Hand Hygiene Habits and Prevalence of Hand Eczema During the COVID-19 Pandemic

Modified glove removal technique to prevent hand contamination in routine phlebotomy

The World Health Organization and the Centers for Disease Control and Prevention (CDC) have established guidelines recommending the performance of hand hygiene routines for healthcare workers following glove removal. However, the completion of frequent hygiene routines can cause allergic and adverse skin reactions. This double-blind, randomized study aimed to address this concern by developing and evaluating a modified glove removal technique that minimizes contamination risk during routine phlebotomy procedures. Furthermore, this study used fluorescent detection to compare the frequency of contamination associated with the CDC-recommended technique and the modified technique using fluorescent detection. One hundred healthcare personnel were enrolled and divided into two groups: one group followed the CDC technique, while the other group implemented the modified technique. Participants received instructional videos and practiced under supervision. They subsequently performed blood collection using a simulation arm covered with fluorescent cream as a contamination marker. After removing gloves, hand contamination was assessed under a black light. The median time required for glove removal in the modified group was four seconds longer than that in the group that followed the CDC technique (p < 0.001). Contamination was observed in 2% (1/50) of subjects using the CDC-recommended technique, while no contamination was detected with the modified technique (p ≥ 0.05). Both the group that followed the CDC technique and the group that used modified glove removal techniques demonstrated the potential to prevent contamination during phlebotomy, thereby reducing the need for hand hygiene and the occurrence of contamination and adverse skin reactions. These findings prompt further exploration into whether proper glove removal can reduce the frequency of completing a hand hygiene routine after each glove removal, specifically within the context of phlebotomy. However, it is essential to note that hand hygiene following glove removal is still recommended to prevent contamination. Further research is warranted to validate these findings.

Correlation between serum 25(OH)D levels with severity of work-related hand eczema among healthcare workers: a cross-sectional study

Hand eczema (HE) is a common condition seen in medical facilities, particularly during the COVID-19 pandemic. The effects of vitamin D on skin inflammation are diverse. The purpose of this study is to examine the relationship between vitamin D levels in healthcare workers as determined by serum 25(OH)D and the severity of HE. In Indonesia, between September and October of 2022, a cross-sectional design was employed for this analytical descriptive study. The hand eczema severity index was used to determine the severity of HE. Out of the 44 healthcare workers who had HE, the findings indicated that 29 had mild HE, 11 had moderate HE, and 4 had severe HE. Subjects with mild, moderate, and severe HE had mean serum 25(OH)D levels of 17.85 ng/mL, 16.45 ng/mL, and 17.87 ng/mL, respectively, falling into the vitamin D deficiency category. Serum 25(OH)D levels and the severity of HE did not significantly correlate (r=-0.056; p=0.359). Serum 25(OH)D levels did not significantly differ between subjects with mild, moderate, and severe HE. The degree of HE was not negatively correlated with serum 25(OH)D levels.

Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy

Introduction

During the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors.

Methods

The survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire.

Results

HCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information.

Discussion

The survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.

Hand Eczema in High School Students in Poland: A Cross-sectional Study

Abstract is missing (Short communication)

A prospective randomized controlled trial of Psychodermatology on the efficacy of Rilastil Difesa Sterile® cream in the hand eczema of healthcare workers during the COVID-19 pandemic

Hand eczema is one of the most frequent dermatological diseases, with an incidence increased during the COVID-19 pandemic. The impact on life quality is considerable, giving rise to the need for a psycho-dermatological approach. This is a Randomized Control Trial (RCT) evaluating, either by the dermatological or psychological point of view, the effectiveness of an emollient and rehydrating topical product (Rilastil Difesa Sterile® cream) versus a standard treatment (i.e. moisturizing basic cream) in a group of 51 healthcare workers suffering from hand eczema during the COVID-19 pandemic. The enrolled subjects were randomized into a treatment or a control arm, treated for 8 weeks, and monitored through a clinical score (HECSI) and questionnaires evaluating the impact of the pathology and treatment on quality of life (DLQI and QOLHEQ). A psychometric evaluation was performed using the SCL-90 R, OCI-R, and CPDI scales. Our data, despite not reaching the statistical significance, demonstrated that both the clinical and psychological scores decreased mostly in patients treated with Rilastil Difesa Sterile® cream when compared to those treated with simple topical emollients. Moreover, we observed a high level of psychic suffering in dermatological patients and a parallel change in dermatological and psychological indicators, thus confirming their connection.

Hand Eczema in the Polish Female Population

BACKGROUND

This study aims to investigate the prevalence of hand eczema, its association with disinfectant usage during the COVID-19 pandemic, and potential correlations with age and dermatological history on hand symptoms in the Polish female population.

METHODS

A personalized online questionnaire was administered from January to March 2021 to 142 participants, including individuals with hand eczema. The questionnaire addressed demographics, dermatological history, disinfectant usage, and symptoms experienced during the pandemic.

RESULTS

The prevalence of hand eczema was higher in younger adults (aged 18-35), with significant exacerbations reported due to increased disinfectant usage. Respondents with a dermatological history were more susceptible to new skin symptoms during the pandemic. The quality of life was substantially impacted, particularly in individuals with hand skin dermatoses.

CONCLUSIONS

The COVID-19 pandemic had a considerable influence on hand eczema, affecting prevalence, symptoms, and quality of life. Disinfectant usage emerged as a key factor in exacerbating hand skin lesions. Further research is warranted to explore the influence of specific disinfecting agents and improve treatment guidelines for personalized management of hand eczema. Despite limitations in the online survey method, these findings highlight the importance of proactive healthcare support for individuals with hand eczema during challenging times.

Soap or alcohol-based products? The effect of hand hygiene on skin characteristics during the COVID-19 pandemic

BACKGROUND

Different strategies for hand skin hygiene have been used to prevent the spread of SARS-CoV-2. However, frequent hand sanitization has been associated with skin damage. The present study aimed to evaluate hand hygiene habits during the COVID-19 pandemic and the effect of the repetitive use of soap or alcohol-based products on skin characteristics.

METHODS

We conducted a survey regards hand hygiene habits acquired during the COVID-19 pandemic. Also, we performed cutometry in a cohort of individuals who cleansed their volar forearms every 30 min, during 4 h, using soap or alcohol-based products.

RESULTS

We received 138 responses from people with medium-high educational level who reported a 2.5-time increase in the frequency of hand cleansing (p < 0.0001) that resulted in skin damage. An in vivo analysis of skin moisture and elasticity was also performed among 19 health workers and students. In general, skin moisture decreased with every cleansing, mainly after 2 h of washing with soap (p < 0.01), while skin elasticity only reduced after 4 h of treatment (p < 0.05). Alcohol-based solution or alcohol-based gel (70% ethanol, both) did not affect skin moisture or elasticity during testing.

CONCLUSION

It is known that the excessive use of soap or alcohol-based products causes dermatological issues. The present study demonstrates that non-medicated soap significantly affects skin moisture and elasticity, probably because the soap removes the hydrolipidic protective barrier, favoring transepidermal water loss, where the lack of the appropriate stratum corneum hydration also affects skin elasticity, mainly associated with changes in epidermal structure.

Dermatological impact of hand hygiene practices during COVID-19: A cross-sectional web-based survey among doctors in a tertiary care hospital in Eastern India

BACKGROUND

The COVID-19 pandemic continues to persist throughout the world with intermittent exacerbation. The changing trend of hand hygiene practices during this pandemic has led to new onset or aggravation of pre-existing hand eczema, especially among doctors. There is a paucity of studies regarding skin changes seen with changing hand hygiene practices in the Indian subcontinent.

OBJECTIVES

To estimate the frequency of various cutaneous manifestations and associated factors with hand hygiene practices in doctors during COVID-19 via a web-based online questionnaire survey.

METHODS

It was a cross-sectional web-based survey conducted at a tertiary care teaching institute from July 2021 to September 2021. Those doctors (faculty, residents, and interns) of the hospital completing the questionnaire with electronic informed consent were included in the study.

RESULTS

A total of 143 doctors completed the survey. The most common symptoms were dryness in 60 (42%) and itching in 25 (17.5%) doctors. The most common skin changes were scaling in 30 (21%) and redness in 16 (11.2%) doctors. There was a significant association between skin changes and frequency of hand washing and hand sanitizer use (p value < 0.05).

CONCLUSION

The prevalence of hand changes and symptoms was 77% in doctors in our study. The most commonly seen hand changes were scaling followed by redness and symptoms observed were dryness and itching.

The relationship of skin disorders, COVID-19, and the therapeutic potential of ginseng: a review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made significant impacts on global public health, including the development of several skin diseases that have arisen primarily as a result of the pandemic. Owing to the widespread expansion of coronavirus disease 19 (COVID-19), the development of effective treatments for these skin diseases is drawing attention as an important social issue. For many centuries, ginseng and its major active ingredients, ginsenosides and saponins, have been widely regarded as herbal medicines. Further, the anti-viral action of ginseng suggests its potential effectiveness as a therapeutic agent against COVID-19. Thus, the aim of this review was to examine the association of skin lesions with COVID-19 and the effect of ginseng as a therapeutic agent to treat skin diseases induced by COVID-19 infection. We classified COVID-19-related skin disorders into three categories: caused by inflammatory, immune, and complex (both inflammatory and immune) responses and evaluated the evidence for ginseng as a treatment for each category. This review offers comprehensive evidence on the improvement of skin disorders induced by SARS-CoV-2 infection using ginseng and its active constituents.

Questionnaire-Based Study Evaluating the Hand Hygiene Practices and the Impact of Disinfection in the COVID-19 Pandemic on Hand Skin Conditions in Poland

During the COVID-19 pandemic, disinfection became an integral part of everybody's life in order to avoid spreading the coronavirus. In 2021, an original anonymous online survey was carried out. The questions concerned the usage of disinfectants. The study population included 56 subjects diagnosed by a physician with hand eczema (HE-derm group) and 114 subjects with no hand skin disease diagnosed by a specialist (non-derm). The HE and non-HE groups were distinguished. Nearly 80% of the HE group, and 10% of the non-HE group, experienced worsening of hand skin lesions caused by increased skin disinfection. HE-group respondents more often declared the occurrence of new hand skin symptoms, over 80% of the subjects of this group had more than 1 new symptom (compared to nearly 40% of the non-HE group). Exacerbations of the skin disease were more frequently observed by the HE group during the pandemic. There was a statistically significant decrease of the quality of life in the HE group compared to the non-HE group during the pandemic. The COVID-19 pandemic caused an increase in the prevalence of hand skin symptoms and deterioration of the skin condition. Education on appropriate disinfection techniques and skincare, as well as early dermatological intervention, might allow us to limit the development of hand skin diseases.

The Adverse and Advantage Effects of Wearing a Facemask in Thai Children: A Survey During the COVID-19 Pandemic

BACKGROUND

There is little information on facemask use during the COVID-19 pandemic in the pediatric population. This became the main purpose of the present study to investigate demographic data of facemask wearing in children, types, and length of facemask, as well as the benefits, drawbacks, and negative consequences of facemask wearing in this population.

METHODS

A cross-sectional study was conducted using a structured questionnaire sent via Google Forms. Caregivers for consecutive convenience were asked in the survey (parents of children under the age of 18).

RESULTS

A total number of 706 children were enrolled. There were 320 boys (45.33%), and 386 girls (54.67%). The children's ages range between 4 months and 18 years, with a median age of 9 years. A surgical mask (549, 77.76%) was the most frequent type of facemask in the study population, followed by a cloth mask (86, 12.18%). Facemasks have been shown to be beneficial in the pediatric population. When compared to a former time when facemasks were not used routinely, there were considerably fewer respiratory infections, reduced diarrhea symptoms, and a drop in hospital admissions. In 317 cases (44.9%), children were shown to have negative consequences from wearing facemasks. The most prevalent adverse effect observed in the study population was non-cutaneous (respiratory discomfort/breathing difficulty) which were found in 240 cases (33.99%). Double masking method (surgical + surgical) and wearing a facemask oversize revealed a higher risk in the presence of facemask adverse effects, whereas wearing a proper size facemask reduces the risk of adverse effects from facemask use in children (Adjusted OR [95% CI] = 0.55 [0.38-0.78], P .0003).

CONCLUSIONS

Wearing a proper-size facemask reduces the risk of adverse effects from facemask use in children. The future suggestion of an appropriate facemask size for a certain age will aid in the avoidance of facemask adverse effects in the pediatric population.

Hand hygiene and hand eczema: a systematic review and meta-analysis

Hand eczema is a common inflammatory condition of the skin that has been linked to hand hygiene. This systematic review and meta-analysis aims to determine the risks of hand eczema associated with hand hygiene, including frequency of handwashing, wet-work and use of alcohol hand rub. A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed for cohort, case-control or cross-sectional studies that analysed the association between hand hygiene and risk of hand eczema. Results of individual studies were presented in respective forest plots and pooled summary relative risks were estimated using a random-effects model. Forty-five studies were included in analysis. Handwashing at least 8-10 times daily significantly increased risk of hand eczema (relative risk [RR] 1.51; 95% confidence interval [CI]: 1.35-1.68; P < .001). The risk was related to handwashing frequency, with higher pooled RR of 1.66 (95%CI: 1.51-1.83; P < .001) with increased handwashing at least 15-20 times daily. However, use of alcohol-based hand sanitizer was not significantly associated with risk of hand eczema. Given the widespread implementation of hand hygiene practices during the COVID-19 pandemic, there is a pertinent need to understand skin care habits specific to the hands to avoid a greater incidence of hand eczema. This article is protected by copyright. All rights reserved.

REVEALING THE MOLECULAR-GENETIC AND CLINICAL PREDICTORS OF GLUCOCORTICOID RESISTANCE IN PATIENTS WITH HAND ECZEMA

OBJECTIVE

The aim: To reveal the possible predictors of the glucocorticoid resistance in patients with hand eczema (HE) based on the demographic, clinical, and molecular-genetic data.

PATIENTS AND METHODS

Materials and methods: 143 patients with HE were included in the study. Demographic, clinical, biochemical (blood content of IgE, IL-17A, IL-2, 25(OH)D), and genetic (rs41423247 genotypes) data were obtained from all patients.

RESULTS

Results: After 2 weeks of treatment by glucocorticoids, all subjects were divided into "responder" and "non-responder" groups according to change of the Hand Eczema Severity Index (HECSI). Statistical analysis was done using SPSS (version 22.0.). Binary logistic regression was used to identify predictors of glucocorticoid resistance. P-value 0.05). The results of the multivariate regression showed that Bcl-1 G-allele (OR =3.83; P = 0.033), and severe eczema (OR = 2.52; P = 0.023) are linked with an elevated risk of glucocorticoid resistance in patients with hand eczema.

CONCLUSION

Conclusions: Insensitivity to glucocorticoids in HE patients is associated with NR3C1 gene Bcl-1 polymorphism, eczema severity and blood level of IL-17, IL-2, 25(OH)D. The final adjustment showed that minor C-allele of the Bcl-1 polymorphism and severe eczema are the strongest predictors of the glucocorticoid resistance.