fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2020-6-4-122-131fcmedicine-474Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESПоражения кожи у медицинских работников в период пандемии СOVID-19, ассоциированные со средствами индивидуальной защитыSkin lesions associated with personal protective equipment in medical workers during the COVID-19 pandemichttps://orcid.org/0000-0003-1397-7374ГалимоваН. И.GalimovaN. I.

Галимова Ника Игоревна, ассистент кафедры эпидемиологии, инфекционных болезней и дерматовенерологии

650056, г. Кемерово, ул. Ворошилова, д. 22а

Nika I. Galimova, Dr. MD, Dermatologist, Assistant Professor, Department of Epidemiology, Infectious Diseases, Dermatology and Venereology

22a, Voroshilova Street, Kemerovo, 650056

nika-pudlik@yandex.ruФГБОУ ВО «Кемеровский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKemerovo State Medical UniversityRussian Federation20212812202164122131Copyright © Галимова Н.И., 20212021Галимова Н.И.Galimova N.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/474Цель

Цель. Обзор результатов опубликованных исследований поражений кожи у медицинских работников, обусловленных средствами индивидуальной защиты.

Материал и методы

Материал и методы. Выполнен обзор исследований, опубликованных в базах данных PubMed, OVID, EMBASE, MEDLINE, Google Scholar, eLIBRARY, UpToDate. Изученные статьи написаны на русском и английском языках и опубликованы с 1 января 2020-го по октябрь 2021 года. Для поиска использовались ключевые слова «медицинские работники», «кожа», «дерматозы», «профессиональный», «PPE» в сочетании со словами «COVID-19» и «SARSCoV-2».

Результаты

Результаты. Контактный дерматит составляет 90% всех случаев заболеваний кожи, причем 20% всех случаев этой патологии приходятся на профессиональный контактный дерматит. В период пандемии COVID-19 в результате продолжительного ношения СИЗ, частого мытья и обработки рук, по разным данным, от 42,8% до 97% медицинских работников сообщили о поражениях кожи в результате повреждающего действия средств индивидуальной защиты. Среди них 61,7% отметили ухудшение ранее существовавшего заболевания кожи, а 90,5% сообщили о появлении новых симптомов поражения кожи, связанных с использованием СИЗ. В числе самых распространенных симптомов поражений кожи у медицинских работников ‒ сухость, зуд, жжение, болезненность кожи и появление на ней высыпаний. Чаще всего у опрошенных медицинских работников регистрировались простой раздражительный и аллергический контактный дерматит, акне, розацеа, себорейный дерматит. Развитие СИЗ-ассоциированных дерматозов зависело от типа СИЗ, материала, из которого они изготовлены, продолжительности использования, наличия кожных заболеваний в анамнезе.

Заключение

Заключение. Профессиональные дерматозы, связанные с использованием СИЗ, широко распространены среди медицинских работников по всему миру. Это свидетельствует о необходимости поиска новых материалов и средств защиты медицинских работников, правил применения, минимизирующих риск развития СИЗ-ассоциированных поражений кожи.

Aim

Aim. Analysis of the incidence of personal protective equipment (PPE)-associated dermatoses among medical workers during the COVID-19 pandemic.

Materials and Methods

Materials and Methods. Screening of the papers indexed by PubMed, EMBASE, Google Scholar, eLibrary, and UpToDate databases, written in English and published from January 1, 2020 to October, 2021. The search keywords were: "medical workers", "skin", "dermatoses", "professional", and "personal protective equipment" in combination with "COVID-19" and "SARS-CoV-2".

Results

Results. Occupational contact dermatitis is responsible for 20% of all cases of contact dermatitis which accounts for 90% of all skin disease cases. During the COVID-19 pandemic, from 42.8% to 97.0% of medical workers reported about skin lesions provoked by prolonged wearing of PPE in combination with regular disinfection. About 61.7% of them noted the deterioration of a pre-existing skin disease, and 90.5% reported the appearance of new skin lesion symptoms associated with the PPE usage. The most common symptoms of skin lesions among medical workers were dryness, itching, burning, soreness, and skin rash. Irritant and allergic contact dermatitis, acne, rosacea, and seborrheic dermatitis were the most prevalent skin disorders among the interviewed medical workers. Risk factors for the development of PPE-associated dermatoses were the type and material of PPE, the duration of PPE wearing, and past medical history of skin diseases. Due to the increased incidence of PPE-associated dermatoses among the medical staff, some countries have developed recommendations on the prevention and treatment of undesirable PPE-associated skin reactions in medical professionals. Current research are focused on developing special tools and devices that would serve as a protective barrier between the skin and PPE, ameliorating the damaging effect of the latter.

Conclusion

Conclusion. PPE-associated dermatoses are currently widespread among the medical workers, highlighting the need in novel materials for PPE manufacturing to minimise the risk of developing PPE-associated skin lesions.

пандемияCOVID-19средства индивидуальной защиты (СИЗ)медицинские работникиpandemicCOVID-19personal protective equipment (PPE)medical workersReferencesAbdali S, Yu J. Occupational Dermatoses Related to Personal Protective Equipment Used During the COVID-19 Pandemic. Dermatol Clin. 2021;39(4):555-568. https://doi.org/10.1016/j.det.2021.05.009Abdali S, Yu J. Occupational Dermatoses Related to Personal Protective Equipment Used During the COVID-19 Pandemic. Dermatol Clin. 2021;39(4):555-568. https://doi.org/10.1016/j.det.2021.05.009Battista RA, Ferraro M, Piccioni LO, Malzanni GE, Bussi M. Personal Protective Equipment (PPE) in COVID 19 Pandemic: Related Symptoms and Adverse Reactions in Healthcare Workers and General Population. J Occup Environ Med. 2021;63(2):e80-e85. https://doi.org/10.1097/JOM.0000000000002100Battista RA, Ferraro M, Piccioni LO, Malzanni GE, Bussi M. Personal Protective Equipment (PPE) in COVID 19 Pandemic: Related Symptoms and Adverse Reactions in Healthcare Workers and General Population. J Occup Environ Med. 2021;63(2):e80-e85. https://doi.org/10.1097/JOM.0000000000002100Jiang Q, Song S, Zhou J, Liu Y, Chen A, Bai Y, Wang J, Jiang Z, Zhang Y, Liu H, Hua J, Guo J, Han Q, Tang Y, Xue J. The Prevalence, Characteristics, and Prevention Status of Skin Injury Caused by Personal Protective Equipment Among Medical Staff in Fighting COVID-19: A Multicenter, Cross-Sectional Study. Adv Wound Care (New Rochelle). 2020;9(7):357-364. https://doi.org/10.1089/wound.2020.1212Jiang Q, Song S, Zhou J, Liu Y, Chen A, Bai Y, Wang J, Jiang Z, Zhang Y, Liu H, Hua J, Guo J, Han Q, Tang Y, Xue J. The Prevalence, Characteristics, and Prevention Status of Skin Injury Caused by Personal Protective Equipment Among Medical Staff in Fighting COVID-19: A Multicenter, Cross-Sectional Study. Adv Wound Care (New Rochelle). 2020;9(7):357-364. https://doi.org/10.1089/wound.2020.1212Balato A, Ayala F, Bruze M, Crepy MN, Gonçalo M, Johansen J, John SM, Pigatto P, Raimondo A, Rustemeyer T, Schuttelaar MA, Svedman C, Aerts O, Uter W, Wilkinson M, Gimenez-Arnau A. European Task Force on Contact Dermatitis statement on coronavirus disease-19 (COVID-19) outbreak and the risk of adverse cutaneous reactions. J Eur Acad Dermatol Venereol. 2020;34(8):e353-e354. https://doi.org/10.1111/jdv.16557Balato A, Ayala F, Bruze M, Crepy MN, Gonçalo M, Johansen J, John SM, Pigatto P, Raimondo A, Rustemeyer T, Schuttelaar MA, Svedman C, Aerts O, Uter W, Wilkinson M, Gimenez-Arnau A. European Task Force on Contact Dermatitis statement on coronavirus disease-19 (COVID-19) outbreak and the risk of adverse cutaneous reactions. J Eur Acad Dermatol Venereol. 2020;34(8):e353-e354. https://doi.org/10.1111/jdv.16557Akl J, El-Kehdy J, Salloum A, Benedetto A, Karam P. Skin disorders associated with the COVID-19 pandemic: A review. J Cosmet Dermatol. 2021;20(10):3105-3115. https://doi.org/10.1111/jocd.14266Akl J, El-Kehdy J, Salloum A, Benedetto A, Karam P. Skin disorders associated with the COVID-19 pandemic: A review. J Cosmet Dermatol. 2021;20(10):3105-3115. https://doi.org/10.1111/jocd.14266Patruno C, Fabbrocini G, Stingeni L, Napolitano M. The role of occupational dermatology in the COVID-19 outbreak. Contact Dermatitis. 2020;83(2):174-175. https://doi.org/10.1111/cod.13568Patruno C, Fabbrocini G, Stingeni L, Napolitano M. The role of occupational dermatology in the COVID-19 outbreak. Contact Dermatitis. 2020;83(2):174-175. https://doi.org/10.1111/cod.13568Han HS, Shin SH, Park JW, Li K, Kim BJ, Yoo KH. Changes in skin characteristics after using respiratory protective equipment (medical masks and respirators) in the COVID-19 pandemic among healthcare workers. Contact Dermatitis. 2021 Apr 4:10.1111/cod.13855. https://doi.org/10.1111/cod.13855Han HS, Shin SH, Park JW, Li K, Kim BJ, Yoo KH. Changes in skin characteristics after using respiratory protective equipment (medical masks and respirators) in the COVID-19 pandemic among healthcare workers. Contact Dermatitis. 2021 Apr 4:10.1111/cod.13855. https://doi.org/10.1111/cod.13855Sanghvi AR. COVID-19: An overview for dermatologists. Int J Dermatol. 2020;59(12):1437-1449. https://doi.org/10.1111/ijd.15257Sanghvi AR. COVID-19: An overview for dermatologists. Int J Dermatol. 2020;59(12):1437-1449. https://doi.org/10.1111/ijd.15257MacGibeny MA, Wassef C. Preventing adverse cutaneous reactions from amplified hygiene practices during the COVID-19 pandemic: how dermatologists can help through anticipatory guidance. Arch Dermatol Res. 2021;313(6):501-503. https://doi.org/10.1007/s00403-020-02086-xMacGibeny MA, Wassef C. Preventing adverse cutaneous reactions from amplified hygiene practices during the COVID-19 pandemic: how dermatologists can help through anticipatory guidance. Arch Dermatol Res. 2021;313(6):501-503. https://doi.org/10.1007/s00403-020-02086-xLee EB, Lobl M, Ford A, DeLeo V, Adler BL, Wysong A. What Is New in Occupational Allergic Contact Dermatitis in the Year of the COVID Pandemic? Curr Allergy Asthma Rep. 2021;21(4):26. https://doi.org/10.1007/s11882-021-01000-3Lee EB, Lobl M, Ford A, DeLeo V, Adler BL, Wysong A. What Is New in Occupational Allergic Contact Dermatitis in the Year of the COVID Pandemic? Curr Allergy Asthma Rep. 2021;21(4):26. https://doi.org/10.1007/s11882-021-01000-3Yu J, Chen JK, Mowad CM, Reeder M, Hylwa S, Chisolm S, Dunnick CA, Goldminz AM, Jacob SE, Wu PA, Zippin J, Atwater AR. Occupational dermatitis to facial personal protective equipment in health care workers: A systematic review. J Am Acad Dermatol. 2021;84(2):486-494. https://doi.org/10.1016/j.jaad.2020.09.074Yu J, Chen JK, Mowad CM, Reeder M, Hylwa S, Chisolm S, Dunnick CA, Goldminz AM, Jacob SE, Wu PA, Zippin J, Atwater AR. Occupational dermatitis to facial personal protective equipment in health care workers: A systematic review. J Am Acad Dermatol. 2021;84(2):486-494. https://doi.org/10.1016/j.jaad.2020.09.074Goh CF, Ming LC, Wong LC. Dermatologic reactions to disinfectant use during the COVID-19 pandemic. Clin Dermatol. 2021;39(2):314-322. https://doi.org/10.1016/j.clindermatol.2020.09.005Goh CF, Ming LC, Wong LC. Dermatologic reactions to disinfectant use during the COVID-19 pandemic. Clin Dermatol. 2021;39(2):314-322. https://doi.org/10.1016/j.clindermatol.2020.09.005Battista RA, Ferraro M, Piccioni LO, Malzanni GE, Bussi M. Personal Protective Equipment (PPE) in COVID 19 Pandemic: Related Symptoms and Adverse Reactions in Healthcare Workers and General Population. J Occup Environ Med. 2021;63(2):e80-e85. https://doi.org/10.1097/JOM.0000000000002100Battista RA, Ferraro M, Piccioni LO, Malzanni GE, Bussi M. Personal Protective Equipment (PPE) in COVID 19 Pandemic: Related Symptoms and Adverse Reactions in Healthcare Workers and General Population. J Occup Environ Med. 2021;63(2):e80-e85. https://doi.org/10.1097/JOM.0000000000002100Sanghvi AR. COVID-19: An overview for dermatologists. Int J Dermatol. 2020;59(12):1437-1449. https://doi.org/10.1111/ijd.15257Sanghvi AR. COVID-19: An overview for dermatologists. Int J Dermatol. 2020;59(12):1437-1449. https://doi.org/10.1111/ijd.15257Bambi S, Giusti GD, Galazzi A, Mattiussi E, Comisso I, Manici M, Rosati M, Lucchini A. Pressure Injuries Due to Personal Protective Equipment in COVID-19 Critical Care Units. Am J Crit Care. 2021;30(4):287-293. https://doi.org/10.4037/ajcc2021178Bambi S, Giusti GD, Galazzi A, Mattiussi E, Comisso I, Manici M, Rosati M, Lucchini A. Pressure Injuries Due to Personal Protective Equipment in COVID-19 Critical Care Units. Am J Crit Care. 2021;30(4):287-293. https://doi.org/10.4037/ajcc2021178Chaiyabutr C, Sukakul T, Pruksaeakanan C, Thumrongtharadol J, Boonchai W. Adverse skin reactions following different types of mask usage during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2021;35(3):e176-e178. https://doi.org/10.1111/jdv.17039Chaiyabutr C, Sukakul T, Pruksaeakanan C, Thumrongtharadol J, Boonchai W. Adverse skin reactions following different types of mask usage during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2021;35(3):e176-e178. https://doi.org/10.1111/jdv.17039Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, Panombualert S, Mairiang D, Saengnipanthkul S, Wichajarn K, Kiatchoosakun P, Kosalaraksa P. The Effects of the Face Mask on the Skin Underneath: A Prospective Survey During the COVID-19 Pandemic. J Prim Care Community Health. 2020;11:2150132720966167. https://doi.org/10.1177/2150132720966167Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, Panombualert S, Mairiang D, Saengnipanthkul S, Wichajarn K, Kiatchoosakun P, Kosalaraksa P. The Effects of the Face Mask on the Skin Underneath: A Prospective Survey During the COVID-19 Pandemic. J Prim Care Community Health. 2020;11:2150132720966167. https://doi.org/10.1177/2150132720966167Mekonnen TH, Yenealem DG, Tolosa BM. Self-report occupational-related contact dermatitis: prevalence and risk factors among healthcare workers in Gondar town, Northwest Ethiopia, 2018-a cross-sectional study. Environ Health Prev Med. 2019;24(1):11. https://doi.org/10.1186/s12199-019-0765-0Mekonnen TH, Yenealem DG, Tolosa BM. Self-report occupational-related contact dermatitis: prevalence and risk factors among healthcare workers in Gondar town, Northwest Ethiopia, 2018-a cross-sectional study. Environ Health Prev Med. 2019;24(1):11. https://doi.org/10.1186/s12199-019-0765-0Quintana-Díaz MA, Aguilar-Salinas CA. Universal masking during COVID-19 pandemic - current evidence and controversies. Rev Invest Clin. 2020;72(3):144-150. https://doi.org/10.24875/RIC.20000196Quintana-Díaz MA, Aguilar-Salinas CA. Universal masking during COVID-19 pandemic - current evidence and controversies. Rev Invest Clin. 2020;72(3):144-150. https://doi.org/10.24875/RIC.20000196Montero-Vilchez T, Martinez-Lopez A, Cuenca-Barrales C, Rodriguez-Tejero A, Molina-Leyva A, Arias-Santiago S. Impact of Gloves and Mask Use on Epidermal Barrier Function in Health Care Workers. Dermatitis. 2021;32(1):57-62. https://doi.org/10.1097/DER.0000000000000682Montero-Vilchez T, Martinez-Lopez A, Cuenca-Barrales C, Rodriguez-Tejero A, Molina-Leyva A, Arias-Santiago S. Impact of Gloves and Mask Use on Epidermal Barrier Function in Health Care Workers. Dermatitis. 2021;32(1):57-62. https://doi.org/10.1097/DER.0000000000000682Damiani G, Gironi LC, Pacifico A, Cristaudo A, Malagoli P, Allocco F, Bragazzi NL, Linder DM, Santus P, Buja A, Savoia P, Pigatto PD; COVID-19 Dermatologic Italian Task Force, Young Dermatologists Italian Network. Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort. Ital J Dermatol Venerol. 2021;156(2):220-225. https://doi.org/10.23736/S2784-8671.21.06895-4Damiani G, Gironi LC, Pacifico A, Cristaudo A, Malagoli P, Allocco F, Bragazzi NL, Linder DM, Santus P, Buja A, Savoia P, Pigatto PD; COVID-19 Dermatologic Italian Task Force, Young Dermatologists Italian Network. Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort. Ital J Dermatol Venerol. 2021;156(2):220-225. https://doi.org/10.23736/S2784-8671.21.06895-4Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T, Song J, Liu D, Chen L, Shi Y, Jiang S, Liu Q, Xie J, Chen H, Duan Y, Xia Y, Zhou Y, Mei Y, Zhou X, Wu J, Fang M, Meng Z, Li H. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol. 2020;183(1):190-192. https://doi.org/10.1111/bjd.19089Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T, Song J, Liu D, Chen L, Shi Y, Jiang S, Liu Q, Xie J, Chen H, Duan Y, Xia Y, Zhou Y, Mei Y, Zhou X, Wu J, Fang M, Meng Z, Li H. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol. 2020;183(1):190-192. https://doi.org/10.1111/bjd.19089Montero-Vilchez T, Cuenca-Barrales C, Martinez-Lopez A, Molina-Leyva A, Arias-Santiago S. Skin adverse events related to personal protective equipment: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2021;35(10):1994-2006. https://doi.org/10.1111/jdv.17436Montero-Vilchez T, Cuenca-Barrales C, Martinez-Lopez A, Molina-Leyva A, Arias-Santiago S. Skin adverse events related to personal protective equipment: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2021;35(10):1994-2006. https://doi.org/10.1111/jdv.17436Marraha F, Al Faker I, Charif F, Chahoub H, Benyamna Y, Rahmani N, Kabbou S, Rkiek Y, Najdi A, Gallouj S. Skin Reactions to Personal Protective Equipment among First-Line COVID-19 Healthcare Workers: A Survey in Northern Morocco. Ann Work Expo Health. 2021;65(8):998-1003. https://doi.org/10.1097/JOM.0000000000002100Marraha F, Al Faker I, Charif F, Chahoub H, Benyamna Y, Rahmani N, Kabbou S, Rkiek Y, Najdi A, Gallouj S. Skin Reactions to Personal Protective Equipment among First-Line COVID-19 Healthcare Workers: A Survey in Northern Morocco. Ann Work Expo Health. 2021;65(8):998-1003. https://doi.org/10.1097/JOM.0000000000002100Metin N, Turan Ç, Utlu Z. Changes in dermatological complaints among healthcare professionals during the COVID-19 outbreak in Turkey. Acta Dermatovenerol Alp Pannonica Adriat. 2020;29(3):115-122. https://doi.org/10.15570/actaapa.2020.25Metin N, Turan Ç, Utlu Z. Changes in dermatological complaints among healthcare professionals during the COVID-19 outbreak in Turkey. Acta Dermatovenerol Alp Pannonica Adriat. 2020;29(3):115-122. https://doi.org/10.15570/actaapa.2020.25Elston DM. Occupational skin disease among health care workers during the coronavirus (COVID-19) epidemic. J Am Acad Dermatol. 2020;82(5):1085-1086. https://doi.org/10.1016/j.jaad.2020.03.012Elston DM. Occupational skin disease among health care workers during the coronavirus (COVID-19) epidemic. J Am Acad Dermatol. 2020;82(5):1085-1086. https://doi.org/10.1016/j.jaad.2020.03.012Park SJ, Han HS, Shin SH, Yoo KH, Li K, Kim BJ, Seo SJ, Park KY. Adverse skin reactions due to use of face masks: a prospective survey during the COVID-19 pandemic in Korea. J Eur Acad Dermatol Venereol. 2021;35(10):e628-e630. https://doi.org/10.1111/jdv.17447Park SJ, Han HS, Shin SH, Yoo KH, Li K, Kim BJ, Seo SJ, Park KY. Adverse skin reactions due to use of face masks: a prospective survey during the COVID-19 pandemic in Korea. J Eur Acad Dermatol Venereol. 2021;35(10):e628-e630. https://doi.org/10.1111/jdv.17447Kiely LF, Moloney E, O'Sullivan G, Eustace JA, Gallagher J, Bourke JF. Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study. Clin Exp Dermatol. 2021;46(1):142-144. https://doi.org/10.1111/ced.14397Kiely LF, Moloney E, O'Sullivan G, Eustace JA, Gallagher J, Bourke JF. Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study. Clin Exp Dermatol. 2021;46(1):142-144. https://doi.org/10.1111/ced.14397Damiani G, Gironi LC, Grada A, Kridin K, Finelli R, Buja A, Bragazzi NL, Pigatto PDM, Savoia P. COVID-19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi-center, real-life, telemedical, and observational prospective study. Dermatol Ther. 2021;34(2):e14848. https://doi.org/10.1111/dth.14848Damiani G, Gironi LC, Grada A, Kridin K, Finelli R, Buja A, Bragazzi NL, Pigatto PDM, Savoia P. COVID-19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi-center, reallife, telemedical, and observational prospective study. Dermatol Ther. 2021;34(2):e14848. https://doi.org/10.1111/dth.14848Damiani G, Gironi LC, Kridin K, Pacifico A, Buja A, Bragazzi NL, Spalkowska M, Pigatto PDM, Santus P; Young Dermatologists Italian Network, Savoia P. Mask-induced Koebner phenomenon and its clinical phenotypes: A multicenter, real-life study focusing on 873 dermatological consultations during COVID-19 pandemics. Dermatol Ther. 2021;34(2):e14823. https://doi.org/10.1111/dth.14823Damiani G, Gironi LC, Kridin K, Pacifico A, Buja A, Bragazzi NL, Spalkowska M, Pigatto PDM, Santus P; Young Dermatologists Italian Network, Savoia P. Mask-induced Koebner phenomenon and its clinical phenotypes: A multicenter, real-life study focusing on 873 dermatological consultations during COVID-19 pandemics. Dermatol Ther. 2021;34(2):e14823. https://doi.org/10.1111/dth.14823Seirafianpour F, Sodagar S, Pour Mohammad A, Panahi P, Mozafarpoor S, Almasi S, Goodarzi A. Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review. Dermatol Ther. 2020;33(6):e13986. https://doi.org/10.1111/dth.13986Seirafianpour F, Sodagar S, Pour Mohammad A, Panahi P, Mozafarpoor S, Almasi S, Goodarzi A. Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review. Dermatol Ther. 2020;33(6):e13986. https://doi.org/10.1111/dth.13986Barnawi GM, Barnawi AM, Samarkandy S. The Association of the Prolonged Use of Personal Protective Equipment and Face Mask During COVID-19 Pandemic With Various Dermatologic Disease Manifestations: A Systematic Review. Cureus. 2021;13(7):e16544. https://doi.org/10.7759/cureus.16544Barnawi GM, Barnawi AM, Samarkandy S. The Association of the Prolonged Use of Personal Protective Equipment and Face Mask During COVID-19 Pandemic With Various Dermatologic Disease Manifestations: A Systematic Review. Cureus. 2021;13(7):e16544. https://doi.org/10.7759/cureus.16544Uthayakumar AK, Panagou E, Manam S, Schauer A, Veraitch O, Walker S, Edmonds E, Crawley J, Martyn-Simmons C. PPE-associated dermatoses: effect on work and wellbeing. Future Healthc J. 2021;8(1):e67-e69. https://doi.org/10.7861/fhj.2020-0210Uthayakumar AK, Panagou E, Manam S, Schauer A, Veraitch O, Walker S, Edmonds E, Crawley J, Martyn-Simmons C. PPEassociated dermatoses: effect on work and wellbeing. Future Healthc J. 2021;8(1):e67-e69. https://doi.org/10.7861/fhj.2020-0210Lee HC, Goh CL. 'Occupational dermatoses from Personal Protective Equipment during the COVID-19 pandemic in the tropics - A Review'. J Eur Acad Dermatol Venereol. 2021;35(3):589-596. https://doi.org/10.1111/jdv.16925Lee HC, Goh CL. 'Occupational dermatoses from Personal Protective Equipment during the COVID-19 pandemic in the tropics - A Review'. J Eur Acad Dermatol Venereol. 2021;35(3):589-596. https://doi.org/10.1111/jdv.16925Gül Ü. COVID-19 and dermatology. Turk J Med Sci. 2020;50(8):1751-1759. https://doi.org/10.3906/sag-2005-182.10.3906/sag-2005-182Gül Ü. COVID-19 and dermatology. Turk J Med Sci. 2020;50(8):1751-1759. https://doi.org/10.3906/sag-2005-182.10.3906/sag-2005-182Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers' physical health during the COVID-19 pandemic: A systematic review and meta-analysis. Am J Infect Control. 2021;49(10):1305-1315. https://doi.org/10.1016/j.ajic.2021.04.084Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers' physical health during the COVID-19 pandemic: A systematic review and meta-analysis. Am J Infect Control. 2021;49(10):1305-1315. https://doi.org/10.1016/j.ajic.2021.04.084Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020;99(24):e20603. https://doi.org/10.1097/MD.0000000000020603Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020;99(24):e20603. https://doi.org/10.1097/MD.0000000000020603Daye M, Cihan FG, Durduran Y. Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatol Ther. 2020;33(6):e14346. https://doi.org/10.1111/dth.14346Daye M, Cihan FG, Durduran Y. Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatol Ther. 2020;33(6):e14346. https://doi.org/10.1111/dth.14346Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, Panombualert S, Mairiang D, Saengnipanthkul S, Wichajarn K, Kiatchoosakun P, Kosalaraksa P. The Effects of the Face Mask on the Skin Underneath: A Prospective Survey During the COVID-19 Pandemic. J Prim Care Community Health. 2020;11:2150132720966167. https://doi.org/10.1177/2150132720966167Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, Panombualert S, Mairiang D, Saengnipanthkul S, Wichajarn K, Kiatchoosakun P, Kosalaraksa P. The Effects of the Face Mask on the Skin Underneath: A Prospective Survey During the COVID-19 Pandemic. J Prim Care Community Health. 2020;11:2150132720966167. https://doi.org/10.1177/2150132720966167Lan J, Song Z, Miao X, Li H, Li Y, Dong L, Yang J, An X, Zhang Y, Yang L, Zhou N, Yang L, Li J, Cao J, Wang J, Tao J. Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020;82(5):1215-1216. https://doi.org/10.1016/j.jaad.2020.03.014Lan J, Song Z, Miao X, Li H, Li Y, Dong L, Yang J, An X, Zhang Y, Yang L, Zhou N, Yang L, Li J, Cao J, Wang J, Tao J. Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020;82(5):1215-1216. https://doi.org/10.1016/j.jaad.2020.03.014Hadjieconomou S, Hughes J, Kamath S. Occupational skin disease during the COVID-19 pandemic, as captured in a Dermatology staff clinic in the United Kingdom. J Eur Acad Dermatol Venereol. 2020;34(11):e670-e671. https://doi.org/10.1111/jdv.16754Hadjieconomou S, Hughes J, Kamath S. Occupational skin disease during the COVID-19 pandemic, as captured in a Dermatology staff clinic in the United Kingdom. J Eur Acad Dermatol Venereol. 2020;34(11):e670-e671. https://doi.org/10.1111/jdv.16754ZahrAllayali A, Al-Doboke A, Alosaimy R, Alabbasi R, Alharbi S, Fageeh S, Altayyar S, Azher R. The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in the Mecca Region, Saudi Arabia. Clin Cosmet Investig Dermatol. 2021;14:889-899. https://doi.org/10.2147/CCID.S309681ZahrAllayali A, Al-Doboke A, Alosaimy R, Alabbasi R, Alharbi S, Fageeh S, Altayyar S, Azher R. The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in the Mecca Region, Saudi Arabia. Clin Cosmet Investig Dermatol. 2021;14:889-899. https://doi.org/10.2147/CCID.S309681Zhang M, Wang L, Yu S, Sun G, Lei H, Wu W. Status of occupational protection in the COVID-19 Fangcang Shelter Hospital in Wuhan, China. Emerg Microbes Infect. 2020;9(1):1835-1842. https://doi.org/10.1080/22221751.2020.1803145Zhang M, Wang L, Yu S, Sun G, Lei H, Wu W. Status of occupational protection in the COVID-19 Fangcang Shelter Hospital in Wuhan, China. Emerg Microbes Infect. 2020;9(1):1835-1842. https://doi.org/10.1080/22221751.2020.1803145Kantor J. Behavioral considerations and impact on personal protective equipment use: Early lessons from the coronavirus (COVID-19) pandemic. J Am Acad Dermatol. 2020;82(5):1087-1088. https://doi.org/10.1016/j.jaad.2020.03.013Kantor J. Behavioral considerations and impact on personal protective equipment use: Early lessons from the coronavirus (COVID-19) pandemic. J Am Acad Dermatol. 2020;82(5):1087-1088. https://doi.org/10.1016/j.jaad.2020.03.013Yan Y, Chen H, Chen L, Cheng B, Diao P, Dong L, Gao X, Gu H, He L, Ji C, Jin H, Lai W, Lei T, Li L, Li L, Li R, Liu D, Liu W, Lu Q, Shi Y, Song J, Tao J, Wang B, Wang G, Wu Y, Xiang L, Xie J, Xu J, Yao Z, Zhang F, Zhang J, Zhong S, Li H, Li H. Consensus of Chinese experts on protection of skin and mucous membrane barrier for healthcare workers fighting against coronavirus disease 2019. Dermatol Ther. 2020;33(4):e13310. https://doi.org/10.1111/dth.13310Yan Y, Chen H, Chen L, Cheng B, Diao P, Dong L, Gao X, Gu H, He L, Ji C, Jin H, Lai W, Lei T, Li L, Li L, Li R, Liu D, Liu W, Lu Q, Shi Y, Song J, Tao J, Wang B, Wang G, Wu Y, Xiang L, Xie J, Xu J, Yao Z, Zhang F, Zhang J, Zhong S, Li H, Li H. Consensus of Chinese experts on protection of skin and mucous membrane barrier for healthcare workers fighting against coronavirus disease 2019. Dermatol Ther. 2020;33(4):e13310. https://doi.org/10.1111/dth.13310Burns ES, Pathmarajah P, Muralidharan V. Physical and psychological impacts of handwashing and personal protective equipment usage in the COVID-19 pandemic: A UK based cross-sectional analysis of healthcare workers. Dermatol Ther. 2021;34(3):e14885. https://doi.org/10.1111/dth.14885Burns ES, Pathmarajah P, Muralidharan V. Physical and psychological impacts of handwashing and personal protective equipment usage in the COVID-19 pandemic: A UK based cross-sectional analysis of healthcare workers. Dermatol Ther. 2021;34(3):e14885. https://doi.org/10.1111/dth.14885Oranges T, Janowska A, Dini V. Reply to: "Skin damage among health care workers managing coronavirus disease-2019". J Am Acad Dermatol. 2020;82(6):e233-e234.https://doi.org/10.1016/j.jaad.2020.04.003Oranges T, Janowska A, Dini V. Reply to: "Skin damage among health care workers managing coronavirus disease-2019". J Am Acad Dermatol. 2020;82(6):e233-e234. https://doi.org/10.1016/j.jaad.2020.04.003Yap KK, Murali M, Tan Z, Zhou X, Li L, Masen MA. Wax-oil lubricants to reduce the shear between skin and PPE. Sci Rep. 2021;11(1):11537. https://doi.org/10.14469/hpc/8076Yap KK, Murali M, Tan Z, Zhou X, Li L, Masen MA. Wax-oil lubricants to reduce the shear between skin and PPE. Sci Rep. 2021;11(1):11537. https://doi.org/10.14469/hpc/8076Zhou N, Yang L, Li Y, Yang J, Yang L, An X, Zhang Y, Suo H, Du H, Zhu J, Tao J, Dong L. Hydrogel patches alleviate skin injuries to the cheeks and nasal bridge caused by continuous N95 mask use. Dermatol Ther. 2020;33(6):e14177. https://doi.org/10.1111/dth.14177Zhou N, Yang L, Li Y, Yang J, Yang L, An X, Zhang Y, Suo H, Du H, Zhu J, Tao J, Dong L. Hydrogel patches alleviate skin injuries to the cheeks and nasal bridge caused by continuous N95 mask use. Dermatol Ther. 2020;33(6):e14177. https://doi.org/10.1111/dth.14177Desai SR, Kovarik C, Brod B, James W, Fitzgerald ME, Preston A, Hruza GJ. COVID-19 and personal protective equipment: Treatment and prevention of skin conditions related to the occupational use of personal protective equipment. J Am Acad Dermatol. 2020;83(2):675-677. https://doi.org/10.1016/j.jaad.2020.05.032Desai SR, Kovarik C, Brod B, James W, Fitzgerald ME, Preston A, Hruza GJ. COVID-19 and personal protective equipment: Treatment and prevention of skin conditions related to the occupational use of personal protective equipment. J Am Acad Dermatol. 2020;83(2):675-677. https://doi.org/10.1016/j.jaad.2020.05.032Abtahi-Naeini B. Frequent handwashing amidst the COVID-19 outbreak: prevention of hand irritant contact dermatitis and other considerations. Health Sci Rep. 2020;3(2):e163.https://doi.org/10.1002/hsr2.163Abtahi-Naeini B. Frequent handwashing amidst the COVID-19 outbreak: prevention of hand irritant contact dermatitis and other considerations. Health Sci Rep. 2020;3(2):e163. https://doi.org/10.1002/hsr2.163Sharma P, Goel N, Dogar K, Bhalla M, Thami GP, Punia K. Adverse skin reactions related to PPE among healthcare workers managing COVID-19. J Eur Acad Dermatol Venereol. 2021;35(8):e481-e483. https://doi.org/10.1111/jdv.17290Sharma P, Goel N, Dogar K, Bhalla M, Thami GP, Punia K. Adverse skin reactions related to PPE among healthcare workers managing COVID-19. J Eur Acad Dermatol Venereol. 2021;35(8):e481-e483. https://doi.org/10.1111/jdv.17290Sud SR. COVID-19 and Keeping Clean: A Narrative Review To Ascertain the Efficacy of Personal Protective Equipment To Safeguard Health Care Workers Against SARS-CoV-2. Hosp Pediatr.;10(7):570-576. https://doi.org/10.1542/hpeds.2020-0135Sud SR. COVID-19 and Keeping Clean: A Narrative Review To Ascertain the Efficacy of Personal Protective Equipment To Safeguard Health Care Workers Against SARS-CoV-2. Hosp Pediatr.;10(7):570-576. https://doi.org/10.1542/hpeds.2020-0135

The authors declare that there are no conflicts of interest present.