| |
Avid Anti-COVID Hand Cleaning May Spark Eczema Outbreak
|
| |
| |
Mark Mascolini
"Overzealous hand hygiene" to fend off COVID-19 may foster an outbreak of hand eczema in the general population, warn Indian clinicians who tracked a spate of new itchy-hand complaints [1]. Hand eczema could be more than a nettlesome nuisance, the clinicians warn. Chafed skin could offer entry to SARS-CoV-2, the COVID-19 virus, because the cell receptor the virus uses (ACE2) abounds in skin blood vessels, basal epidermis, and hair follicles [2].
Dermatologists in Bhopal, Nashik, and Guwahati, India report a surge in hand eczema cases from March 24 through April 5, as COVID-19 began spreading through India. None of the 9 men or 7 women affected were healthcare workers, almost all admitted excess hand hygiene, almost always with sanitizers containing alcohol.
Analyzing oral histories and clinical photos or videos, clinicians diagnosed irritant contact dermatitis in 10 people, allergic contact dermatitis in 5, and a mixed pattern in 1. The most frequent symptoms and signs were itching, burning, dryness, erythema, scaling, and vesiculation. Several patients had a distinct eczema pattern—fine scaling starting in the web spaces between fingers, perhaps because sanitizers get trapped in this area.
The authors note a recent study from China in which three quarters of healthcare workers caring for COVID-19 patients had hand eczema possibly related to rigorous hand hygiene [3]. The dermatologists warn against the frequent habit of hand washing just before or after applying sanitizers because damp hands may be more permeable to sanitizers or detergents. They advise allowing sanitizers to dry after cleansing, then applying a hypoallergenic hand cream or emollient.
References
1. Singh M, Pawar M, Bothra A, Choudhary N. Overzealous hand hygiene during COVID 19 pandemic causing increased incidence of hand eczema among general population. J Am Acad Dermatol. April 10, 2020. doi: https://doi.org/10.1016/j.jaad.2020.04.047
2. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203:631-637. doi:10.1002/path.1570
3. Lan J, Song Z, Miao X, et al. Skin damage among healthcare workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020;S0190-9622(20)30392-3. doi:10.1016/j.jaad.2020.03.014
|
|
| |
| |
|
|
|
