A new article published in Journal of the American Academy of Dermatology reported a high incidence of cutaneous complications related to prevention measures among health care workers treating patients with epidemic coronavirus (COVID-19) infection. The authors expressed that it may be difficult to continue wearing protective gear in the face of cutaneous ulceration, and attempts to shift points of pressure and abrasion may reduce the effectiveness of the protective mask.

It was reported that the prevalence of skin damage related to enhanced prevention measures was 97.0% among frontline health care workers and included cutaneous lesions affecting the nasal bridge, hands, cheek and forehead. The nasal bridge was the most commonly affected site (83.1%). Additionally, frequent hand hygiene was associated with a higher incidence of hand dermatitis. Whereas, the length of time wearing the face shield was not significantly associated with the risk of facial lesions. It was not the N95 mask alone but also goggles that were implicated in most injuries.

It was proposed that shorter rotating shifts in high-intensity protective gear may reduce the incidence of skin ulceration, but goggle fit may be more important and preemptive measures have the potential to preserve the workforce and reduce the risk of infection among hospital workers.

Atopy, winter season, low humidity, frequency of hand washing, wet work, glove use, and duration of employment are important risk factors for hand dermatitis among medical personnel, and positive irritant patch tests with a low concentration of sodium lauryl sulfate can predict those at highest risk. Latex-free gloves are now standard in many hospitals and clinicsand efforts to reduce repetitive exposure to low-level irritants have potential to decrease occupational skin disease.

Outbreaks of COVID-19 are now being reported across the globe, and we can learn from the experience of those who have fought this infection on the front lines. In inference, it was stated that prevalence of skin disease related to protective equipment is high and simple interventions, including the use of adhesive barrier films before donning protective gear, may help preserve the workforce vital for caring for patients with the disease.

Source: Journal of the American Academy of Dermatology. 2020 May; 82(5): 1085–1086. Published online 2020 Mar 18. doi: 10.1016/j.jaad.2020.03.012