An article published in Dermatologic Therapy stated that the diagnosis of COVID-19 is based primarily on clinical findings – for example, fever, fatigue, dry cough, pneumonia, headache, diarrhea, hemoptysis, dyspnea, rhinorrhea, or radiological findings. Triage of in-patients is an important step before strategizing treatment. Preventive measures of importance in clinical dermatology include – surface disinfection with ethanol (62%-71%), 0.1% sodium hypochloride, or 0.5% hydrogen peroxide. The use of sanitary masks, gloves and protective eyewear by physicians and healthcare personnel, as well as hand washes and disinfection with alcoholic solutions. 

The authors informed that since more frequent hand sanitization is necessary, the use of alcoholic hand disinfectants should be preferred as they preserve the epidermal barrier better than handwashing with soap. Additionally, disinfection of the medical staff must be practiced after direct contact with a patient and before and after surgical procedures. Unwanted side effects of precautionary measures during this pandemic are – skin disorders and/or aggravated preexisting skin disease with the use of personal protective equipment; appearance of facial inflammatory papules due to prolonged use of protective goggles; delayed pressure urticaria;hyperhidrosis causing increased risk for bacterial and fungal skin infections; acne and aggravation of rosacea; seborrheic dermatitis; and facial itching could occur.

For this, a combination of paper towels with facial masks has been recommended to reduce moisture. Also, cleansing of hands should be practiced before the wearing of protective gloves, such that hands are clean, disinfected and dry. After changing gloves, a hand wash is recommended followed by a skin moisturization to prevent disruption of the epithelial barrier. Moisturizers alone or in combination with barrier creams can confer significantly improved protection against occupational hand dermatitis in the shortterm and in the longterm perspectives.

Other preventive guidelines include – reduction of dermoscopy; selection of patients; disinfection of body area and dermatoscope; and mandatory application of protective covers for the dermatoscope.

It was inferred that dermatologists are important in preventive measures of the health care staff and in the differential diagnosis of generalized rash with fever. They also need to guide patients with severe inflammatory skin disease and systemic drug therapy. Furthermore, ethical care for advanced skin cancer patients poses a major challenge.

Source: Dermatologic Therapy. 2020 Sep;33(5):e13430. doi: 10.1111/dth.13430.