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Introduction: Currently, only little data is available on the impact of the COVID-19 pandemic on inpatient dermatosurgical care in German dermatological clinics., Methods: A retrospective analysis of all dermatosurgical cases that were treated in inpatient setting in nine German dermatological clinics in four federal states in 2019, 2020 and 2021 was performed. The diagnoses were recorded using the ICD-10 codes. In addition, demographic data such as age, gender and the length of inpatient stay were analysed., Results: In 2019, 2020 and 2021, a total of 10,739, 9185 and 9828 dermatosurgical inpatients were treated respectively. Thus, the reduction of inpatient dermatosurgical cases was 14.5% in 2020 and 8.5% in 2021 compared to 2019. Inpatient surgical treatment of melanoma decreased by 10.1% of cases in 2020. This decrease was only 1.4% in 2021 compared to 2019. The number of inpatient surgeries performed for benign lesions such as melanocytic nevi or viral warts reduced sharply in both pandemic years., Conclusion: Our data show for the first time how inpatient care for the entire spectrum of dermatosurgical diseases developed during the COVID-19 pandemic in Germany. After the initial marked decline in inpatient dermatosurgical cases in 2020, there was less difference in 2021 compared to 2019. This trend can be interpreted as an indication that there is still a strong need for inpatient dermatosurgical care that cannot yet be met on an outpatient basis., (© 2024. The Author(s).)

Introduction: Coronavirus disease (COVID-19) quickly became a pandemic causing a global concern affecting public health directly and indirectly. Dermatology outpatient services were not an exception to the impact of COVID-19, especially in Sub-Saharan Africa. To the best of our knowledge, no similar study has been done in this region, and identifying patterns of dermatological diseases would help prepare adequately for future crises., Objective: This study examined the changes in diagnostic patterns at the dermatology clinic before the COVID-19 pandemic and during the pandemic., Methods: This retrospective study was conducted on dermatology outpatients seen at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Diagnoses were compared during the pandemic (March to August 2020) with the corresponding period of the previous year., Results: A total of 534 patients with 559 diagnoses were included. The average weekly dermatology clinic visits remained unchanged during the pandemic, although there was a 25.8% reduction in dermatology outpatients. The most common reasons for visiting the outpatient clinic during the COVID-19 pandemic were acne vulgaris, scabies, atopic dermatitis, dermatophytosis, and pityriasis versicolor. While the percentage of scabies significantly decreased during the pandemic; the percentage of allergic contact dermatitis, prurigo nodularis, candidiasis, hemangioma, and lupus erythematosus increased respectively., Conclusion: Although the COVID-19 pandemic had a negligible impact on the average weekly number of skin clinic visits, it caused a change in diagnostic patterns. Understanding the pattern of skin diagnoses may help hospitals better prepare for future pandemics., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Previous research has not investigated the persistent cutaneous immune-related adverse events (cirAEs) related to long COVID to investigate the long-term sequelae. This multinational study, using a propensity-matched overlap weighting method, utilizes large national claims-based cohorts, using ICD-10 code diagnosis, focusing on patients aged ≥20 years from three countries: South Korean, Japanese, and the British cohorts. To estimate the risk of cirAEs in long COVID, the persistence or emergence of cirAEs occurring 4 weeks after the initial SARS-CoV-2 infection, we employed a Cox proportional hazard regression model. The Korean cohort (n = 5,937,373; mean age 49.2 years [SD: 13.2]), the Japanese cohort (n = 4,307,587; 42.5 years [13.6]), and the UK cohort (n = 395,435; 71.0 years [8.07]) were presented. An increased risk of cirAEs in long COVID was observed (HR, 1.10; 95% CI, 1.06-1.14) in Korean cohort, while a similar association was observed in Japanese and UK cohorts. The long-term risk of cirAEs in long COVID was higher in more severe COVID-19 cases (1.31; 1.22-1.39). Unlike the increased risk of cirAEs in long COVID, COVID-19 vaccination attenuated the risk, especially with two or more doses (1.03; 0.95-1.11) or heterologous regimens (0.98; 0.76-1.27). The time attenuation effect indicated a sustained risk for up to 6 months postinfection (<3 months: 1.13 [1.07-1.19]; 3-6 months: 1.14 [1.06-1.22]). SARS-CoV-2 infection is associated with an increased risk of cirAEs in the aspect of long COVID. Vaccination might reduce this risk, highlighting the need for preventive strategies in long COVID management., (© 2024 Wiley Periodicals LLC.)

Scientists from various areas of the world indicate in their studies that skin lesions occur in the course of infection with the SARS-CoV-2 virus. This article is a review of the most frequently described cutaneous manifestations of SARS-CoV-2 virus infection and the potential pathophysiology of their development, as well as information on abnormalities in histopathological tests. The article describes the impact of some factors related to the COVID-19 pandemic on the exacerbation of chronic dermatological diseases. This work was constructed on the basis of 142 research studies, reviews, and meta-analyses, focusing on the methods and materials used in individual works as well as the results and conclusions resulting from them. Some skin lesions may be a potential prognostic marker of the course of the disease and may also be a prodromal symptom or the only symptom of SARS-CoV-2 virus infection. Stress related to the COVID-19 pandemic may exacerbate some chronic dermatological diseases. A correlation was observed between the type of skin lesions and the patient's age. The occurrence of skin diseases may also be influenced by drugs used to treat infections caused by SARS-CoV-2. A relationship was observed between the patient's ethnic origin and skin lesions occurring in the course of COVID-19. There is a need to further diagnose the cutaneous manifestations of SARS-CoV-2 infection and to learn the detailed pathomechanism of their occurrence in order to better understand the essence of the disease and find an appropriate treatment method., (© 2024. The Author(s).)

Background: Skin manifestations' true prognostic value, and clinical and epidemiological pictures in SARS-CoV-2 infection in African populations are poorly described and understudied. More familiarity with COVID-19 cutaneous manifestations may aid in early clinical diagnosis or guide prognosis., Methods: In this literature review, we looked for potential studies published from December 2019 to March 2023 on COVID-19 cutaneous lesions in African populations. Our key questions were focused on the prognostic values of cutaneous manifestations related to COVID-19., Results: Our findings show that cutaneous manifestations of COVID-19 vary by country and severity of COVID-19, primarily multisystem inflammatory syndrome (MIS). Significant differences were also found between various dermatological lesions, primarily MIS, erythema multiforme-like, livedoid, vesicular, or varicella-like rashes, urticarial, maculopapular or morbilliform rashes, and chilblain-like or pernio-like rashes. There were 47.5% (115/242) of MIS cases reported in nine published African studies. Our findings also revealed that MIS may be diagnosed in 2-7 days due to early onset rash. Advanced age, obesity, diabetes, cardiovascular disease, HIV, tuberculosis, asthma, atopic disease, underweight, malnutrition, and malignancy were found to be associated with COVID-19 cutaneous manifestations in African populations., Conclusions: COVID-19-related skin manifestations in African populations are important as a driving force in COVID-19 prognosis., (© 2023 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Background: Although Dermatology is largely considered an outpatient specialty, there is an increasing need for Dermatology input in the acute and inpatient setting. During the COVID-19 pandemic, Dermatology services had to be reorganized to facilitate staff redeployment and minimize the risk of exposure to COVID-19 for patients and staff. This led to an unprecedented increase in teleconsultations aided by clinical images., Objectives: The main aim of our retrospective study was to analyse the acute Dermatology referrals received in the pre-COVID-19 era and during COVID-19 pandemic., Methods: We retrospectively analysed acute Dermatology referrals using the acute referral log., Results: We retrospectively analysed 500 and 110 acute Dermatology referrals received in the pre-COVID-19 period and during COVID-19 pandemic, respectively. In the pre-COVID-19 era, consultations were most commonly requested by Oncology/Haemato-Oncology, Emergency Departments and General Practice, while during the COVID-19 pandemic General Practice was the most common source of referrals. A wide variety of dermatological conditions were encountered with the most common been eczematous dermatoses., Conclusions: Although Dermatology is largely an outpatient-based specialty, this study shows the demand for urgent Dermatology input the care of sick patients with severe skin diseases and in the management of skin problems in patients admitted or receiving treatment for other diseases. Re-organization of Dermatology services during the COVID-19 pandemic resulted in a marked increase in teleconsultations (28% versus 84.5%) and highlighted the importance of complete skin-directed physical examination by the referring clinician as well as procurement of good quality clinical images., (© 2023 European Academy of Dermatology and Venereology.)

Little is known about trends in teledermatology adoption and use for managing dermatologic patients, especially changes in use influenced by the COVID-19 pandemic. In this retrospective cohort study, we analyzed encounter data from the Healthjump dataset (containing electronic health record data from throughout the USA) for visits from November 2019 to July 2021 with a primary dermatology-related diagnosis. There was a striking rise in teledermatology use with the onset of the pandemic in February 2020, peaking in April 2020 with 2178 teledermatology encounters (32.8% of all encounters). Subsequently, teledermatology use waned. Most teledermatology care was delivered via synchronous means with little use of asynchronous or telephone communication. When compared to those with neoplastic skin diseases, patients with inflammatory skin diseases were more likely to be seen via teledermatology (OR 3.30, 95% CI 3.12-3.49). Certain demographic groups were less likely to receive care via teledermatology, such as men (compared with females, OR 0.76, 95% CI 0.74-0.78) and patients 65 and older (compared with those below 65, OR 0.59, 95% CI 0.57-0.62). Our work shows increased adoption of teledermatology at the onset of the COVID-19 pandemic with decreasing use over time. Future efforts are needed to ensure continued and expanded use of a valuable care modality to reach vulnerable populations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

COVID-19 is an infectious disease caused by SARS-CoV-2, which emerged in China in 2019 and rapidly spread worldwide to become a pandemic in March 2020. Although the most severe manifestations concern the lower respiratory tract, COVID-19 is a multiorgan disease that also affects the skin. Several types of skin lesions have been reported to be associated with SARS-CoV-2 infection, though their causal relationship with the virus has not yet been well documented. In addition to the cutaneous manifestations that develop in patients with COVID-19-thought to be caused by the virus-other findings associated with the pandemic in a broader sense include dermatoses triggered or aggravated by the infection, the adverse cutaneous effects due to the drugs and protective devices used to prevent or fight the infection, and the adverse cutaneous effects of COVID-19 vaccines. We provide an overview of these dermatoses associated with the COVID-19 pandemic.

Objective: to investigate the prevalence of skin lesions and factors associated with the use of N95 respirators among health professionals in Brazil., Method: cross-sectional study conducted with 11,368 health professionals using a respondent-driven sampling method adapted for online environments. Univariate and multivariate analyses were performed to investigate the association between the "skin lesions with the use of N95 respirators" variable and gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and high-quality Personal Protective Equipment., Results: the prevalence of skin lesions was 61.8%. Women were 1.203 times (95% CI: 1.154-1.255) more likely to develop a lesion than men. The chances of skin lesions in psychologists (PR=0.805; 95% CI: 0.678-0.956) and dentists (PR=0.884; 95% CI: 0.788-0.992), were lower when compared to Nursing professionals. Professionals with a positive COVID-19 diagnosis and working in the Intensive Care Unit have an increased chance of presenting skin lesions (PR=1.074; 95% CI: 1.042-1.107); (PR=1.203; 95% CI: 1.168-1.241), respectively., Conclusion: the prevalence of skin lesions caused by the use of N95 respirators was 61.8% and was associated with female gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and highquality Personal Protective Equipment. (1) The overall prevalence of skin lesions was 61.8%. (2) The most affected professional category was Nursing. (3) Women were more likely to develop skin lesions than men.

Aim: To explore the prevalence and risk factors for medical adhesive-related skin injury (MARSI) caused by protective dressings among medical staff members during the 2019 coronavirus disease pandemic (COVID-19) in China., Materials and Methods: A cross-sectional survey was conducted using a questionnaire. The questionnaire was released through the Questionnaire Star website and was completed online. The prevalence of MARSI was calculated and risk factors were analyzed using a multiple regression model., Results: A total of 414 front-line medical staff members treating COVID-19 patients were enrolled from 46 hospitals across four provinces and two municipalities. Overall, 83.1% used protective medical adhesive dressings applied to the head and face to prevent skin damage from personal protective equipment. The prevalence of MARSI caused by adhesive dressings was 41.9%. By multiple regression analysis, the type of dressing, duration of dressing usage, and pain score were risk factors for MARSI development., Conclusions: The high prevalence indicates MARSI is common among front-line medical staff members, especially those using hydrocolloid dressings and longer durations of dressing usage. Pain upon dressing removal can be severe and increased the risk of MARSI. We call for paying more attention to MARSI and recommend multisite studies with larger sample sizes to enhance the generalizability of these findings., Competing Interests: Declaration of competing interest None declared., (Copyright © 2023 Tissue Viability Society / Society of Tissue Viability. Published by Elsevier Ltd. All rights reserved.)

There is accumulating evidence to indicate an association between coronavirus infectious disease 2019 (COVID-19) and clusters of incident cutaneous eruptions. Of these, chilblains-like perniosis have received widespread medical and media attention. These typically affect the toes, and have been called "COVID-toes." Other acral lesions such as large bullae have also been reported. However, a definitive causal relationship with the severe acute respiratory syndrome coronavirus 2 has not yet been definitively proven, nor has a pathogenic mechanism been established. These episodes are self-limiting, but we need to know whether long-term sequelae exist.

Background: Occupational skin diseases (OSDs) are common in healthcare workers (HCWs)., Objectives: To investigate and compare the incidence and clinical features of OSDs among HCWs before and during the COVID-19 pandemic., Materials and Methods: Incident cases of OSDs were investigated in the cohort of HCWs at Trieste Hospitals from 1 July 2018 (3340 workers) to 31 October 2021 (137 532 person-months)., Results: The monthly incidence was ranging from 0 to 11.90 cases per 10 000 person-months in pre-COVID-19 period (cumulative incidence 4.22; 95% confidence interval [CI]: 2.9-6.0) and from 0 to 13.61 cases per 10 000 person-months in COVID-19 period (cumulative incidence 5.06; 95% CI: 3.6-6.9). The incidence rate ratio (IRR) between COVID-19 and pre-COVID-19 period was 1.22 (95% CI: 0.73-1.98). The incidence of OSDs in the COVID-19 period was 6.1 (4.2-8.6) and 2.7 (95% CI: 1.1-5.6) cases × 10 000 person-months for women and men, respectively, with an IRR of 2.25 (95% CI: 0.98-5.9). Incidence in nurses in the COVID-19 period was 6.7 (95% CI: 4.2-10.2) cases × 10 000 person-months., Conclusions: Incidence of OSDs was a little bit higher during the COVID-19 pandemic compared to the previous period but fluctuation of numbers were mainly related to calendar period, with higher incidence in winter and spring. Incidence data were higher than that observed in 2004-2013 in the same cohort. Face dermatitis cases doubled after the start of COVID-19 pandemic. Overall data demonstrated a non-significant increase of OSDs in HCWs during the pandemic, probably due to the preventive strategies set up in our cohort over the years., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Less biopsies were expected when large scale social restrictions were enforced during COVID-19 pandemic., Aim: To compare the skin diseases prompting biopsy before and during the COVID-19 pandemic., Materials and Methods: A retrospective study of skin diseases was performed; the skin problems were then grouped into major histopathological reactions., Results: A total of 229 biopsies were performed before the COVID-19 outbreak, whereas only 160 biopsies were done during the pandemic. Before versus during the outbreak, the proportion of major reactions were granulomatous 20.52% vs 21.88%, neoplasms 17.47% vs 20%, psoriasiform 14.85% vs 10%, vesiculobullous 9.61% vs 8.75%, others 10.92% vs 7.50%, interface dermatitis 6.99% vs 10%, vasculopathy 6.99% vs 5.63%, spongiotic 6.55% vs 8.13%, panniculitis 3.49% vs 3.75%, and superficial and deep dermal infiltrate 2.62% vs 4.38%., Conclusion: A decreased total number of patients prompting less biopsies were reported during the COVID-19 outbreak. However, the three largest percentages of major histopathological reactions were still similar, namely granulomatous, neoplasms, and psoriasiform.

Understanding the utility of virtual visits in pediatric dermatology practice has become increasingly important in the telehealth era. We compared the conditions diagnosed in pediatric dermatology between traditional in-person visits and virtual telehealth visits during the initial 8-month phase of the COVID-19 pandemic at an urban medical institution. When given the option, pediatric dermatology patients and their families were more likely to choose telehealth visits for the diagnosis and/or management of acne, hemangiomas, and contact dermatitis; however, they were more likely to choose in-person visits for atopic dermatitis, viral warts, and alopecia areata. These differences may be attributed to clinical features of pediatric skin conditions, treatment options, and other factors which may influence patient preference for telehealth or in-person care for their condition. J Drugs Dermatol. 2022;21(11):1260-1263. doi:10.36849/JDD.6843.

Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side-effects, which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from 1 January 2019 to 31 December 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946 366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions, which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions or scheduled for filler injections should receive additional precounselling and monitoring. A better understanding of potential side-effects may strengthen public confidence in those wary of new vaccine technologies., (© 2022 European Academy of Dermatology and Venereology.)

COVID-19 can present with a range of skin manifestations, some of which specific of the pediatric age. The aim of this systematic literature review was to determine the type, prevalence, time of onset, and evolution of cutaneous manifestations associated with COVID-19 in newborns, children, and adolescents, after excluding multisystem inflammatory syndrome in children (MIS-C). PubMed, Tripdatabase, ClinicalTrials, and Cochrane Library databases were searched using an ad hoc string for case reports/series and observational studies, published between December 2019 and February 2022. Study quality was assessed using the STROBE and CARE tools. Seventy-three (49 case reports/series and 24 studies) out of 26,545 identified articles were included in the analysis. Dermatological lesions were highly heterogeneous for clinical presentation, time of onset, and association with other COVID-19 manifestations. Overall, they mainly affected the acral portions, and typically presented a favorable outcome. Pseudo-chilblains were the most common., Conclusions: Mucocutaneous manifestations could be the only/predominant and early manifestation of COVID-19 that could precede other more severe manifestations by days or weeks. Therefore, physicians of all disciplines should be familiar with them., What Is Known: • A variety of cutaneous manifestations have been reported in association with COVID-19. • Urticaria, maculopapular, or vesicular rashes can occur at any age, while chilblains and erythema multiforme are more common in children and young patients., What Is New: • Skin lesions related to SARS-CoV-2 infection often show a peculiar acral distribution. • Mucocutaneous lesions of various type may be the only/predominant manifestation of COVID-19; they could present in paucisymptomatic and severely ill patients and occur at different stages of the disease., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: During the first Italian lockdown period, the imponent amount of hospital COVID-19 patients forced the healthcare system to re-organize visits but no information are available on outpatient ethnical patterns. Here we evaluated healthcare management changes on dermatological outpatient non-surgical settings visits during the SARS-CoV-2 pandemic., Methods: In this retrospective study we collected data of scheduled, performed and not-performed visits, together with patients' characteristics (i.e., age, gender) with a particular attention for ethnicities among the outpatients accessing during the first Italian lockdown (March 5-April 30, 2020). Then, we compared these data with the corresponding ones in 2019 (before COVID-19 pandemic)., Results: During the Italian lockdown the dermatological department registered a great decrement (-83.5%, P<0.001) in visits compared to the corresponding time period in 2019. Performed and scheduled visits to non-oncological stable patients together with emergency accesses to dermatology decreased. Non-Italian patients decreased accesses, especially the South East Asians (-70.4%) and North Africans (-90.0%)., Conclusions: Hospitals policy and mass media deeply condition the public opinion, and this aspect may explain a different access to the hospital among non-Italian patients. Telemedicine should be promoted especially among non-Italian communities in Italy to overgo patients' skepticism and incentivize prevention and early treatment in dermatological conditions.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the novel global coronavirus disease 2019 (COVID-19) disease outbreak. Its pathogenesis is mostly located in the respiratory tract. However, other organs are also affected. Hence, realising how such a complex disturbance affects patients after recovery is crucial. Regarding the significance of control of COVID-19-related complications after recovery, the current study was designed to review the cellular and molecular mechanisms linking COVID-19 to significant long-term signs including renal and cardiac complications, cutaneous and neurological manifestations, as well as blood coagulation disorders. This virus can directly influence on the cells through Angiotensin converting enzyme 2 (ACE-2) to induce cytokine storm. Acute release of Interleukin-1 (IL1), IL6 and plasminogen activator inhibitor 1 (PAI-1) have been related to elevating risk of heart failure. Also, inflammatory cytokines like IL-8 and Tumour necrosis factor- α cause the secretion of von Willebrand factor (VWF) from human endothelial cells and then VWF binds to Neutrophil extracellular traps to induce thrombosis. On the other hand, the virus can damage the blood-brain barrier by increasing its permeability and subsequently enters into the central nervous system and the systemic circulation. Furthermore, SARS-induced ACE2-deficiency decreases [des-Arg9]-bradykinin (desArg9-BK) degradation in kidneys to induce inflammation, thrombotic problems, fibrosis and necrosis. Notably, the angiotensin II-angiotensin II type 1 receptor binding causes an increase in aldosterone and mineralocorticoid receptors on the surface of dendritic cells cells, leading to recalling macrophage and monocyte into inflammatory sites of skin. In conclusions, all the pathways play a key role in the pathogenesis of these disturbances. Nevertheless, more investigations are necessary to determine more pathogenetic mechanisms of the virus.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has been a rising concern since its declaration as a pandemic by the World Health Organization on 11 March 2020. Recently, its association with multiple underlying organs has been identified that includes cardiac, renal, gastrointestinal, nervous systems, and cutaneous manifestations. Cutaneous COVID-19 findings have been supposedly classified into the following categories: vesicular (varicella-like), papulo-vesiculsar, chilblains-like ("COVID toes") maculopapular, and urticarial morphologies. In this review, we aim to focus on the proposed pathophysiology behind the various dermatological manifestations associated with COVID-19 and their associated management. We also included prevalence and clinical features of the different COVID-19-related skin lesions in our review. A comprehensive narrative review of the literature was performed in PubMed databases. Data from case reports, observational studies, case series, and reviews till June 2022 were all screened and included in the review.

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., (© 2022 Wiley Periodicals LLC.)

In 2020, the World Health Organization declared the COVID-19 pandemic. This infectious pathology can be associated with different manifestations in different body systems, among which are dermatological lesions. The purpose of this work is to determine the most frequent dermatological signs, in the lower limbs, produced by SARS-CoV-2. To carry this out, a bibliographic search was performed in the following databases: PubMed, SciELO, ScienceDirect, Cochrane Database of Systematic Reviews, and the Google Scholar literature. The inclusion criteria were articles that included confirmed subjects or those with a clinical suspicion of COVID-19, written in the Spanish or English languages, and the results presented clinical manifestations in the lower extremities. Initially, 128 scientific documents were identified and, after reading the title and abstract, 18 articles were selected. The most frequent skin lesions on the lower limbs are acral lesions such as pernio erythema or ischemic lesions, maculopapular rash, petechiae, and erythematous plaques.

Following the worldwide COVID-19 pandemic, individuals have begun to take preventive measures to avoid exposure. Among the precautionary measures, facemask was mostly emphasized. This study aimed to determine the prevalence of dermatological symptoms linked with face mask usage and explore other associated factors. This cross-sectional survey was conducted throughout all eight divisions of Bangladesh. 1297 people were approached using a fixed-step procedure on a random route sample where 803 fulfilled the inclusion criteria. The overall prevalence of dermatological manifestation in this study was 40.85%. The common dermatological manifestations due to facemasks use were acne (26%), allergy symptoms (24%), traumatic symptoms (24%), and other symptoms (26%). Two important frequently reported risk factors were previous history of skin diseases and obesity. Females were more likely to have acne (CI: 1.199, 3.098; p = .007) and allergy issues (CI: 1.042, 2.359; p = .031). N95 and KN95 masks were more likely to produce allergic symptoms, while surgical mask users were more likely to develop acne. Acne was prevalent more than twice (CI: 1.42, 4.26; p = 0.001) in persons with a COVID-19 infection history. Further exploration is required to find out the reason. Surgical mask users reported more complaints than other types of masks, and prolonged use caused more skin symptoms. Modifications in the pattern of facemask usage and planning for work recesses might also be advised to provide for a pause from uninterrupted facemask use., Competing Interests: The authors have declared that no competing interests exist.

Dermatologic conditions account for a large proportion of healthcare visits in the United States, yet there continues to be barriers to dermatologic care particularly among the rural and underserved populations. Patients among these populations are particularly vulnerable to poor outcomes and increased morbidity. Teledermatology offers a potential solution to increase access to high-quality dermatologic care. Studies have previously examined the convenience, cost-effectiveness, and clinical efficacy of teledermatology compared to in-person dermatology visits. There is a need to assess which populations are appropriate and in what settings teledermatology can be most effective. We surveyed patients of a South Dakota dermatology practice to assess perceptions and experiences with teledermatology visits in the context of the COVID-19 pandemic. Significant factors leading patients to prefer in-person visits compared to teledermatology were being over the age 65 (OR 2.9 95 percent CI 1.9,3.8 and p-value 0.036) or experiencing technical difficulties during the visit (OR 2.9 95 percent CI 1.9,3.9 and p-value 0.048). We found the chief complaint played an important role in patient preference for visit modality. Patients with acne or acne follow up compared to all other chief complaints had a strong preference for teledermatologic visits (OR 4.7 95 percent CI 4.0,5.4 and p-value 0.000018) whereas patients with possible malignant lesions strongly preferred having an in-person visit (OR 6.6 95 percent CI 5.5,7.8 and p-value 0.0004). Based on these results, we suggest a targeted use of teledermatology with pre-visit screening measures to maintain a patient center approach and avoid redundant visits., (Copyright© South Dakota State Medical Association.)

Background: The COVID pandemic has affected the human race both physically and mentally. Mask use remains the standard way of preventing the spread of this virus. The continuous mask use has led to the emergence of various dermatoses like acne, pigmentation, and seborrhea in mask contact areas. The present survey has been undertaken to describe the various dermatoses encountered in the medical fraternity especially doctors, who are frequently exposed to prolonged mask use., Aims: To estimate the frequency of various cutaneous manifestations seen among doctors following mask use via web-based online questionnaire survey., Methods: It was a cross-sectional web-based study conducted at a tertiary care teaching institute from June 2021 to August 2021. All the doctors of the hospital completing the questionnaire were included in the study with informed consent., Results: A total of 178 participants completed the survey. The most common complaint was increased sweating (55.6%) followed by acne (34.3%) and oily skin (34.3%). Significant association was found between skin changes and duration (>6 h/day) of mask use, increasing number, and type of mask (N 95) used (p value <0.05)., Conclusion: The knowledge of various mask-induced/aggravated dermatoses will help formulate proper precautionary protocols enhancing efficient mask usage for prolonged periods., (© 2022 Wiley Periodicals LLC.)

Background: The COVID-19 pandemic has led to widespread changes in medical care. However, it is still unclear to what extent the care of patients suffering from moderate-to-severe psoriasis, chronic spontaneous urticaria or atopic dermatitis has been affected., Objectives: This study was conducted to determine the impact of the SARS-CoV-2 pandemic on medical care in dermatological practices, focusing on physicians’ concerns related to susceptibility to infections in combination with different treatment modalities., Materials & Methods: Dermatologists working in medical offices in the German federal states of Bavaria and Lower Saxony participated in a cross-sectional, non-interventional, questionnaire-based study investigating the influence of COVID-19 on dermatological care. The study was performed after the first wave of the coronavirus pandemic in July/August, 2020., Results: A total of 195 dermatologists participated in the study. Almost one in five practices were closed for at least one week during the pandemic. The care of patients with chronic inflammatory skin diseases was impaired, affecting diagnostic investigation. Physicians stated that the pandemic substantially influenced systemic therapy. Nearly half of physicians surveyed were concerned about increased susceptibility to infections under biological therapy. No significant differences were identified between the German federal states of Bavaria and Lower Saxony in the south and north of Germany, respectively., Conclusion: This study reveals a significant impact of the COVID-19 pandemic on the care of dermatological patients in medical offices in Germany. New management modalities and continuous education are needed to improve care in pandemic situations.

The documentation of ethnopharmaceutical knowledge has always been important for the preservation of countries' cultural, social, and economic identity. The COVID-19 pandemic with the collapse of healthcare, which has left the individual health to self-care, has also forced us to look back at ethnopharmacology from a practical point of view. This is the first study in Lithuania, dedicated entirely to ethnopharmaceuticals used for skin diseases and cosmetics, and the first study to analyse ethnopharmacology as a Lithuanian phenomenon during the ongoing COVID-19 pandemic. The main purpose of this study was to collect and evaluate ethnopharmaceutical knowledge regarding skin diseases and cosmetics in Šiauliai District, Lithuania during the COVID-19 pandemic from July 2020 to October 2021. This study surveyed 50 respondents; the survey was conducted using the deep interview method. The respondents mentioned 67 species of medicinal plants from 37 different families used for skin diseases (64.18%), cosmetics (13.44%) and cosmeceuticals (22.38%). Of the 67 plant species, 43 (64%) were not included in the European Medicines Agency monographs and only 14 species (21%) of all included species were used with European Medicines Agency approved medical indications for skin diseases. In terms of public health, the safety of "self-treatment" and recovery rituals for skin diseases are no less important than ethnopharmacological knowledge and its application, this being especially relevant during the COVID-19 pandemic.

Aim: Dermatological care has already been deeply impacted by the coronavirus disease-2019 (COVID-19) epidemic. The consequences may continue long after the epidemic resolves. In this study, we aimed to evaluate the change of dermatological practice since the COVID-19 outbreak is almost controlled in mainland China., Material and Methods: Patients requesting a dermatology outpatient visit from January to May in 2019 and 2020 were retrospectively investigated., Results: The number of patients decreased significantly shortly after the COVID-19 outbreak, and it started to increase after the spread of coronavirus was gradually controlled at the end of February in China. The three most common diseases were atopic dermatitis (11.0%), acne (10.2%), and warts (7.2%) in 2019, while acne (8.9%), warts (5.8%), and acute urticaria (5.6%) in 2020. The most statistically significant increased reasons for requesting an outpatient visit from March to May in 2020 was pet-related dermatophytoses, followed by cosmetic consultation and irritated contact dermatitis, an increase of 88.2%, 84.7%, and 58.8%, respectively, over the same period of 2019., Conclusion: Understanding the trends and impacts of dermatologic diseases on patients and health systems during this epidemic will allow for better preparation of dermatologists in the future.

Lockdown was enforced in many countries across the globe to flatten the coronavirus disease (COVID-19) curve. In these difficult times, people with skin diseases faced unique challenge, as major clinical facilities came to a standstill. Teledermatology helped to an extent to bridge this provider-seeker gap to an extent. We compiled data of patients seeking dermatology services during this period in Bangladesh, India, and Nepal. Most of the patients were middle-aged (70%) and had good access to teledermatology. Dermatoses were primarily due to frequent handwashing, use of alcohol-based sanitizers, excessive use of water (12.6%), improper skin care (43.3%), sun exposure (20.5%), lockdown-induced stress (22.04%), infections (15.75%), flare of preexisting diseases (8.66%), and hair disorders (11%). Many dermatoses had a causal overlap. Teledermatology proved to be useful for patients with skin diseases who were unable to access direct face-to-face consultations.

As of March 2020, skin lesions associated with COVID-19 have been described. The objectives of the study were to characterize the skin lesions in these patients, analyze their temporal relationship, association with the severity of the disease, extracutaneous symptoms and laboratory parameters. A prospective, observational, analytical and cross-sectional study was conducted in hospitalized patients diagnosed with COVID-19. Dermatoses were classified as primary and secondary. Forty-five patients were included, 44.4% with primary dermatoses and 53.3% with secondary lesions. The mean age was 46 years (SD: 17), with a male predominance (68.9%). The primary lesions appeared after a median of 5 days (IQR: 3-10) from the onset of COVID-19 symptoms and the secondary ones after 14.5 days (IQR: 7-20). The primary dermatoses found were maculopapular rash (65%), urticarial (20%, half with vesicular lesions), livedo reticular (10%) and purpura (5%). The most frequent secondary dermatoses were adverse drug reactions (37.1%) and infectious dermatoses (25.9%). Maculopapular rash was associated with moderate COVID-19 and pressure injuries with severe COVID-19 (p < 0.05). The finding of neutrophilia was higher among those with secondary infectious dermatoses (p < 0.05). No significant differences were found when evaluating other laboratory parameters. This work shows the skin manifestations in patients hospitalized with COVID-19 in our environment. The most prevalent pattern was the maculopapular rash that was associated with the moderate form of the disease. The appearance of lesions 2 weeks after the onset of COVID-19 symptoms was associated with secondary dermatoses.

Competing Interests: Conflicts of interest None disclosed.

Background : We compared the pattern of cutaneous dermatoses among Iraqi females of all ages between 4 months preceding the coronavirus disease 2019 (COVID-19) pandemic, and the same months 1 year later within the COVID-19 pandemic. Methods : This was a cross-sectional study, that targeted all female patients attending an outpatient clinic for dermatology and venereology in Al-Kindy teaching hospital, Baghdad between October 2019 to the end of January 2020, and the same 4-month duration 1 year later (October 2020 to the end of January 2021) after the COVID-19 peak period had passed and there was no or partial curfew to exclude seasonal impact. Results : A total of 2657 female-patients of all ages were enrolled in this study with 1314 females during the 4 months pre COVID-19, and 1343 females during the pandemic. The mean age of patients presented before the pandemic was 27.2±16.6 years, while the mean age of patients during the pandemic was 28.1±15.6 years with no statistically significant difference in mean ages (P >0.05). Hair loss in general with telogen effluvium specifically increased significantly. Cutaneous contagious viral infections were reduced significantly and specifically of these molluscum contagiosum and condylomata accuminata. Other forms of infections including bacterial and parasitic were also reduced while dermatophytosis was increased but not to a significant level. Acne vulgaris, rosacea, lichen planus, urticaria, pityriasis rosea, seborrheic dermatitis, and vitiligo were increased, but psoriasis, alopecia areata, other types of dermatitis, and melasma were reduced but none to a significant level. Conclusions : The COVID-19 pandemic resulted in changes in the pattern of diseases presented to an out-patient clinic for dermatology and venereology. This could be either related to COVID-19 infection or stress associated with the pandemic, because of curfew, or wearing facemasks which may cause a decrease or increase in certain diseases., Competing Interests: No competing interests were disclosed., (Copyright: © 2022 A. Abdullah G.)

Background : We compared the pattern of cutaneous dermatoses among Iraqi females of all ages between 4 months preceding the coronavirus disease 2019 (COVID-19) pandemic, and the same months 1 year later within the COVID-19 pandemic. Methods : This was a cross-sectional study, that targeted all female patients attending an outpatient clinic for dermatology and venereology in Al-Kindy teaching hospital, Baghdad between October 2019 to the end of January 2020, and the same 4-month duration 1 year later (October 2020 to the end of January 2021) after the COVID-19 peak period had passed and there was no or partial curfew to exclude seasonal impact. Results : A total of 2657 female-patients of all ages were enrolled in this study with 1314 females during the 4 months pre COVID-19, and 1343 females during the pandemic. The mean age of patients presented before the pandemic was 27.2±16.6 years, while the mean age of patients during the pandemic was 28.1±15.6 years with no statistically significant difference in mean ages (P >0.05). Hair loss in general with telogen effluvium specifically increased significantly. Cutaneous contagious viral infections were reduced significantly and specifically of these molluscum contagiosum and condylomata accuminata. Other forms of infections including bacterial and parasitic were also reduced while dermatophytosis was increased but not to a significant level. Acne vulgaris, rosacea, lichen planus, urticaria, pityriasis rosea, seborrheic dermatitis, and vitiligo were increased, but psoriasis, alopecia areata, other types of dermatitis, and melasma were reduced but none to a significant level. Conclusions : The COVID-19 pandemic resulted in changes in the pattern of diseases presented to an out-patient clinic for dermatology and venereology. This could be either related to COVID-19 infection or stress associated with the pandemic, because of curfew, or wearing facemasks which may cause a decrease or increase in certain diseases., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 A. Abdullah G.)

During the COVID-19 pandemic, rapid, real-world evidence is essential for the development of knowledge and subsequent public health response. In dermatology, provider-facing and patient-facing registries focused on COVID-19 have been important sources of research and new information aimed at guiding optimal patient care. The 7 dermatology registries included in this update now include more than 8000 case reports sourced from physicians and patients from countries all over the world., Competing Interests: Disclosure Dr L.E. French is president of the ILDS. Dr E.E. Freeman is principal investigator of the AAD/ILDS COVID-19 Dermatology Registry. The ILDS provides financial support for the AAD/ILDS registry. Dr E.E. Freeman is an author for UpToDate. Drs S.R. Feldman, C.E.M. Griffiths, S.K. Mahil, H.B. Naik, and C.H. Smith have received funding or support from and Drs L.E. French, A.D. Irvine, and P.I. Spuls have been consultants for AbbVie; Dr M.A. Lowes has served on the advisory board for AbbVie. Drs S.R. Feldman, L.E. French, C.E.M. Griffiths, S.K. Mahil, R. Sinclair, and C.H. Smith have received funding or support from Novartis. Drs S.R. Feldman, C.E.M. Griffiths, R. Sinclair, C.H. Smith, and D. Wall have received funding from Pfizer. Drs S.R. Feldman, S.K. Mahil, and C.H. Smith have received funding from and Drs A.D. Irvine and P.I. Spuls have been consultants for Sanofi. Drs S.R. Feldman, C.E.M. Griffiths, A.D. Irvine, S.K. Mahil, R. Sinclair, and D. Wall have received funding or honoraria from Eli Lily; Drs S.R. Feldman, L.E. French, C.E.M. Griffiths, S.K. Mahil, R. Sinclair, and D. Wall have received funding or honoraria from Janssen. Drs S.R. Feldman and C.E. M. Griffiths have received funding or support from BMS, Almirall, Amgen, Galderma, LEO Pharma, Stiefel GSK, and Sun Pharmaceuticals. Drs C.E.M. Griffiths and S.K. Mahil have received funding or support from Celgene and UCB Pharma. Dr C.E.M. Griffiths has received honoraria and/or research grants from MSD and Sandoz. Dr S.R. Feldman received research, speaking and/or consulting support from Alvotech, Boehringer Ingelheim, Mylan, Ortho Dermatology, Samsung, Menlo, Helsinn, Arena, Forte, Merck, Regeneron, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Suncare Research, Informa, UpToDate, and National Psoriasis Foundation. Dr S.R. Feldman is founder and majority owner of www.DrScore.com and is founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. Dr L.E. French received speaking and/or consulting support from Galderma, Amgen, Leo Pharma, Biotest, and Pincell Srl. Dr H.B. Naik has received consulting fees from 23andme, Abbvie, and DAVA Oncology and advisory board fees from Boehringer Ingelheim and is an investigator for Pfizer. She also is an associate editor for JAMA Dermatology. Dr M.A. Lowes has served on the advisory boards for Abbvie, InflaRx, Janssen, and Viela Bio, and consulted for Almirall, BSN medical, Incyte, Janssen, Kymera, and XBiotech. Dr C.H. Smith is an investigator on Medical Research Council and Horizon 2020–funded consortia with industry partners (see psort.org.uk and biomap-imi.eu). Drs H.B. Naik (board member) and M.A. Lowes (vice president) are unpaid members of the US Hidradenitis Suppurativa Foundation. Drs L. Castelo-Soccio, K.M. Cordoro and I. Lara-Corrales are part of the PeDRA COVID-19 Response Task Force, a collaboration between the SPD and the PeDRA. Dr C. Flohr is President of the British Society for Paediatric Dermatology and Chief Investigator of the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR) (ISRCTN11210918). Dr C. Flohr and the patient-facing part of the SECURE-AD registry are supported by the National Institute for Health Research Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK. Dr A.D. Irvine is the unpaid Chairman of National and International Skin Registry Solutions (NISR) Ltd, a not-for-profit charity dedicated to developing registries for patients with skin disease. NISR supports the Secure-AD registry. Dr A.D. Irvine is a co–principal investigator on the A-STAR and has been a consultant or speaker for Regeneron and LEO Pharma outside of the scope of the current work. Dr P.I. Spuls has received departmental independent research grants from a few pharmaceutical companies for the TREAT NL registry, is involved in performing clinical trials with many pharmaceutical industries that manufacture drugs used for the treatment of conditions like psoriasis and atopic dermatitis, for which financial compensation is paid to the department/hospital, and is chief investigator of a systemic and phototherapy atopic eczema registry (TREAT NL) for adults and children and one of the main investigators of the SECURE-AD registry. Drs D. Wall and R. Sinclair colead and are members of the steering committee, along with Dr N. Meah, of the SECURE-Alopecia registry. Drs R. Sinclair, D. Wall, and N. Meah are leading the development of the Global Registry of Alopecia Areata Disease Severity and Treatment Safety. Dr D. Wall is an employee of the charity NISR. Dr R. Sinclair also reports serving as a consultant or paid speaker for or participating in clinical trials sponsored by LEO Pharma, Amgen, Merck & Co, Celgene Corporation, Coherus BioSciences, Regeneron Pharmaceuticals, MedImmune, GlaxoSmithKline, Cutanea, Samson Clinical, Boehringer Ingelheim, Merck Sharpe & Dohme, Oncobiologics, F. Hoffman–La Roche, and Bayer AG and serves as the current president of the Australasian Hair and Wool Research Society. G.C. Chamberlin and D.E. McMahon and Drs E.A. Balogh and A.V. Marzano have no conflicts of interest to declare., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background and Objectives : The COVID-19 pandemic has a considerable influence on public health, either directly or indirectly. We investigated outpatient skin disease diagnoses at the dermatology clinic to determine the effect of the COVID-19 pandemic on these patients. Materials and Methods : We conducted a retrospective study using the International Codes of Diseases data from the outpatient department of Dermatology clinic, Vajira hospital, Navamindradhiraj University, Bangkok, Thailand from January 2019 to June 2021. Results : A total of 20,915 patients with 34,116 skin diagnoses were included in the study. The average weekly dermatologic clinic visits remained unchanged between the years with and without COVID-19 pandemic. While the percentage of xerosis cutis, other skin infections (syphilis and parasitic infections), hair and nail disorders, pigmentary disorders, benign skin tumors and drug eruptions were significantly decreased during the COVID-19 pandemic years, the percentage of other dermatitis, fungal and viral skin infections, acne, psoriasis, urticaria, vesiculobullous and autoimmune diseases were increased. Conclusion : The COVID-19 pandemic had a minimal effect on the average weekly skin clinic visits, but the diagnosed skin diseases pattern was affected. Knowing the pattern of skin diseases may help aid hospitals to better prepare for future pandemics in securing appropriate medications and supplies and training the medical teams.

Background: Google Trends is a powerful online database and analytics tool of popular Google search queries over time and has the potential to inform medical practice and priorities., Objective: This review aimed to survey Google Trends literature in dermatology and elucidate its current roles and relationships with the field., Methods: A literature search was performed using PubMed to access and review relevant dermatology-related Google Trends studies published within the last 5 years., Results: Current research utilizing Google Trends data provides insight related to skin cancer, pruritus, cosmetic procedures, and COVID-19. We also found that dermatology is presently the highest-searched medical specialty-among 15 medical and surgical specialties as well as general practitioners. Google searches related to dermatology demonstrate a seasonal nature for various skin conditions and sun-related topics, depending on a region's inherent climate and hemi-sphere. In addition, celebrity social media and other viral posts have been found to potentiate Google searches about dermatology and drive public interest., Conclusions: A limited number of relevant studies may have been omitted by the simplified search strategy of this study, as well as by restriction to English language articles and articles indexed in the PubMed database. This could be expanded upon in a secondary systematic review. Future re-search is warranted to better understand how Google Trends can be utilized to improve the quality of clinic visits, drive public health campaigns, and detect disease clusters in real time., (©Torunn Elise Sivesind, Mindy D Szeto, William Kim, Robert Paul Dellavalle. Originally published in JMIR Dermatology (http://derma.jmir.org), 25.05.2021.)

Background: COVID-19 is a health emergency. SARS-CoV-2 was discovered in Wuhan (Hubei Province, China) and has rapidly spread worldwide, leaving no country untouched. COVID-19 is a respiratory infection characterized by a pneumonia of unknown etiology. It is transmitted through respiratory droplets; for example: through breathing, talking, and coughing. Transmission of the virus is high. Health care workers play important roles in helping those affected by COVID-19; this could not be done without the use of personal protective equipment (PPE). PPE involves the use of goggles, masks, gloves, and gowns and is known to reduce COVID-19 transmission; however, multiple reports of skin disease and damage associated with occupational mask-wearing have emerged., Objective: The objective of this study is to review the literature for newly emerging dermatological conditions as a result of occupational mask-wearing during the COVID-19 pandemic., Methods: A narrative review of new reports of dermatological conditions associated with occupational mask-wearing was carried out in May 2020 by referencing keywords including: "covid mask dermatology," "covid dermatological damage," "covid mask skin," "covid N95 mask damage," and "covid mask skin damage" from PubMed, supplemented by searches on both Google Scholar and ResearchGate. A total of 287 articles were found, of which 40 were successfully included in this study, and an additional 7 were selected from the reference lists of these 40 articles. The findings were tabulated and analyzed under the following headings: dermatological diagnosis, causes, and management., Results: Qualitative analysis of the reviewed data was carried out. A number of dermatological conditions were found to increasingly occur owing to prolonged and frequent use of face masks. Pressure-related injuries were often the most serious complaint; recommendations to reduce this type of injury include the use of hydrocolloid dressings, plastic handles, education, and regular moisturization. Innovation in PPE as well as services, such as virtual clinics, need to be advanced to protect the welfare of health care staff., Conclusions: In these unprecedented times, PPE has been an effective barrier to the transmission of COVID-19 among health care workers. This has allowed health care workers to provide care to patients, with minimal risk. However, our findings suggest that despite the obvious benefits of using face masks to protect the respiratory system, there are also considerable health consequences to the skin. Future research studies are required to focus on improving face masks to ensure both the protection of the respiratory system as well as skin care, which, according to our study, has been overlooked., Competing Interests: Conflicts of Interest: None declared., (©Robyn-Jenia Wilcha. Originally published in JMIR Dermatology (http://derma.jmir.org), 06.05.2021.)

Background: As teledermatology has been widely adopted during the COVID-19 pandemic, it is essential to examine patients' experiences and satisfaction with teledermatology., Objective: We aimed to assess the teledermatology experiences of new and existing clinic patients in the context of the rapid shift toward teledermatology practices during the COVID-19 pandemic., Methods: We conducted a cross-sectional study of 184 teledermatology patients who were assessed during the COVID-19 pandemic at a major southeastern medical center from May 13 to June 5, 2020. The primary outcome was patient satisfaction levels among new and existing patients. The secondary outcome was patients' willingness to use teledermatology in the future., Results: Of the 288 teledermatology patients who were assessed during the study period, 184 (63.9%) completed the survey. Patients reported high overall satisfaction with teledermatology, with 86.4% (159/184) of participants reporting positive overall satisfaction and experiences with teledermatology. New patients had significantly higher Likert scores for overall satisfaction with teledermatology than those of follow-up patients (new patients: mean 4.70; existing patients: mean 4.43; P =.03). Overall, patients' satisfaction with teledermatology did not significantly differ based on age ( P =.36), race and ethnicity ( P =.46), education level ( P =.11), residence ( P =.74), or insurance status ( P =.74). There were no significant differences in overall satisfaction between patients with and without prior telehealth experience ( P= .53), between the video and telephone visit types ( P =.17), and among platform types ( P= .22). Prior telehealth experience was associated with higher odds of being willing to use telehealth in the future (odds ratio 2.39, 95% CI 1.31-4.35; P =.004)., Conclusions: This cross-sectional survey study demonstrates that during the rapid expansion of teledermatology, new clinic patients had significantly higher scores for overall satisfaction with their teledermatology experience compared to those of established clinic patients ( P =.03). Prior telehealth experience was associated with higher odds of being willing to use teledermatology in the future. Overall, teledermatology expansion was met with high levels of patient satisfaction during the COVID-19 pandemic., Competing Interests: Conflicts of Interest: None declared., (©Judy Hamad, Amy Fox, Maria Suzanne Kammire, Alison Nancy Hollis, Saif Khairat. Originally published in JMIR Dermatology (http://derma.jmir.org), 05.05.2021.)

Introduction: Since COVID-19 has become a pandemic, extensive literature has been produced. The commonest symptoms of COVID-19 disease are fever, cough, anosmia, and lymphocytopenia. However, other apparently less common clinical symptoms have been described, including skin lesions. We conducted a systematic review to evaluate skin involvement in COVID-19., Methods: The authors performed a systematic review of literature, in accordance with the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA). The search was reiterated until May 06, 2020., Results: Overall, 1593 patients (M/F ratio: 1 : 9) with suspect of COVID-19 were examined. The mean age was 37.8 (range 0-91) years. Among the analyzed patients, 84 (5.3%) were pediatrics (<18 years). Chilblains are very common among skin lesions and represent almost half of all skin lesions reported (46%); in 75% of patients with cutaneous manifestation, the latter presented before other typical clinical manifestation of COVID-19. Vasculitis or thrombosis was identified in almost 70% of patients who suffered from skin manifestations., Conclusion: The present study highlights the importance of skin involvement in COVID-19. Limbs should be examined to eventually foresee the onset of further typical symptoms. Chilblains can be considered typical features. Studies with higher scientific evidence are required., (© 2021 the International Society of Dermatology.)

The most important function of the stratum corneum (SC), the uppermost layer of the human epidermis, is the formation of the epidermal permeability barrier. Lipids, particularly ceramides, cholesterol, and free fatty acids, together form lamellar membranes in the extracellular spaces of the SC that limit the loss of water and electrolytes. In addition to preventing water and electrolyte loss, the SC as a permeability barrier prevents the entry of harmful irritants, allergens, and microorganisms into the skin. Disruption of the epidermal barrier leads to skin that is irritated, more reactive, and more sensitive than normal skin. SC thickness, lipid profile, and barrier function vary with different ethnic groups, which is also reflected the differences in prevalence and manifestation of diverse skin conditions related to the skin barrier function such as atopic dermatitis and sensitive skin. In addition to these compromised skin barrier related conditions, we are just now starting to understand the direct and indirect impact of COVID-19 on the skin and how current preventative measures are contributing to skin barrier disorders. Our understanding of various approaches for restoration of skin barrier, especially the role of topically applied mixtures of cholesterol, ceramides, and essential/nonessential free fatty acids (FFAs) allows for the strengthening of the compromised skin barrier and alleviation of symptoms and discomfort associated with skin barrier disorders. Ceramide containing products on the market are commonly available and offer protection and reparative benefits to the skin barrier. J Drugs Dermatol. 20(4 Suppl):17-22. doi:10.36849/JDD.S589C.

Aim: In this study, we compared the current diagnoses of patients admitted to the dermatology outpatient clinic with the diagnoses during the non-pandemic period, and we examined the effect of COVID-19 on the patient profile., Methods: Diagnoses were compared by examining the patient files of the 3-month period when the pandemic was influential in our country and the 2-week non-pandemic period corresponding to the same season a year ago. The outpatient diagnoses in the first month and the last month of the 3-month pandemic period were also compared., Results: During the 3-month pandemic process, the most common reasons for applying to the outpatient clinic were acne, urticaria, psoriasis, and allergic/irritant contact dermatitis. Urticaria, psoriasis, allergic/irritant contact dermatitis, scabies, liken planus, mycosis fungoides, zona zoster, recurrent aphthous stomatitis and polymorph light eruption were statistically more common in the pandemic period. Moreover, acne, other eczematous dermatities, verruca, androgenic alopecia, and melanocytic nevus diagnoses were found to decrease statistically during the pandemic period when compared with the non-pandemic period., Conclusion: Unlike other studies, the present study evaluated the patient diagnoses during the pandemic period and the period a year before and discussed the possible reasons for the changes in patient profiles., (© 2020 John Wiley & Sons Ltd.)

Competing Interests: Conflicts of interest None disclosed.