The effect of the "stay-at-home" policy on requests for dermatology outpatient clinic visits after the COVID-19 outbreak

Status of the scabies outbreak before, during and after the Covid- 19 pandemic: a single-center hospital-based retrospective evaluation

BACKGROUND

Scabies is an infestation that can be seen in all age groups, ethnicities, genders, socio-economic groups and in all societies. It is estimated that there are at least 200 million cases worldwide yearly. In this study, we aimed to evaluate the situation before, during and after Covid- 19.

METHODS

All patients admitted to our outpatient clinic between January 1, 2017 and April 30, 2024 and patients diagnosed with scabies were included in our study and examined retrospectively. The age and gender of the patients, the number of patients admitted monthly and the number of patients diagnosed with scabies among them were evaluated monthly.

RESULTS

Between January 1, 2017 and April 30, 2024, 257,536 patients applied to our outpatient clinic. Of these patients, 9407 were diagnosed with scabies. When the percentage of cases was evaluated by years, it was observed that it started to increase in 2019, reached high levels and remained stable in 2020-2022, and then continued to rise in the first 4 months of 2023 and 2024.

CONCLUSION

As a result, we found an increase in the number of scabies cases during the pandemic period. Although the rate of scabies cases is stable between 2020 and 2022, it is seen that the increase continues and will continue in 2023 and the following years.

Indirect Impact of Pandemic on the Diagnosis of New Primary Melanoma: A Retrospective, Multicenter Study

Background/Objectives: The indirect impact of the pandemic on the diagnosis and treatment of new primary melanoma has been carefully evaluated in recent years. The aim of the present study was to investigate if the indirect impact of the pandemic in Italy could be detectable also in the second year of the pandemic, as suggested by the characteristics of melanoma at diagnosis. Methods: Retrospective analysis of 1640 diagnoses of cutaneous melanoma in pre-pandemic period and 1292 diagnoses in the pandemic period from 10 centers (from 1 March 2019 to 28 February 2022). Results: Our findings confirmed an indirect impact of the pandemic on characteristics of incident melanoma, also in the second year of the pandemic in Italy (Breslow thickness p < 0.0001, tumor stage p = 0.002, ulceration p = 0.04, SNLB p = 0.03), without statistically significant differences between centers. A statistically significant reduction in the time interval from diagnosis to surgical treatment was observed, but only in centers that had to modify their case mix to address the needs of treating COVID-19 patients (p = 0.0002). Conclusions: Our study confirmed the indirect impact of the pandemic on melanoma characteristics at the diagnosis in the second year of the pandemic in Italy. We also found no differences in melanoma characteristics between hospitals with different organization. Diagnostic delays may be related to a delayed access of the patient to the entire diagnostic pathway, and therefore, especially in the case of a pandemic, policies to support early diagnosis are crucial.

Prevalence and Comparison of Superficial-Cutaneous Fungal Infections Before and During the COVID-19 Pandemic in Shiraz, Iran: A Retrospective Study (2018-2021)

The use of personal protective equipment such as gloves and masks and protective measures such as repeated contact of hands with water and skin disinfectants are recommended to prevent the spread of Corona virus disease 2019 (COVID-19). However, these hygiene measures may cause skin injury and skin diseases, including superficial-cutaneous-fungal infections (SCFIs). The aim of this study was to determine the prevalence and comparison of SCFIs before and during the COVID-19 pandemic. In this retrospective cross-sectional study, the data of patients suspected of SCFIs who had been referred to two clinical mycology laboratories in Shiraz, Iran, before and during the COVID-19 pandemic were reviewed. Collected data included date of admission, demographic information, site of infection, risk factors associated with SCFIs, and results of diagnostic tests. A total of 3781 patients suspected of having SCFIs were included in the study. Among them, 1750 (46.28%) patients were positive for SCFIs, 778 (44.45%), and 972 (55.54%) belonged to the periods before and during the COVID-19 pandemic, respectively. The highest frequency of SCFIs before and during the pandemic was observed in the age group of 21-50 years (n = 910, 52%). Dermatophytosis was the most common SCFI before and during the COVID-19 pandemic. The highest and lowest infection sites before and during the pandemic were the fingernails (n = 496, 28.34%) and the auricle (n = 3, 0.17%), respectively. Our findings showed that the prevalence of SCFIs has increased during the COVID-19 pandemic. Knowing the pattern of SCFIs might help dermatologists with initial and experimental antifungal therapy for future pandemic diseases.

COVID-19-induced hair shedding and related risk factors: A Saudi perspective

Introduction

Many cases of telogen effluvium (TE), acute hair shedding, following coronavirus disease 2019 (COVID-19) were reported during the pandemic.

Methodology

We conducted a cross-sectional study to assess the relationship between COVID-19 and TE in Saudi Arabia. Self-administered online questionnaires were distributed online between March and September 2022 in Saudi Arabia. A multivariate logistic regression model was used to determine risk factors associated with TE post-COVID-19 (significance at P < 0.05).

Results

Of the 703 responders, 392 were included in the study. 59.70% (n = 234) recognized hair shedding during or after COVID-19. The time taken to realize hair shedding (3 or 6 months) and the duration varied (3, 6, >6 months). The risk factors significantly related to TE post-COVID-19 were: female sex (P < 0.001, odds ratio [OR] = 2.98), COVID-19 antiviral treatment (P = 0.032, OR = 3.02), and TE history (P = 0.001, OR = 3.78).

Conclusion

Healthcare providers and physicians should be aware of the relationship between TE and COVID-19, to easily recognize, treat, and improve their patients' outcomes).

The changing pattern of common respiratory viruses among children from 2018 to 2021 in Wuhan, China

BACKGROUND

Acute respiratory infections in children are a global public health challenge. Owing to the coronavirus disease (COVID-19) pandemic, non-pharmaceutical interventions, including patient isolation, social distancing, hand washing, and mask wearing, have been widely implemented, impacting the transmission of common respiratory viruses. The aim of this study was to clarify the epidemiological features of respiratory viruses in children less than 14 years of age in Wuhan before and after COVID-19.

METHODS

Respiratory specimens were collected from patients aged < 14 years at two hospitals in Wuhan, China, from January 2018 to December 2021. Seven respiratory viruses were identified using an immunofluorescence assay. Pathogen profiles and seasonality were analysed.

RESULTS

The number of visits and virus detection rate decreased dramatically after February 2020. The respiratory virus detection rate peaked in January and December and decreased dramatically in February and August. The detection rate was lower in 2021 than in 2018 and 2019. Respiratory syncytial virus (RSV) was identified as the leading pathogen in children aged < 1 year and 1-4 years before and after the COVID-19 pandemic. In children aged 5-14 years, influenza virus was detected at the highest rate before, and RSV after, the COVID-19 pandemic. RSV was the most common virus in coinfections.

CONCLUSIONS

This study revealed the epidemiological patterns of common respiratory viruses from 2018 to 2021. The spectrum of pathogens involved in paediatric respiratory infections had partly changed. Non-pharmaceutical interventions resulted in fewer opportunities for the spread of common viruses but also in an "immunity debt" that could have negative consequences when the pandemic is under control in Wuhan.

The Impact of the Initial Phase of the COVID-19 Pandemic on Patients With Autoimmune Bullous Diseases

Introduction The follow-up of patients with autoimmune bullous diseases (AIBDs) was temporarily interrupted during the initial phase of the COVID-19 pandemic due to restrictions in healthcare services, given the high contagiousness and rapid spread of SARS-CoV-2. Our objective was to assess the impact of the initial phase of the COVID-19 pandemic on the treatments and disease activity of AIBD patients. Methods We conducted a telephone survey of patients with AIBDs who had been regularly followed up in our hospital prior to the onset of the pandemic. A structured questionnaire that we designed was used. This questionnaire comprised questions examining the following issues between March and June of 2020: patients' follow-up, treatment, COVID-19 infection status, and changes in disease activity. Results Thirty-nine patients were included in the study. Among those, 26 (66.7%) were immunosuppressed. The frequency of follow-up for 37 patients (94.9%) changed significantly (p<0.001): 28 patients (71.8%) did not visit the hospital, and 26 of them (92.9%) did not communicate at all. The treatment for 10 patients (25.6%) was altered, either by their physician or by themselves. Disease activity reactivated in patients who altered their own treatments. There was only one patient (2.6%) who contracted COVID-19. Conclusions Documenting this period revealed that some patients were negatively impacted by the pandemic initially. The most significant contributing factor was the interruption of patient-physician communication.

Video education improves patients' knowledge and satisfaction in treatment of solar lentigines with picosecond 755-nm alexandrite laser: A retrospective study

Background

Picosecond lasers are widely used in dermatologic and cosmetic practice. In clinical practice, informed consent for laser treatments is critical to ensure patients' understanding of health information.

Objectives

To evaluate whether video-based informed consent improves patient comprehension and satisfaction.

Methods

The study was performed from August 1 to November 30, 2022. Solar lentigines patients who fulfilled the inclusion criteria were included. Before October 1, 2022, traditional informed consent methods were performed. In the subsequent 2 months, a video-based informed consent was used as an adjunct to traditional consenting methods. Finally, patient comprehension of relevant knowledge about laser treatment and client satisfaction were assessed.

Results

A total of 106 patients were included. The mean number of correct answers in the comprehension assessment in the video-based informed consent group was significantly higher than that in the traditional informed consent group (4.4 ± 1.2 vs. 3.4 ± 1.1, p < 0.001). Compared to the traditional informed consent group, more correct answers in the video-based informed consent group were provided by older patients (3.9 ± 1.2 vs. 2.9 ± 1.1, p = 0.004) and patients with lower education levels (4.1 ± 1.1 vs. 3.0 ± 1.2, p < 0.001). The mean satisfaction score in the video-based informed consent group was significantly higher than that in the traditional informed consent (27.8 ± 5.7 vs. 24.3 ± 6.2, p = 0.003).

Conclusion

Video-based informed consent helps patients learn clinical literacy more effectively and improves patient satisfaction, especially in those with lower education levels and older ages.

The Impact of COVID-19 Pandemic on Arthropod-Related Diseases

Background

The Covid-19 pandemic that caused by the infection with the novel Coronavirus SARS-CoV-2 has revealed individual and global vulnerabilities all over the world. Many countries that had been struggled with arthropod-borne diseases (VBDs) are now embroiled in another challenge caused by COVID-19 pandemic. The situation that poses major obstacles 1) by misdiagnosis 2) delay in early and appropriate treatment of VBDs 3) difficulties in applying regular strategy for vector control and prevention methods and finally 4) irregularity in financing supports. Given the possible scenario of syndemics, it is important to plan integrated and combined measurement with the maximum participation of the people and health authorities. Here, the impact of COVID-19 pandemic on some major arthropod-related diseases will be discussed.

Methods

To access the collective data all related databases such as Science direct, PubMed, Elsevier, Google scholar, as well WHO web page were searched with key words "arthropoda-related diseases, COVID-19 with the name of each individual disease".

Results

The results showed that the management, control, and treatment of most important arthropod-related diseases could be delayed due to COVID-19 pandemic.

Conclusion

Dealing with COVID-19, it is crucial to consider the other main killers such as malaria, dengue fever, etc. more especially in vulnerable populations by greater political, financial and global commitment. Continued surveillance will be essential to monitor for any possible changes.

The effect of COVID-19 on development of hair and nail disorders: a Turkish multicenter, controlled study

BACKGROUND

A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection.

METHODS

This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined.

RESULTS

The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 ± 2.77 and 3.64 ± 3.04, respectively, in the hair loss group and were 5.77 ± 3.18 and 2.81 ± 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4-7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222-7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05).

CONCLUSION

The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19.

Impact of COVID-19 on inpatient care related to skin conditions

Background

The COVID-19 pandemic significantly affected our society and healthcare system. This study aims to evaluate the effects of COVID-19 on the number of hospitalized patients with dermatological diseases in Croatia, as well as the number of these patients treated surgically and conservatively, before (2017-2019) and during the pandemic (2020-2021).

Materials and methods

This is a retrospective, comparative study of the hospital admission rate for patients with skin, subcutaneous tissue, and breast disorders both before and during the pandemic. This study used data from the Croatian Institute of Public Health (CIPH) and the Croatian Health Insurance Fund (CHIF). Inpatient data for the CHIF data collection were categorized using the Australian Refined Diagnosis Related Groups (AR-DRGs). All hospital admissions for dermatology patients at all non-specialized hospitals in Croatia were tracked during two periods, before (2017-2019) and during the pandemic (2020-2021).

Results

The average number of dermatology patients in all hospitals fell by 29% during the pandemic. The overall number of dermatological patients admitted to hospitals fell by 32% in 2020 and by 26% in 2021 when compared to the number of patients admitted each year on average over the preceding 3 years. Additionally, there was an average 22% fall in surgical procedures performed during the pandemic. The only exception for surgical procedures is Major Breast Reconstruction for which is noted an increase, as also for Malignant Breast Disorders, Minor Complexity and Major Skin Disorders, Minor Complexity in a group of non-surgically treated patients.

Conclusion

Examining the all consequences of the Croatian dermatological patient care interruption will require more investigation. Reduced access to medical care during the pandemic is anticipated to lead to later illness diagnosis, a later start to treatment, a poorer disease prognosis, as well as higher medical expenditures.

Comparative Evaluation of Dermatological Emergency Consultations in the Coronavirus Pandemic Era: Tertiary Clinic Experience

INTRODUCTION

Due to the increase in COVID-19 patients during the pandemic, the workload of emergency departments has increased. The profile of patients seeking non-COVID medical care has changed significantly because of the pandemic; this includes dermatological emergencies.

OBJECTIVE

The aim was to evaluate and compare adult dermatological emergency consultations during the COVID-19 period with the pre-pandemic period.

METHODS

Consulted patients from ED to dermatology between March 11, 2019, and March 11, 2021 were included (Pre-pandemic and pandemic). Age, gender, zone of triage, consultation hour, consultation date, consultation response time, ICD-10 codes were recorded.

RESULTS

The total number of consultations was 639. The mean age of the patients was 44.4 in the pre-pandemic period and 46.1 in the pandemic period. The mean consultation response time was 44.4 minutes in the pre-pandemic period and 60.3 minutes in the pandemic. In the pre-pandemic period, the most common consulted diseases were herpes zoster, urticaria, and allergic contact dermatitis. During the pandemic, the most common consulted diseases were herpes zoster, other dermatitis, and urticaria. There was a statistically significant difference in the incidence of other dermatitis, impetigo/folliculitis, cutaneous vasculitis, and pruritus (p<0.05) CONCLUSIONS: Emergency departments are the busiest and fastest areas of the hospital. Pandemics such as COVID-19 may also occur in the coming years. Informing society about dermatological emergencies and adding adequate dermatology training to the training of emergency physicians will facilitate appropriate patient management in emergency departments.

Changing spectrum of hair and scalp disorders over the last decade in a tertiary medical centre

BACKGROUND

Hair- and scalp-related disorders (HSRDs) encompass a wide range of conditions that affect people of all ages.

OBJECTIVE

To evaluate the workload and trends in HSRDs at an outpatient dermatological clinic in a tertiary medical centre over a 10-year period.

METHODS

Medical records for HSRD visits to the outpatient dermatology clinic at the Sheba Medical Center, an Israeli tertiary care center, were reviewed between 1 January, 2010 and 31 December, 2020.

RESULTS

There were 10,396 HSRD visits with a new-to-follow-up visit ratio of 1:1.9. The annual number of HSRD visits, as well as their proportion out of all dermatological outpatient visits, have increased from 295 (1.24%) in 2010 to 1726 (9.44%) in 2020. The patients' mean age was 35.3 years (women 39.5 years, men 28.8 years), age range 1-87 years. Over the decade, there was a growing predominance of women with an average female-to-male ratio of 2:1. The winter season accounted for 28.7% of annual visits, followed by the autumn (25.6%), summer (24.3%) and spring (21.4%). The most prevalent HSRDs included androgenetic alopecia (30.6%), alopecia areata (19.3%), telogen effluvium (15.4%), non-scarring folliculitis (15.4%), seborrheic dermatitis (14.9%), lichen planopilaris (7.1%) and folliculitis decalvans (6.6%). Androgenetic alopecia demonstrated the highest increase over the decade examined (from 17% to 32%).

CONCLUSION

HSRDs account for a significant percentage of visits at a tertiary dermatology outpatient clinic. The number of HSRD visits has increased annually over the past decade. The recent advancement in diagnosis and treatment may account, at least in part, for the growing burden of HSRDs within dermatological ambulatory care.

Impacts of COVID-19 Pandemic on Dermatology Outpatient Department at a Tertiary Hospital in Eastern China: A Pre-Post Study

Background

The COVID-19 pandemic has considerable impact on health care system in the world directly. Although the pandemic has been effectively controlled, people’s lifestyle, stress of job, economic status and health conditions have all changed. Therefore, it is unclear whether the COVID-19 pandemic has affected the distribution of diseases in dermatology outpatient department, especially in the post-pandemic era and how we should respond to these changes.

Objective

We aimed to assess the impact of the COVID-19 pandemic on diagnosis of dermatology outpatient department in eastern China.

Methods

A pre-post study design was a retrospective study to assess the changes of diseases diagnoses from the outpatient department of Dermatology, Taicang first people’s hospital, Suzhou University, Suzhou, China in the 2021 (Post-COVID-19 pandemic) compared to the 2019 (Pre-COVID-19 pandemic). Statistical analysis was performed using the SPSS 23.0 and Excel 2010. The data were analysed by methods independent t-test and Pearson’s chi-square test. A two-sided p-value of <0.05 was considered statistically significant.

Results

A total of 67,994 patients in 2019 and 67,288 patients in 2021 were included in the study. During the pre-pandemic year, the most common diagnoses in the outpatient department were urticaria, fungal dermatitis, acne, herpes zoster, seborrheic dermatitis. Urticaria, acne, allergic dermatitis, fungal dermatitis, herpes zoster, were statistically more common in the post-pandemic period. Acne, animal-related diseases, allergic dermatitis, insect dermatitis, alopecia, and verruca vulgaris diagnoses were found to increase statistically during the post-pandemic period when compared with the pre-pandemic period.

Conclusion

The COVID-19 pandemic had a minimal effect on the average yearly dermatology outpatients department visits, but the distribution of dermatology diagnoses was affected. As a result, governments and health departments may introduce innovative ways and training of medical teams according to the impact of the pandemic to ensure normal medical care.

Mask disinfection using atmospheric pressure cold plasma

OBJECTIVES

Mask usage has increased over the last few years due to the COVID-19 pandemic, resulting in a mask shortage. Furthermore, their prolonged use causes skin problems related to bacterial overgrowth. To overcome these problems, atmospheric pressure cold plasma was studied as an alternative technology for mask disinfection.

METHODS

Different microorganisms (Pseudomonas aeruginosa, Escherichia coli, Staphylococcus spp.), different gases (nitrogen, argon, and air), plasma power (90-300 W), and treatment times (45 seconds to 5 minutes) were tested.

RESULTS

The best atmospheric pressure cold plasma treatment was the one generated by nitrogen gas at 300 W and 1.5 minutes. Testing of breathing and filtering performance and microscopic and visual analysis after one and five plasma treatment cycles, highlighted that these treatments did not affect the morphology or functional capacity of the masks.

CONCLUSION

Considering the above, we strongly believe that atmospheric pressure cold plasma could be an inexpensive, eco-friendly, and sustainable mask disinfection technology enabling their reusability and solving mask shortage.

Impact of state of emergency for coronavirus disease 2019 on hospital visits and disease exacerbation: the Japan COVID-19 and Society Internet Survey

BACKGROUND

Studies on the impact of coronavirus disease 2019 (COVID-19) on people's routine medical care are limited, and understanding the factors associated with medical care avoidance can inform us about the ongoing pandemic.

OBJECTIVES

We aimed to assess the impact of Japan's state of emergency and stay-at-home policy for COVID-19 on hospital visits and disease exacerbation; we also identified related factors.

METHODS

This cross-sectional study used data from the Japan COVID-19 and Society Internet Survey (JACSIS), which included randomly sampled research agency panellists in Japan. Among the 28,000 participants, we included 7,747 respondents who reported having any disease. We described baseline characteristics and avoidance-related hospital visit outcomes. We used multivariable logistic regression analyses to assess the association between chronic diseases and outcomes of hospital visit avoidance.

RESULTS

Among 7,747 participants, 17.7% of patients with chronic diseases avoided hospital visits, 2.1% of patients postponed hospitalization or surgery, 4.9% of patients ran out of drug, and 5.3% of patients experienced disease exacerbation during the COVID-19 pandemic in April and May 2020. Exacerbations occurred mostly in participants with mental diseases, chronic pain and headache, and diabetes (OR 3.33 [95% confidence interval (CI): 2.51-4.41], 2.83 [95% CI: 2.19-3.66], and 1.53 [95% CI: 1.10-2.13], respectively). Patients with cardiovascular disease or cancer did not experience exacerbation [OR 0.55 (95% CI: 0.31-0.97), 0.79 (95% CI: 0.43-1.45)].

CONCLUSIONS

The rates of hospital visit avoidance and exacerbation varied among patients with different diseases under the COVID-19 stay-at-home policy in April and May 2020, and disease-specific preparedness may be necessary for the pandemic.

Seasonal Patterns and Trends in Dermatoses in Poland

Background: The amount of data available online is constantly increasing, including search behavior and tracking trends in domains such as Google. Analyzing the data helps to predict patient needs and epidemiological events more accurately. Our study aimed to identify dermatology-related terms that occur seasonally and any search anomalies during the SARS-CoV-2 pandemic. Methods: The data were gathered using Google Trends, with 69 entries between January-2010 and December-2020 analyzed. We conducted the Seasonal Mann–Kendal Test to determine the strength of trends. The month with the highest seasonal component (RSV) and the lowest seasonal component (RSV) was indicated for every keyword. Groups of keywords occurring together regularly at specific periods of the year were shown. Results: We found that some topics were seasonally searched in winter (e.g., herpes, scabies, candida) and others in summer (e.g., erythema, warts, urticaria). Conclusions: Interestingly, downward trends in searches on sexually transmitted diseases in comparison with increased infection rates reported officially show a strong need for improved sexual education in Poland. There were no significant differences in trends for coronavirus-related cutaneous symptoms during 2020. We have shown that the seasonality of dermatologically related terms searched in Poland via Google did not differ significantly during SARS-CoV-2 pandemic.

Prevalence of Scabies in the Covid-19 Pandemic Period and Determination of Risk Factors for Scabies: a Hospital-Based Cross-Sectional Study in Northeast Turkey

BACKGROUND

There is an increase in the incidence of scabies in Turkey, which started before the Covid-19 pandemic, and this situation is considered as an epidemic. With this study, we aimed to reveal the prevalence of scabies during the pandemic period and the risk factors that are effective in the transmission of scabies.

METHODS

Our study was performed as a cross-sectional study in 376 patients who applied to our dermatology outpatient clinic between 1st and 30th April 2021. Sociodemographic and socioeconomic characteristics, living space, health behavior, and health care utilization of the patients were questioned.

RESULTS

The prevalence of scabies was determined as 10.9%. Features such as sex, area of residence, age, formal education status, employment status, total income, number of shower, number of people per room, water source, and heating method, which were found to be significant as a result of the double test, were included in the logistic regression analysis. Scabies was found 2.728 times (CI 1.325-5.557) more in those who live in rural areas than those who live in urban areas, 2.714 times (CI 1.365-5.451) more in men than women, 2.707 times (CI 1.256-5.833) more in nonworking than working, 2.354 times (CI 1.057-5.243) more in those with less than 9 showers per month than those with 9 or more showers per month.

CONCLUSION

During the Covid-19 pandemic period, the prevalence of scabies in Turkey is increasing and it is becoming a serious health problem. Our study emphasizes this increase and determines the risk factors for transmission.

Association Between Hair Diseases and COVID-19 Pandemic-Related Stress: A Cross-Sectional Study Analysis

Introduction:

Psychological stress from the ongoing coronavirus disease 2019 (COVID-19) pandemic can potentially aggravate the course of several stress-sensitive skin and hair diseases. This study aimed to determine the potential association of COVID-19 stress with hair diseases, such as telogen effluvium (TE), alopecia areata (AA), and seborrheic dermatitis (SD), among medical students in Bangladesh.

Methods

This online-based cross-sectional study was conducted among 404 medical students of Bangladesh using a self-administered questionnaire, including sociodemographic information, status of hair diseases (i.e., TE, AA, and SD), COVID-19 fear scale, impact of event scale specific for COVID-19 (IES-COVID-19), and COVID-19 student stress questionnaire (CSSQ) scale, to determine pandemic-related stress. The logistic regression model was used to analyze the association.

Results

Overall prevalence of TE, AA, and SD was 61.1, 24.7, and 57.7%, respectively, with female predominance in case of TE and male predominance in case of AA and SD. More than half of the participants had COVID-19-related fear and traumatic stress symptoms. In the multiple logistic regression model, smoking [adjusted odds ratio (aOR) 2.93, 95% CI 1.29–6.65 for AA and aOR 4.19, 95% CI 1.83–9.56 for TE], COVID-19-related fear (aOR 1.70, 95% CI 1.01–2.89 for AA and aOR 2.620, 95% CI 1.25–5.48 for TE), and COVID-19-related traumatic stress symptoms (aOR 1.84, 95% CI 1.08–3.13 for AA, aOR 2.61, 95% CI 1.19–5.68 for TE, and aOR 1.92, 95% CI 1.14–3.25 for SD) were the risk factors of hair fall disorders.

Conclusion

Our study showed that a large number of medical students experienced TE, AA, and SD during the pandemic era. COVID-19-related stress and fear potentially have an association with these diseases.

Depression before and during-COVID-19 by Gender in the Korean Population

This study explored the association between Coronavirus disease (COVID-19) and depression by comparing Patient Health Questionnaire-9 (PHQ-9) results pre-pandemic (2019) and after the start of the pandemic (2020). Data of 444,051 participants (200,206 male (45.1%); 243,845 female (54.9%)) were obtained from the Korean Community Health Survey conducted from 2019 to 2020. The independent variable of interest in this study was the year, divided into binary categories, 2019 and 2020. The dependent variable was depression, measured by the PHQ-9 scale. This dependent variable was also binary, dividing those who are considered depressed or not by a cut-off score of 10. A logistic regression model was employed to examine the association. Our results reveal that compared to participants in 2019, patients from the study sample of 2020 were marginally more likely to be depressed, especially female patients (male OR: 1.092, 95% CI [0.998 to 1.195], female OR: 1.066, 95% CI [1.002 to 1.134]). Moreover, using the participants from the year 2019 as a reference group, those who appeared anxious in response to the COVID-19-related questions in the survey showed more tendency to have a PHQ-9 score of 10 or more. Compared to participants from the 2019 group, those from 2020 more likely to be depressed were those with no-one to contact in case of emergency due to COVID-19 (male OR: 1.45, 95% CI [1.26 to 1.66], female OR: 1.46, 95% CI [1.33 to 1.60]), and individuals with concerns regarding economic loss (male OR: 1.18, 95% CI [1.07 to 1.30], female OR: 1.11, 95% CI [1.04 to 1.18]) and infection of a vulnerable family member at home due to COVID-19 (male OR: 1.16, 95% CI [1.05 to 1.28], female OR: 1.09, 95% CI [ 1.02 to 1.16]).

Impact of pandemic COVID-19 on dermatology and venereology outpatient clinic in a tertiary referral hospital in Yogyakarta, Indonesia

COVID-19 has spread throughout the world rapidly, including in Indonesia. During this pandemic, there are differences in the number and types of patient cases who attend the dermatology and venereology outpatient clinic. This study aimed to investigate the differences in the number of cases, disease profiles, diagnostic procedures, and therapy procedures before and during the COVID-19 pandemic in the dermatology and venereology outpatient clinic in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. At the beginning of the COVID-19 pandemic, there was a 61.2% decrease in patients visiting outpatient clinic compared to the same period in previous year. There was also a decrease in the number of diagnostic procedures and therapeutic procedures performed in the outpatient clinic. For the disease profile of the total number of patients who visited the outpatient clinic, there was a slight difference. In 2019, the number of cases of acne vulgaris became the second largest, but in 2020, the number of cases of acne vulgaris decreased to the fifth largest. These results support the finding that COVID-19, although not a skin disease, has an impact on dermatology and venereology outpatient clinic.

Increased Prevalence of Neuropsychiatric Disorders during COVID-19 Pandemic in People Needing a Non-Deferrable Neurological Evaluation

Background: The novel coronavirus disease of 2019 (COVID-19) outbreak provoked a profound healthcare system reorganization. This study aimed to compare the reasons for requesting a non-deferrable neurological evaluation before the COVID-19 pandemic and during the lockdown. Methods: Retrospective observational study including non-deferrable neurological outpatients before the pandemic (pre-COVID-19 group, n = 223) and during the Italian second wave of the COVID-19 pandemic (LOCKDOWN group, n = 318). Results: The number of patients sent for cerebrovascular disorders, headache, and vertigo significantly dropped between the pre-COVID-19 era and the lockdown period. While in the pre-COVID-19 group, the most frequent diagnosis was cerebrovascular disorder; neuropsychiatric disorders ranked first in the LOCKDOWN group. Moreover, the percentage of appropriate non-deferrable neurological evaluations significantly increased in the LOCKDOWN group compared with the pre-COVID-19 group. Discussion: Our study shows a significant increase of neuropsychiatric disorders in non-deferrable neurologic evaluations during the Italian second wave of the COVID-19. Overall, cases were more severe and required a more complex management during the lockdown compared with the pre-COVID era. These findings confirm that a careful approach to prevent the psychological consequences of the pandemic is needed, and long-term rearrangements of the healthcare system are desirable to guarantee appropriate management.

Pustular psoriasis flare-up in a patient with COVID-19

INTRODUCTION

The various cutaneous manifestations have lately appeared in the setting of COVID-19. Psoriasis flare-ups have been reported during a COVID-19 infection.

CASE PRESENTATION

We present a case of a 32-year-old woman with COVID-19 who presented with generalized pustular psoriasis. She received oral prednisolone, hydroxyzine, and topical clobetasol. The patient received follow-up two weeks later and found that her lesions were favorably desquamating.

METHODS

The PubMed, SCOPUS, and ISI Web of Science databases were thoroughly searched for English studies reporting psoriasis flare-ups following SARS-CoV-2 infection. Ten case reports/series were included after screening.

CONCLUSIONS

Our case report brings awareness to clinicians for the possible cutaneous manifestation of COVID-19, which should be considered part of the differential diagnoses.

The effect of the COVID-19 pandemic on community mental health: A psychometric and prevalence study in Turkey

BACKGROUND

COVID-19, which is characterised by life-threatening symptoms, difficulty in breathing, and pneumonia symptoms and requires global emergency intervention, may cause psychological problems such as phobia, fear and anxiety. This study aims to examine the psychometric properties of the Fear of COVID-19 Scale (FCV-19S) in Turkish people and to determine the level of fear of COVID-19 among Turkish people.

METHODS

The research was carried out between March and April 2020. A Personal Information Form and the FCV-19S were used to collect the research data. In the validity and reliability stage, 84 people were contacted randomly for data collection. After the validity and reliability analyses of the scale, a total of 431 Turkish people volunteered to participate in the study and answered the questions in the online questionnaire form using a convenience and snowball sampling method. Confirmatory factor analysis, item-total correlation and Cronbach's alpha coefficient were calculated for psychometric evaluation. Bivariate analysis was applied to determine the level of fear of COVID-19.

RESULTS

Cronbach's alpha coefficient was 0.89, which is stated to have high reliability. FCV-19S scores of participants were determined to be 21.47 ± 6.28. FCV-19S scores of females were determined as 20.48 ± 6.33 and FCV-19S scores of males were determined as 19.78 ± 7.34 according to the bivariate analysis (p < .05). Age, marital status, having children and living alone or with others, tobacco use and anxiety about going to the hospital during the pandemic did not affect on fear of COVID-19 (p > .05). Particularly being female, the presence of chronic disease requiring long-term medication and rarely taking protective measures recommended by the Ministry of Health and having a chronic disease had a significant effect on higher levels of fear of COVID-19 (p < .05).

CONCLUSION

The FCV-19S is a valid and reliable tool for determining the fear of COVID-19. It was found that the fear level of COVID-19 infection was high in Turkish people.

A Comparison of Diagnosed Skin Diseases between the Years with and without COVID-19 Pandemic

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.

The impact of COVID-19 pandemic in dermatology outpatient clinics in Turkey: A survey study

BACKGROUND

The COVID-19 pandemic has substantially affected the healthcare systems around the world. It has also induced some changes in working habits at dermatology clinics. The majority of dermatology clinics limited the number of patients at outpatient clinics and postponed the elective procedures.

AIMS AND OBJECTIVES

To evaluate the working conditions and habits of dermatologists in Turkey during the COVID-19 pandemic.

METHODS

This is a survey study with seventeen questions in which two hundred fifteen dermatologists working in Turkey participated.

RESULTS

Our results revealed that 53.5% of the participants worked in the areas related to COVID-19 during the pandemic. The average number of dermatology outpatient days in a week was five among the 48.8% of dermatologists, 21.4% of those had three working days, and 18.1% of those had four days. During the pandemic, the most common reasons for referral to outpatient clinics were acne and acneiform eruptions (88.8%), dermatitis (73.5%), and hair loss (71.2%). Participants hesitated to use the following treatments: long-term systemic steroid (77.7%), cyclosporine (69.8%), and methotrexate (60%).

CONCLUSION

It is observed that the COVID-19 pandemic had affected the working habits and conditions of the dermatologists, which might be considered for the designing of new working approaches.

The impact of COVID-19 on neglected parasitic diseases: what to expect?

Here we highlight coinfections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with ectoparasites, helminths, and protozoa, described in the literature, and the urgent need to understand the conditions of these associated pathologies. We emphasize the notion that such information is crucial for the continuity of measures that have been used for decades to control neglected parasitic diseases.

Oral isotretinoin treatment in patients with acne vulgaris during the COVID-19 pandemic: A retrospective cohort study in a tertiary care hospital

Background

Patients with acne vulgaris continue to present increasingly in dermatology outpatient clinics and seek treatment during the COVID‐19 pandemic. As far as we know, the effect of isotretinoin on COVID‐19 has not been studied before.

Aim

We aimed to evaluate whether patients receiving oral isotretinoin are at increased risk of COVID‐19 infection by comparing them with patients on topical treatment for acne vulgaris.

Methods

The data were collected retrospectively from a cohort of 267 acne vulgaris patients, who were under follow‐up for acne vulgaris treatment during the pandemic period.

Results

Total of 227 patients (141 receiving isotretinoin treatment and 86 receiving topical treatment) were included of whom 29 patients had COVID‐19 infection during acne vulgaris treatment. Fifteen (10.6%) patients were receiving oral isotretinoin and 14 (16.3%) were receiving topical acne treatment at the time of COVID‐19 infection. The mean cumulative dose was 2340 ± 1988 mg at the time of COVID‐19 infection. The mean elapsed time between the onset of isotretinoin treatment and positive PCR result for COVID‐19 was 13.3 ± 10.3 weeks. Nine patients (64.3%) receiving isotretinoin treatment and 9 patients (60%) under topical treatment had loss of taste and smell during COVID‐19 infection. Isotretinoin treatment was not found to be associated with a significant increased risk of getting COVID‐19 (odds ratio, 0.671; 95% confidence interval, 0.247–1.823; P  = 0.434).

Conclusion

As a conclusion, the results of this study encourage dermatologists and acne vulgaris patients to initiate oral isotretinoin treatment safely during the pandemic period.

Epidemiological and virological characteristics of respiratory tract infections in children during COVID-19 outbreak

BACKGROUND

To investigate the impact of protective measures and isolation on respiratory tract infections in children during the COVID-19 outbreak.

METHODS

We extracted data on outpatient visits and respiratory infection visits, and tests of respiratory viruses (adenovirus (ADV), influenza A (FluA), influenza B (FluB) and respiratory syncytial virus (RSV)) from electronic healthcare records in Children's Hospital, Zhejiang University School of Medicine during the COVID-19 outbreak (January-April, 2020), compared with those in 2018 and 2019 during the same periods.

RESULTS

We found that outpatient visits in January, 2020 was comparable with those in 2018 and 2019, but decreased by 59.9% (288,003 vs. 717,983) and 57.4% (288,003 vs. 676,704), respectively during the period of February-April, 2020, as compared with the same periods in 2018 and 2019. The total number of respiratory tract infections from January to April 2020 decreased by 65.7% (119,532 vs.348,762) and 59.0% (119,532 vs.291,557), respectively compared with the same periods in 2018 and 2019. The proportion of respiratory tract infections during the outbreak also dropped compared with the same periods in 2018 and 2019 (P<0.001). We also found significantly decreased number of completed tests for respiratory viruses and positive cases of ADV, FluA, FluB, and RSV during February-April, 2020.

CONCLUSIONS

In this study, we found that outpatient visits and respiratory tract infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent respiratory virus infections in children.

Comparison of patients' diagnoses in a dermatology outpatient clinic during the COVID-19 pandemic period and pre-pandemic period

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.

Dermatology outpatient clinic outcomes after COVID-19 outbreak: What is new normal?

Coronavirus disease-2019 (COVID-19), which emerged in late 2019 and caused a pandemic, has significantly affected outpatient admissions to dermatology outpatient clinics. There have been changes in the number and composition of the patients who applied to the outpatient clinics. The dermatology outpatient clinic applications have dramatically decreased due to restrictions and prohibitions, and active participation of dermatologists in the field immediately after the pandemic. The composition of the diagnoses has also altered for reasons such as excessive use of hygiene products and types of protective equipment usage related to COVID-19. Intensive precautions have been taken in the first 3 months of the pandemic (March, April, and May). As of 12 May, controlled socialization started with new regulations. This period has been called "the normalization process." This study aims to evaluate the changes of the patients admitted to dermatology outpatient clinics within the normalization process. Despite the increasing number of COVID-19 patients and related deaths in the whole country with the new normal, the admissions to dermatology outpatient clinics have increased. During this period, acne and related diseases, pigmentation disorders, and viral skin infections had increased; dermatoses, xerosis cutis, and superficial fungal infections had reduced. It seems that nonurgent dermatological complaints affect the quality of life of patients and cause the need for an application. Although restrictions reduce these numbers, measures should be taken to protect patients and society during the ongoing pandemic.

Head lice were also affected by COVID-19: a decrease on Pediculosis infestation during lockdown in Buenos Aires

Pediculosis is a worldwide disease affecting school-aged children produced by the presence of the head louse, Pediculus humanus capitis De Geer, an obligate ectoparasite on the human scalp feeding exclusively on blood. Transmission occurs primarily through direct physical head-to-head contact. In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak as a pandemic. COVID-19 is caused by SARS-CoV-2, a variant of the coronavirus. Therefore, on March 18, 2020, the Argentinean government established mandatory isolation for an indefinite period. This obligatory isolation interrupted regular classes avoiding direct contact between children, thus affecting the dispersal route of individuals and the evolution of head louse populations. In this study, we evaluated through an online survey how confinement affected the prevalence of lice during lockdown compared to the situation prior to confinement. The survey allowed to discriminate the different control strategies, the number of treatments, and the amount of insects recorded by parents. Data of 1118 children obtained from 627 surveys were analyzed. As the main result, it was observed that prevalence of lice decreased significantly from before (69.6%) to during (43.9%) COVID-19 lockdown. Moreover, head lice infestation was more effectively controlled in households with up to 2 children in comparison to households with 3 or more children. This is the first study that analyzed the prevalence of head lice during COVID-19 pandemic. In addition, this work demonstrated the impact of social distance in the population dynamics of head lice and how it could affect the control strategies in the future.

Evaluation of the effect of COVID ‐19 pandemic on dermatological diseases with dermatological quality life index

Disease‐related skin lesions have been reported in 8% to 20% of COVID‐19 patients. In the literature, cutaneous symptoms associated with the disease are generally emphasized. However, there are very few studies on the effect of this new SARS‐CoV‐2 virus entering our lives on dermatological diseases, and none of them have used the dermatological quality of life index (DLQI). In our study, we aimed to evaluate the difficulties faced by the patients who applied to the dermatology outpatient clinic during the pandemic period and the course of their diseases with the dermatological quality of life index. The study was carried out prospectively by including dermatology patients who will apply to the outpatient clinic in June‐July 2020. 282 patients were evaluated in the study. DLQI was significantly lower in the group using regular emollients (P < .001). When DLQI was compared between disease groups, it was found to be significantly different (P: .017). DLQI was found to worsen significantly compared to prepandemic studies. It was found that using moisturizer in this period helps to maintain the dermatological quality of life.

Strategies to maximize clinical efficiency while maintaining patient safety during the COVID-19 pandemic: an interview-based study from private practice dermatologists

BACKGROUND

Many dermatologists have experienced significant changes to their practices due to the COVID-19 pandemic.

OBJECTIVE

It is vital to recognize how the pandemic has affected dermatology practices and identify methods to maximize clinical efficiency while maintaining patient safety.

METHODS

Private practice dermatologists in metropolitan areas were interviewed regarding various issues, including patient volume, types of visits or procedures being performed, screening for COVID-19, and operational modifications.

RESULTS

On average, there was a 65.2% decrease in patient volume during the initial surge of the COVID-19 outbreak, which was improved to a 15.5% decrease in July 2020. Despite this reduction in patient volume, the proportion of acute dermatologic issues, biopsies performed, and skin cancer concerns were all increased compared to pre-COVID. All of the dermatologists reported notable changes in regards to scheduling, staff, operations, and workplaces.

LIMITATIONS

Interview participants were limited to metropolitan dermatologists mainly within the California region.

CONCLUSION

Improving patient communication, implementing protocols to facilitate social distancing, and utilizing teledermatology were reported to be essential to optimizing efficiency and safety. As the COVID-19 pandemic continues to evolve, it is important that dermatologists identify specific ways to practice efficiently and effectively, while mitigating the spread of the virus.

Relative changes in the pattern of diseases presenting in dermatology outpatient clinic in the era of the COVID-19 pandemic

As an increasing number of COVID-19 cases, there were changes in the number of patients who attended the dermatology outpatient clinics. We aimed to investigate the change profiles of dermatologic diseases in the first and second months of the COVID-19 pandemic in Turkey by comparing with the corresponding period of the previous year. The total number and diagnosis of patients, who attended a tertiary care hospital for the dermatology outpatient clinic between 1 April 2020 and 31 May 2020, were included in this study. These data were compared with the corresponding period of the previous year. The percentage of the patients with scabies, contact dermatitis, psoriasis, pityriasis rosea, urticaria, and alopecia areata were statistically significantly increased a month after the occurrence of the COVID-19 pandemic, while the percentage of patients with scabies, alopecia areata, telogen effluvium, acne vulgaris, and xerosis cutis were statistically significantly increased 2 months after the occurrence of the COVID-19 pandemic (P < 0.05). An increase in the number of certain diseases such as urticaria and pityriasis rosea may indicate the risk of asymptomatic COVID-19 carriage in these patients. Polymerase chain reaction (PCR) and/or antibody-based further studies should be performed to explore whether certain dermatologic diseases are related to asymptomatic COVID-19 cases.

Analysis of dermatologic conditions in Turkey and Italy by using Google Trends analysis in the era of the COVID-19 pandemic

Many areas of life including patterns of dermatological diseases that patients attend to the hospital were tremendously affected by implementing stay-at-home orders during the COVID-19 pandemic. We aimed to identify the dermatologic interest of the public during the COVID-19 pandemic by using Google Trends. The terms "acne", "hair loss", "eczema", "genital warts", "molluscum contagiosum", "botox", "skin cancer", and "sunscreen" were analyzed on April 1, May 1, June1, 2020, and the corresponding period of the previous year in Turkey and Italy by using Google Trends. The searching spectrum was between March 31, 2019 and June 1, 2020. The relative change of search term "acne" was +10, +29, +13/-1, +17,+33, "hair loss" was +14, +40, +16/+3, +16, +15, and "eczema" was +2, +34, -4/ +3, +25, +18, on the other hand, the relative change of the "genital warts" was -15, -48, +10/-44, -30, +18 and "molluscum contagiosum" was -12, -2, -4/-4, -1, -12 while "botox" was, -10, -43, -8/-41, -31, +4, "skin cancer" was -27, -38, -38/-22,+33, -7 and sunscreen was -6, -25, -71/-13, 0, -45 in Turkey/Italy on April 1, May 1, and June 1, 2020, respectively. A statistically significant positive correlation was found between the number of COVID-19 cases in Turkey and search terms of the general dermatology group during the COVID-19 pandemic (P < 0.05). The search terms including "acne", "eczema", "hair loss" appears to be increasing while "molluscum contagiosum", "genital warts" "botox", "skin cancer", and "sunscreen" decreasing in the era of the COVID-19 pandemic. Understanding the trends and impacts of dermatologic diseases on public perceptions during the COVID-19 pandemic will allow for better preparation of dermatologists.

The effect of the "stay-at-home" policy on requests for dermatology outpatient clinic visits after the COVID-19 outbreak

The Coronavirus Disease 2019 (COVID-19) emerged late in Turkey but it showed a rapid progression later. We aimed to investigate the changes in the number of patients who requested a dermatology outpatient clinic visit due to the increased social and medical burden caused by COVID-19 in Turkey during the first days of the pandemic. We also examined the most common dermatologic diseases diagnosed during the COVID-19 outbreak. A statistically significant negative correlation was found between the number of COVID-19 patients in the country and the number of patients requesting a dermatology outpatient clinic visit in the secondary and tertiary care hospitals during self-quarantine. In the first 10 days after the COVID-19 outbreak, acne (28.2%), urticaria (12.8%), scabies (12.8%), irritant contact dermatitis (10.3%), and xerosis cutis (10.2%) were the most common diseases seen in the dermatology clinic at the secondary care hospital, while acne (23.3%), warts (5.4%), seborrheic dermatitis (4.5%), urticaria (3.8%), and psoriasis (3.32%) were the most common diseases seen in the dermatology clinic at the tertiary care hospital. This is our first study on the frequency and nature of outpatient dermatology visits during this novel coronavirus pandemic. Understanding the trends and impacts of dermatologic diseases on patients and health systems during this pandemic will allow for better preparation of dermatologists in the future.

The Impact of the COVID-19 Pandemic on Pediatric Clinical Practice in Wenzhou, China: A Retrospective Study

Introduction: The COVID-19 pandemic has affected all aspects of life worldwide. The aim of the present study was to review and describe and acknowledge the impact of COVID-19 on the pediatric health care system at a pediatric tertiary hospital in Wenzhou. Methods: A retrospective study was conducted at Yuying Children's Hospital of Wenzhou Medical University, a public pediatric tertiary hospital in Southern Zhejiang Province that specializes in pediatrics. The data regarding the primary diagnosis of patients were extracted from the electronic medical records system of the hospital. Data for outpatients and inpatients treated at the pediatric department were analyzed in the time frame of 22 weeks since the beginning of the pandemic (from December 30, 2019 to June 2, 2020) and compared with data from the same period in 2019. Results: The total number of outpatient cases in the previous 22 weeks of the year declined from 560,620 in 2019 to 247,030 in 2020, and inpatient cases decreased from 14,177 to 7,555. This negative trend settled by week 6 and 7 and subsequently approached the 2019 numbers. The most noticeable decrease in the number of cases was observed in children of preschool age. Moreover, the number of weekly visits decreased at the beginning of the epidemic, reached the lowest value during the lockdown period, and recovered after the lockdown. Conclusion: Based on the results of this study, clinical practice in a pediatric department in Wenzhou was substantially affected by the epidemic and measures such as physical distancing and increased personal hygiene, particularly in preschool-age children. An understanding of the trends and impacts of the pandemic on pediatric patients and health systems will facilitate better preparation of pediatricians in the future.