. Villar
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
| | - Abdulqadir J. Nashwan
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
- University of Calgary in QatarDohaQatar
| | - Rejo G. Mathew
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
| | - Ahmed S. Mohamed
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
| | - Sathish Munirathinam
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
| | - Ahmad A. Abujaber
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
- University of Calgary in QatarDohaQatar
| | - Mahmood M. Al‐Jabry
- Department of NursingHazm Mebaireek General HospitalHamad Medical CorporationDohaQatar
| | - Mujahed Shraim
- Department of Public HealthCollege of Health SciencesQU HealthQatar UniversityDohaQatar
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Yaqoob S, Saleem A, Jarullah FA, Asif A, Essar MY, Emad S. Association of Acne with Face Mask in Healthcare Workers Amidst the COVID-19 Outbreak in Karachi, Pakistan. Clin Cosmet Investig Dermatol 2021; 14:1427-1433. [PMID: 34675578 PMCID: PMC8504703 DOI: 10.2147/ccid.s333221] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
Background In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personal protective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type. Methods This cross-sectional study was carried out at Medicare Cardiac and General Hospital, Jinnah Medical College Hospital, Jinnah Postgraduate Medical Centre and Jamal Noor Hospital located in Karachi, Pakistan. A total of 348 HCWs were interviewed, of which only 193 met the inclusion criteria. All information was recorded on a predesigned proforma and analyzed using SPSS 25.0. Results Among 193 participants, acne was prevalent in 103 (53.4%) participants with maximum cases reported in female HCWs, and in doctors (p<0.05). Out of 73 HCWs using N-95 masks, 46 (44.7%) developed acne, with a p-value of 0.036. Skin type and past history of acne also yielded statistically significant results. Among all the skin types, HCWs with oily skin (64, 62.1%) were prone to face resurgence of acne or new-onset acne. The most common sites of eruption of acne were along the cheeks (45.1%) followed by the nose (40.9%). Majority of the population suffered from mild acne. Moderate and severe acne eruption was particularly observed in those wearing N-95 and surgical masks. Conclusion The use of face masks is associated with high rates of acne eruption. Disseminating the guidelines and indications of World Health Organization (WHO) regarding proper use of mask, encouraging awareness among HCWs and following proper doffing and donning protocol as endorsed by Centers for Disease Control and Prevention (CDC) will possibly minimize the adverse reactions.
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Affiliation(s)
- Sadia Yaqoob
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Amna Saleem
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | | | - Areeba Asif
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Mohammad Yasir Essar
- Department of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Shaista Emad
- Department of Biochemistry, Sohail University, Karachi, Pakistan
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Özkesici Kurt B. The course of acne in healthcare workers during the COVID-19 pandemic and evaluation of possible risk factors. J Cosmet Dermatol 2021; 20:3730-3738. [PMID: 34637186 PMCID: PMC8662215 DOI: 10.1111/jocd.14530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/16/2021] [Accepted: 10/05/2021] [Indexed: 12/19/2022]
Abstract
Background There are a limited number of publications reporting an increase in acne in the COVID‐19 outbreak. Objective The study aimed to evaluate the course and the clinical features of acne and possible risk factors during the COVID‐19 pandemic in healthcare workers. Method A total of 172 physicians (female, n = 159, male; n = 13, mean age = 35.03 ± 5.27 years) who had acne in any period of their life were included in the study. A self‐administered online questionnaire was applied. Results During the COVID‐19 pandemic, 45.35% of the participants reported that their acne complaints increased, 27.33% reported relapses, and 7.56% reported occurrence for the first time. Newly formed acne was reported most frequently on the chin (78.26%). The number of female participants, smoking, increased stress, and the rate of surgical mask use were found to be higher in the group whose acne occurred for the first time, relapsed, or increased than in the group whose acne complaints were unchanged or decreased (p < 0.05). In the group whose acne relapsed or increased, adult‐onset acne, presence of scar, and use of systemic acne treatment before the COVID‐19 pandemic were more common than in the group whose acne complaints were unchanged or decreased (p < 0.05). Conclusion Almost half of the participants reported an increase in acne. More than a third of the participants reported that their acne relapsed or they had acne for the first time. In addition to the use of surgical masks, factors such as increased stress, smoking, adult‐onset acne, presence of scar, and previous systemic acne treatment were found to be responsible for acne development.
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Affiliation(s)
- Birgül Özkesici Kurt
- Clinic of Dermatology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
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Sampe SA, Endah PMMS, Sambo M, Abdu S. Shortage of Personal Protective Equipment and Nurse Safety in the Coronavirus Disease-19 Pandemic: A Cross-sectional Study in Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: There has been a substantial scarcity of personal protective equipment (PPE) in several countries during the ongoing pandemic of Coronavirus disease-19 (COVID-19). Nurses in Indonesia also experience a shortage of PPE as the number of COVID-19 patients in Indonesia continues to increase. There is no accurate data yet regarding the exact number of PPE scarcity for nurses.
AIM: This study aimed to describe the availability of PPE and adverse consequences long-term used off the PPE and examine the relationship between shortage PPE and nurse behavior response in Indonesia.
METHODS: An online-based survey was used to collect data on the nurse, regardless of their discipline, training background, or degree of experience, who are directly involved in managing COVID-19 patients. In this study, a total of 211 questionnaires were gathered. The survey was conducted using the Google form. This study employs univariate and bivariate analysis.
RESULTS: Most of the mask N95 provision reaches up to 80%. The second is the hazmat (71%) and the lowest in the gloves (30%). Around 71% of respondents generally resist removing their PPE until the shift is complete. Then, 62% of the respondents are ready to propose to the leaders of the PPE, and 51% show that they are modifying the PPE. Nasal blisters are the most prevalent type of injury sustained by nurses while wearing PPE (86%), followed by headaches and dehydration. This study found that most respondents (60.7%) with insufficient PPE had a positive behavior reaction, whereas just 18% had a poor behavior reaction.
CONCLUSION: Most nurses have difficulties accessing N95 and experience some adverse effects of prolonging PPE use. Policymakers should take urgent action to tackle these concerns.
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Erize-Herrera JA, García-Mireles V, Uh-Sánchez I, Felix-Téllez F, Encarnación-Martínez M, Estrada-Aguilar L. Manifestaciones dermatológicas en los profesionales de la salud asociadas al uso de equipo de protección personal para la atención de los pacientes con infección por COVID-19 en los hospitales del área metropolitana de la ciudad de México. PIEL 2021. [PMCID: PMC7705331 DOI: 10.1016/j.piel.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers' physical health during the COVID-19 pandemic: A systematic review and meta-analysis. Am J Infect Control 2021; 49:1305-1315. [PMID: 33965463 PMCID: PMC8102386 DOI: 10.1016/j.ajic.2021.04.084] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have been obliged to wear personal protective equipment (PPE). We assessed the impact of PPE use on HCWs' physical health and we examined factors related to a greater risk of adverse events due to PPE use. METHODS We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria. We searched PubMed, Medline, Scopus, ProQuest, CINAHL, and medRxiv from January 1, 2020 to December 27, 2020. RESULTS Our review included 14 studies with 11,746 HCWs. The estimated overall prevalence of adverse events among HCWs was 78% with a range from 42.8% to 95.1% among studies. Among others, the following factors were related to the risk of adverse events among HCWs due to PPE use: obesity, diabetes mellitus, smoking, pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients. CONCLUSIONS The frequency of adverse events among HCWs due to PPE use is very high. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.
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Affiliation(s)
- Petros Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Despoina Fragkou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Daphne Kaitelidou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
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37
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Siwal SS, Chaudhary G, Saini AK, Kaur H, Saini V, Mokhta SK, Chand R, Chandel UK, Christie G, Thakur VK. Key ingredients and recycling strategy of personal protective equipment (PPE): Towards sustainable solution for the COVID-19 like pandemics. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2021; 9:106284. [PMID: 34485055 PMCID: PMC8404393 DOI: 10.1016/j.jece.2021.106284] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/26/2021] [Accepted: 08/25/2021] [Indexed: 05/24/2023]
Abstract
The COVID-19 pandemic has intensified the complications of plastic trash management and disposal. The current situation of living in fear of transmission of the COVID-19 virus has further transformed our behavioural models, such as regularly using personal protective equipment (PPE) kits and single-use applications for day to day needs etc. It has been estimated that with the passage of the coronavirus epidemic every month, there is expected use of 200 billion pieces of single-use facemasks and gloves. PPE are well established now as life-saving items for medicinal specialists to stay safe through the COVID-19 pandemic. Different processes such as glycolysis, hydrogenation, aminolysis, hydrolysis, pyrolysis, and gasification are now working on finding advanced technologies to transfer waste PPE into value-added products. Here, in this article, we have discussed the recycling strategies of PPE, important components (such as medical gloves, gowns, masks & respirators and other face and eye protection) and the raw materials used in PPE kits. Further, the value addition methods to recycling the PPE kits, chemical & apparatus used in recycling and recycling components into value-added products. Finally, the biorenewable materials in PPE for textiles components have been discussed along with concluded remarks.
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Affiliation(s)
- Samarjeet Singh Siwal
- Department of Chemistry, M.M. Engineering College, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana 133207, India
| | - Gauri Chaudhary
- Department of Chemistry, M.M. Engineering College, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana 133207, India
| | - Adesh Kumar Saini
- Department of Biotechnology, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana 133207, India
| | - Harjot Kaur
- Department of Chemistry, M.M. Engineering College, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana 133207, India
| | - Vipin Saini
- Department of Pharmacy, Maharishi Markandeshwar University, Kumarhatti, Solan, Himachal Pradesh, 173229, India
| | - Sudesh Kumar Mokhta
- Department of Environment, Science & Technology, Government of Himachal Pradesh, 171001, India
| | - Ramesh Chand
- Department of Health and Family Welfare, Government of Himachal Pradesh, 171001, India
| | - U K Chandel
- Department of surgery, Indira Gandhi Medical College and Hospital (IGMC), Shimla, Himachal Pradesh 171001, India
| | - Graham Christie
- Institute of Biotechnology, Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge CB2 1QT, UK
| | - Vijay Kumar Thakur
- Biorefining and Advanced Materials Research Center, SRUC, Kings Buildings, Edinburgh EH9 3JG, UK
- Enhanced Composites and Structures Center, School of Aerospace, Transport and Manufacturing, Cranfield University, Bedfordshire MK43 0AL, UK
- Faculty of Materials Science and Applied Chemistry Institute of Polymer Materials, Riga Technical University, P.Valdena 3/7, LV, 1048 Riga, Latvia
- Department of Mechanical Engineering, School of Engineering, Shiv Nadar University, Uttar Pradesh 201314, India
- School of Engineering, University of Petroleum & Energy Studies (UPES), Dehradun, Uttarakhand, India
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38
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Abdali S, Yu J. Occupational Dermatoses Related to Personal Protective Equipment Used During the COVID-19 Pandemic. Dermatol Clin 2021; 39:555-568. [PMID: 34556245 PMCID: PMC8165076 DOI: 10.1016/j.det.2021.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The recent coronavirus disease 2019 (COVID-19) pandemic has led to the dramatic increase in use of personal protective equipment (PPE) among health care providers and the general public. Herein the authors discuss the various occupational dermatoses including allergic and irritant contact dermatitis, acne, seborrheic dermatitis, and rosacea related to frequent handwashing, disinfecting of surfaces, and prolonged wear of various PPE including face masks, gloves, and gowns. The authors provide an overview of published PPE-associated occupational dermatoses during the COVID-19 pandemic and also discuss prevention strategies and treatment options to help patients with these complaints.
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Affiliation(s)
- Selli Abdali
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114, USA.
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Quality of Life, Sleep Quality, Depression, Anxiety, Stress, Eating Habits, and Social Bounds in Nurses during the Coronavirus Disease 2019 Pandemic in Qatar (The PROTECTOR Study): A Cross-Sectional, Comparative Study. J Pers Med 2021; 11:jpm11090918. [PMID: 34575695 PMCID: PMC8468709 DOI: 10.3390/jpm11090918] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
There have been numerous concerns regarding the physical and mental health of nurses during the COVID-19 pandemic. Stress, sleep deprivation, anxiety, and depression potentiated nurses’ vulnerability to poor eating habits. Aims and Objectives: The purpose of this study was to explore the differences between nurses’ characteristics with COVID-19 facility designation, and sleep quality, depression, anxiety, stress, eating habits, social bonds, and quality of life. Design: A cross-sectional, comparative study. Methods: An online survey was sent using the corporation’s email to nurses working in three hospitals in Qatar from September to December 2020. One of them is a designated COVID-19 facility. The sleep quality, depression, eating habits, social bonds, and quality of life were measured using The Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale 21 (DASS-21), Emotional Eater Questionnaire (EEQ), Oslo Social Support Scale (OSSS-3), and the World Health Organization Quality of Life (WHOQOL-BREF), respectively. Results: A total of 200 nurses participated in the study (RR: 13.3%). No statistically significant association was found between designated facility (COVID-19 vs. not COVID-19) or nurses’ characteristics and ISI categories (OR 1.15; 95% CI 0.54, 2.44). Nurses working in COVID-19 facilities had increased odds of having higher EEQ categories by 2.62 times (95% CI 1.18, 5.83). Similarly, no statistically significant associations were found between any of the nurses’ characteristics and OSSS-3 categories. On the other hand, no statistically significant associations were found between any of the nurses’ characteristics and QOL domains except for the gender and social relationships’ domain. Conclusion: Overall, the quality of life of nurses in Qatar is on a positive level whether they are assigned to a COVID-19 facility or not. Although no significant difference was found with regard to the sleep quality, stress, anxiety, depression, and eating habits between nurses in a COVID-19 facility and in a non-COVID-19 facility, special interventions to diminish stressors need to be implemented and maintained.
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40
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Keng BMH, Gan WH, Tam YC, Oh CC. Personal protective equipment-related occupational dermatoses during COVID-19 among health care workers: A worldwide systematic review. JAAD Int 2021; 5:85-95. [PMID: 34485949 PMCID: PMC8407949 DOI: 10.1016/j.jdin.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Occupational dermatoses caused by personal protective equipment (PPE) in the ongoing COVID-19 pandemic are emerging occupational health challenges that must be promptly and effectively addressed to ease burden on our health care workers. Objective A systematic review was conducted to determine common PPE-related dermatoses, affected body sites, and implicated occupational contactants. We further proposed solutions to mitigate this problem. Methods Online databases were searched for articles on PPE-related dermatoses in health care workers during the COVID-19 pandemic written in English and published from January 1, 2020, to January 30, 2021. Results Sixteen studies, including a total of 3958 participants, were included. The most common dermatoses were xerosis, pressure-related erythema, and contact dermatitis, mainly affecting the face and hands. The most widely implicated contactants were increased frequency of hand hygiene, gloves, N95 masks, and goggles. Proposed solutions were categorized as individual self-care, protection of the workforce, and long-term preventive measures. Conclusion Through measures such as regular basic skin care education, early access to specialty clinics via telemedicine, and designing of better-fit PPE, the challenges posed by PPE-related occupational dermatoses can be significantly reduced.
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Affiliation(s)
| | - Wee Hoe Gan
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yew Chong Tam
- Education Resource Centre, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Duke-NUS Medical School, Singapore, Singapore.,Department of Dermatology, Singapore General Hospital, Singapore, Singapore
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41
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Jakhar D, Grover C, Kaur I, Das A, Kaul S. COVID-19 and Healthcare Worker: What We Need to Know. Indian J Dermatol 2021; 66:264-271. [PMID: 34446949 PMCID: PMC8375534 DOI: 10.4103/ijd.ijd_462_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
COVID-19 pandemic has challenged and overwhelmed most healthcare institutions and healthcare workers, across the world. Despite being unprepared for this pandemic, frontline workers have worked relentlessly to provide the much-needed care to these patients. Doctors from different branches of medicine, including dermatologists, came forward and played a substantial role in mitigating the impact of this pandemic on the general population. Sadly, in the process, these healthcare workers faced many personal, social, psychological, economic, and health-related issues. The psychological burden and health-related issues received due attention in the main-stream news as well as scientific research papers. With most frontline workers isolated from their families, social media became the new platform to reduce the sense of isolation and share their anxiety, insomnia, and fatigue. This article is aimed at highlighting various challenges faced by healthcare workers during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Deepak Jakhar
- Consultant Dermatologist, Dermosphere Clinic, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Chander Grover
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Ishmeet Kaur
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Subuhi Kaul
- Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
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42
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Altun E, Topaloglu Demir F. Occupational facial dermatoses related to mask use in healthcare professionals. J Cosmet Dermatol 2021; 21:2535-2541. [PMID: 34450685 PMCID: PMC8662203 DOI: 10.1111/jocd.14415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/17/2021] [Indexed: 01/24/2023]
Abstract
Background Mask use can lead to facial dermatoses due to factors, such as hyperhydration, seborrhea, high humidity caused by sweating, and the occlusive effect of the mask. Aim We investigated mask‐related facial dermatoses in healthcare personnel who, since the beginning of the COVID‐19 pandemic, had to wear a mask for long hours. Methods In this study, healthcare professionals working at Medipol Mega University Hospital since the beginning of the pandemic were screened for facial dermatoses between December 2020 and February 2021 with a dermatological examination and interview. Results Of the 101 healthcare professionals, 51 (50.5%) were doctors and 50 (49.5%) nurses, and 36 (35.6%) were male and 65 (64.4%) were female. All the participants had been actively working at the hospital for 35–46 weeks since the beginning of the pandemic and wearing N95 or surgical masks for an average of 6–13 h a day. During the dermatological examination, the most common facial dermatosis was acne, which was observed in 55.4% (n = 56) of the cases. Of the 56 acne cases, 41.1% (n = 23) had acne in their history, while 58.9% (n = 33) had new‐onset acne. Being female, using a N95 surgical mask compared to surgical mask, and the daily average duration of mask use were determined as risk factors for acne development due to mask use. Conclusions The use of masks, more frequently N95, caused both an increase in existing acne and the development of new acne.
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Affiliation(s)
- Ece Altun
- Department of Dermatology and Venereology, Istanbul Medipol University, Istanbul, Turkey
| | - Filiz Topaloglu Demir
- Department of Dermatology and Venereology, Istanbul Medipol University, Istanbul, Turkey
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43
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Olisova OY, Teplyuk NP, Grekova EV, Lepekhova AA. Dermatoses caused by face mask wearing during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2021; 35:e738-e741. [PMID: 34310757 PMCID: PMC8447160 DOI: 10.1111/jdv.17546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
- O Yu Olisova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N P Teplyuk
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - E V Grekova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A A Lepekhova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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44
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Schwensen JF, Simonsen AB, Zachariae C, Johansen JD. Facial dermatoses in healthcare professionals induced by the use of protective masks during the COVID-19 pandemic. Contact Dermatitis 2021; 85:710-711. [PMID: 34296441 PMCID: PMC8444920 DOI: 10.1111/cod.13948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Jakob Fb Schwensen
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne Birgitte Simonsen
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, University of Copenhagen - Herlev and Gentofte Hospital, Copenhagen, Denmark.,National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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45
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Han HS, Shin SH, Park JW, Li K, Kim BJ, Yoo KH. Changes in skin characteristics after using respiratory protective equipment (medical masks and respirators) in the COVID-19 pandemic among healthcare workers. Contact Dermatitis 2021; 85:225-232. [PMID: 33813749 PMCID: PMC8251455 DOI: 10.1111/cod.13855] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/19/2021] [Accepted: 03/31/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) outbreak has presented unique dermatologic challenges due to respiratory protective equipment (RPE)-related skin conditions. OBJECTIVE To objectively evaluate the effects of RPE including medical masks and respirators on the skin barrier by measuring various physiological properties of the skin. METHODS A cross-sectional study was designed. Twenty healthy healthcare workers were included in this study. Skin parameters including skin hydration, transepidermal water loss (TEWL), erythema, sebum secretion, pH, and skin temperature were measured in the RPE-covered and RPE-uncovered areas of the face 4 and 8 hours after wearing RPE and 14 hours after not wearing RPE. RESULTS Skin hydration, TEWL, erythema, pH, and skin temperature increased in the RPE-covered areas after wearing RPE for 4 and 8 hours. By contrast, in the RPE-uncovered areas, skin hydration decreased and TEWL, erythema, and pH showed minimal changes over time. Based on the repeated-measure analysis, the changes in skin physiological properties over time were significantly different between RPE-covered and RPE-uncovered areas. CONCLUSION We observed that skin physiological characteristics change with the prolonged use of RPE such as medical masks and respirators. These changes may lead to various adverse skin reactions after long-term use.
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Affiliation(s)
- Hye Sung Han
- Department of DermatologyChung‐Ang University College of MedicineSeoulSouth Korea
| | - Sun Hye Shin
- Department of DermatologyChung‐Ang University College of MedicineSeoulSouth Korea
| | - Jae Wan Park
- Department of DermatologyChung‐Ang University College of MedicineSeoulSouth Korea
| | - Kapsok Li
- Department of DermatologyChung‐Ang University College of MedicineSeoulSouth Korea
| | - Beom Joon Kim
- Department of DermatologyChung‐Ang University College of MedicineSeoulSouth Korea
| | - Kwang Ho Yoo
- Department of DermatologyChung‐Ang University College of MedicineSeoulSouth Korea
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46
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Dowdle TS, Thompson M, Alkul M, Nguyen JM, Sturgeon ALE. COVID-19 and dermatological personal protective equipment considerations. Proc (Bayl Univ Med Cent) 2021; 34:469-472. [PMID: 34219927 DOI: 10.1080/08998280.2021.1899730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Cutaneous injury and irritation among health care workers has substantially risen during the COVID-19 pandemic. In a field already laden with skin-induced injury and irritation due to high levels of handwashing and glove wearing, increases have been reported in handwashing-induced xerosis, irritant dermatitis, and contact dermatitis from N95 respirators and other surgical masks. Masks, goggles, face shields, and gloves all potentially create abrasions from long hours of use, leading to itching, pain, and aggravation of underlying skin conditions. Personal protective equipment (PPE)-related skin injury can be serious, and the American Academy of Dermatology has released recommendations on preventing and treating occupationally induced dermatologic conditions during the COVID-19 pandemic. These are reviewed and discussed in conjunction with overarching guidelines for mitigating the spread of the virus.
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Affiliation(s)
- Travis S Dowdle
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Mallory Thompson
- School of Medicine, Texas Christian University/University of North Texas Health Science Center, Fort Worth, Texas
| | - Mahmud Alkul
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Jeannie M Nguyen
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Ashley L E Sturgeon
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas
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47
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Abstract
ABSTRACT Protecting nurses in healthcare facilities from SARS-CoV-2 infection is essential for maintaining an adequate nursing force. Foundational guidelines, consistently utilized, protect the nursing staff from infection. This article describes guidelines designed to reduce acute infection and associated morbidity and mortality among nursing staff and improve compliance with infection prevention protocols.
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Affiliation(s)
- Terrance L Baker
- Terrance L. Baker is a staff physician at Johns Hopkins Medicine in Baltimore, Md., and associate faculty at the University of Maryland School of Nursing in Baltimore, Md., and State University of New York at Stony Brook School of Nursing in Brookhaven, N.Y. Jack V. Greiner is an associate professor of ophthalmology at Harvard Medical School in Boston, Mass. Modesta Vesonder is associate faculty at the University of Maryland School of Nursing in Baltimore, Md., and CEO of Katani Hospital in Katani, Kenya
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48
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Kudukkil Thazhathuveettil S, Kavanal AJ, Vinay K, Sahoo S, Suri V, Malhotra P. Localized mid face miliaria in a healthcare worker due to N95 respirator use: A case report and management strategies. Dermatol Ther 2021; 34:e14809. [PMID: 33492777 PMCID: PMC7995192 DOI: 10.1111/dth.14809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Anwin Joseph Kavanal
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology, and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Swapanjeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Reasearch, Chandigarh, India
| | - Vikas Suri
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of clinical hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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49
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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: 40] [Impact Index Per Article: 13.3] [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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50
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Hoernke K, Djellouli N, Andrews L, Lewis-Jackson S, Manby L, Martin S, Vanderslott S, Vindrola-Padros C. Frontline healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal. BMJ Open 2021; 11:e046199. [PMID: 33472794 PMCID: PMC7818840 DOI: 10.1136/bmjopen-2020-046199] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To report frontline healthcare workers' (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs' fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic. DESIGN A rapid qualitative appraisal study combining three sources of data: semistructured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145 000 social media posts) and government PPE policies (n=25). PARTICIPANTS Interview participants were HCWs purposively sampled from critical care, emergency and respiratory departments as well as redeployed HCWs from primary, secondary and tertiary care centres across the UK. RESULTS A major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national level guidance was often not feasible when there were shortages, leading to reuse and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about differential access to adequate PPE, particularly for women and Black, Asian and Minority Ethnic HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use. CONCLUSION This study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs.
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Affiliation(s)
- Katarina Hoernke
- Institute for Global Health, University College London, London, UK
| | - Nehla Djellouli
- Institute for Global Health, University College London, London, UK
| | - Lily Andrews
- Institute of Epidemiology and Health Care, University College London, London, UK
| | | | - Louisa Manby
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sam Martin
- Oxford Vaccine Group, University of Oxford, Oxford, UK
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