"Mask vitiligo" secondary to frictional dermatitis from surgical masks

Various aspects of the relationship between vitiligo and the COVID-19 pandemic or SARS-CoV-2 vaccines: Clinical pearls for dermatologists

BACKGROUND

Coronavirus disease 2019 (COVID-19) has given rise to several new onset or exacerbated dermatologic disorders including vitiligo.

AIM AND METHOD

Here, we present different aspects of relationship between SARS-CoV-2 infection or its associated vaccines and vitiligo and aim to provide solutions to overcome the potential challenges.

RESULTS AND CONCLUSION

In brief, as the benefits overweigh the risks and since vaccine-triggered de novo or flares of vitiligo are uncommon and benign, these patients are recommended to get SARS-CoV-2 vaccines. Moreover, in individuals with previously recognized vitiligo, who are at risk of developing SARS-CoV-2 infection or those who are currently infected, special dermatologic consultation is needed in order to balance the immunosuppressive agents in their therapeutic regimen to prevent COVID-related morbidity and mortality.

Facial atopic dermatitis may be exacerbated by masks: insights from a multicenter, teledermatology, prospective study during COVID-19 pandemic

BACKGROUND

Patients with atopic dermatitis (AD) display a defective skin barrier, consequently they may experience inflammatory flares with different exposures, including masks. Actually, beside scattering case reports, no study focused on the possible AD flaring due to masks.

METHODS

In this multicenter prospective study AD patients with facial manifestation were followed with teledermatology and evaluated by two board-certified dermatologists at the baseline (T0) and after 1 month (T1) in which patients started to wear masks >6 hours per day. Demographics and clinical parameters, included and not limited to Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI), were carefully collected and analyzed.

RESULTS

We enrolled 57 AD patients (M/F 28/29, 33.91±12.26 years old) that wore surgical masks (38 [66.7%]), community masks (11 [19.3%] and N95 (8 [14.0%]). Both DLQI and EASI increase during the time period (P<0.0001). DLQI variation was not influenced by age, BMI, and gender, mask type used and AD therapy (P=0.99), whilst EASI variation was significantly influenced by BMI, gender, and therapy (P=0.004).

CONCLUSIONS

Mask wearing may prove detrimental to patients with atopic eczema and the same may not necessarily be the case for asthma patients.

Friction-Induced Skin Disorders-A Review

ABSTRACT

Friction is unavoidable in activites of daily life and is associated with various dermatological disorders. A comprehensive literature review showed friction can induce epidermal changes, dermatitis, alteration of the dermis, diseases of abnormal deposition, alteration of the hair and follicles, nail diseases, pigmentary disorders, and skin tumors. Cultural, religious, and occupational factors may predispose to the development friction-related skin disorders. However, friction often occurs together with other external stimuli, such as pressure and occlusion. Careful observation and investigation are required to establish the exact role of friction in the development of various dermatoses.

Free formaldehyde in non-medical face masks purchased from the Japanese market since the COVID-19 outbreak

Since the Coronavirus Disease 2019 (COVID-19) pandemic began, people have been wearing face masks for many hours every day. As these face masks are in contact with the skin, it is important to pay more attention to their quality and safety. This study examined the concentration of free formaldehyde in 90 non-medical face masks and related products (33 nonwoven, 30 woven cloth, 12 polyurethane, and 15 related products) because formaldehyde is a common contact allergen in textile products. For products consisting of mixed materials, each material was sampled, resulting in 103 samples for analysis. Free formaldehyde (34-239 μg/g) was found in three cloth masks, which consisted of cotton and polyester, with antibacterial and antiviral labeling. It was confirmed that the detected formaldehyde originated from the mask-finishing treatment by a hydrochloric acid extraction discrimination test. These masks may elicit contact dermatitis if the consumers have already been sensitized to formaldehyde. However, the risk of contact dermatitis caused by formaldehyde in masks may be considered low since the frequency of formaldehyde detection in masks in Japan is low.

Contact dermatitis due to personal protective equipment use and hygiene practices during the COVID-19 pandemic: A systematic review of case reports

BACKGROUND

Prolonged use of personal protective equipment (PPE) may lead to contact dermatitis during the coronavirus disease 19 (COVID-19) pandemic. This paper aims to identify the causative factors of contact dermatitis from PPE and hygiene practices.

METHODS

The search was conducted adhering to PRISMA 2020 guidelines. A Delphi process was employed to ensure that the aims of this study were met. PubMed and Web of Science databases were systematically searched through September 12, 2021, using search terms: Contact dermatitis, case report, covid-19. The findings were tabulated as author/year, gender, age, presentation, cause, dermatological diagnosis, testing modality, provided treatment, symptom resolution (time in days), prognosis, and follow-up.

RESULTS

The mean age of all individuals was 29.75 years, with 75% females. All cases presented with erythema, with 62.5% reporting pruritus and 37.5% reporting burning facial symptoms. Surgical masks and hand-hygiene products (37.5%) were the most commonly reported causative agent with 25% due to KN95/FFP type 2 use. Allergic contact dermatitis (50%) and irritant contact dermatitis (25%) were common diagnoses. Treatments included creams, emollients, and desloratadine, with restriction of irritant-causing factors. The prognosis was generally good among the cases, with 62.5% presenting complete resolution within a week and 12.5% showing moderate improvement at the fourth month after discontinuing use.

CONCLUSION

This study finds pertinent links between PPE use and contact dermatitis during the COVID-19 pandemic. While many cases are bound to go underreported in literature, well-designed, large-scale studies in the future may help promote these associations in a more comprehensive manner.