Dermatoses due to Personal Protective Equipment and other protective/preventive measures in COVID-19 pandemic- A study on frontline Health care workers

<p><strong>Background: </strong>The use of personal protective equipment (PPE) around the world in view of COVID-19 pandemic has led to high incidence of occupational dermatoses amongst healthcare workers (HCWs). Amongst all staff members visiting dermatology services, irritant dermatitis (body, hand) and acne form eruption remained the most common concerns. Apart from improving staff morale and quality of life, prevention and management of these conditions will also minimize the risk of breaching stringent PPE protocol. Preventive strategies including frequent breaks from PPE and less than 6 hours of continuous PPE usage can make the working environment more conducive for HCWs.<strong></strong></p><p><strong>Methods: </strong>A quantitative descriptive research-based study is utilized, in which participants who fulfilled the required criteria were selected and were asked to fill the questionnaire. Results were analysed.</p><p><strong>Results: </strong>Redness and itching are the commonest complaints encountered followed by skin rash and acne. Facial occupational dermatoses due to PPE revealed that allergic and irritant contact dermatitis are most common, followed by acne form eruptions and contact urticaria.</p><p><strong>Conclusions: </strong>With adequate hydration, workplace modifications, taking regular breaks from wearing PPE gear may help in alleviation of dermatoses and motivate HCWs in their fight against pandemic.</p><p><strong> </strong></p>

Mekanisme Kejadian Dermatitis Kontak Iritan Akibat Paparan Buah Nanas (Ananas Comosus)

Irritant contact dermatitis is the skin's response to contact with various exposures to substances such as biological, chemical and physical. The occurrence of DKI can be influenced by endogenous and exogenous factors. Exogenous factors such as exposure to substances from the surrounding environment and endogenous factors such as skin defense function and the presence of a previous history of dermatitis such as atopic dermatitis. This literature review aims to understand the mechanism of the occurrence of irritant contact dermatitis due to exposure to pineapple(Ananas comosus)especially in workers and prevention. The study was conducted by collecting a number of books, research articles and scientific journals that deal with the mechanism of the occurrence of irritant contact dermatitis due to exposure to pineapple(Ananas comosus). Literature review has been conducted in Julì 2019. Pineapple or Ananas comosus is a member of the bromeliad family and is known to be the cause of irritant dermatitis and stomatitis. Pineapple extraction contains a number of proteolytic enzymes known as bromelain, which are also chemical and physical irritants including citric acid and calcium oxalate. Therefore, pineapple fruit can be one of the causes of irritant contact dermatitis. This mechanism starts from mild exposure to continuously causing barrier distrubsi which causes the activation of cytokines and T lymphocytes that cause symptoms in the form of inflammation and lesions on the skin

Pattern of skin disorders in hilly district of Pauri Garhwal with their dermoscopic findings: an epidemiological study

<p><strong>Background:</strong> The pattern of skin disorders is largely affected by climate, geography, occupation, socio-economic status, nutrition, genetics and habits of the community. Nowadays, dermoscope is being increasingly used as a non-invasive aid in diagnosis of various skin disorders. Objective of the study was to study the etiology, distribution and dermoscopic findings of various skin disorders in 5 remote villages of hilly district of Pauri Garhwal, Uttarakhand over a period of 1 month (April 2021).</p><p><strong>Methods:</strong> The study was conducted as a weekly OPD in 5 villages of Hilly district of Pauri over a period of 1 month with free consultation and medications. Details of patients, their complaints, clinical diagnosis and dermoscopic findings were recorded.</p><p><strong>Results:</strong> Overall, allergic/irritant dermatitis were found to be most common (30%) followed by infective disorders (27.25%), photodermatitis (20.2%), inflammatory disorders (4.3%), miscellaneous disorders (LSC, stasis dermatitis, pityriasis rosea, others) up to 9.5% and viral exanthematous rash possibly COVID-19 associated in 8.62% cases. Most common dermoscopic finding of allergic/irritant dermatitis were red dots (92%), in photodermatitis were brown dots (82.09%) and viral exanthem was diffuse erythema (100%).</p><p><strong>Conclusions:</strong> Hilly areas contribute to a large burden of dermatological disorders which needs to be catered too. With the help of this knowledge, we can plan appropriate range of health services to meet the patient’s needs in hilly regions.</p>

Indelible ink dermatitis during COVID: A series of 97 cases

Indelible ink is formulated by National Physical Laboratory and produced by Mysore Paints and Varnishes Limited since 1962. It is most used to prevent voter fraud in elections. The ink’s believed to be composed of silver nitrate (7%–25%), which binds to the proteins in skin and nails. The ink is said to be relatively safe at this concentration. However, frequent exposure, older ink, and higher concentrations can result in cumulative exposure and various degrees of damage. Herein, we report irritation reactions with the ink in several students labelled for home quarantine during COVD19 pandemic. Overall, 97 students (aged 15–17 years) with travel history were screened and quarantined according to COVID19 protocols. They were stamped with “HOME QUARANTINE” on the ventral aspect of the right forearm. Approximately 4-6 hours later, all students complained of localised burning and swelling to a variable extent. The severity was more in girls. They were treated with topical antibiotics, steroids and cetirizine tablets which showed symptomatic improvement. Irritation with indelible ink has rarely been reported, especially, with a large sample size. This report highlights the risk of severe irritant dermatitis with indelible ink and hence the need for its judicious use.

NATURAL COSMETICS IN THE CARE OF YOUNG CHILDREN

The article provides general information about the skin physiology of newborns and infants. Structural features of the skin and main adaptive shifts in newborns, are described. Тhe child has an increase in the skin barrier function of the skin, which prevents transepidermal water loss; active synthesis of natural moisturizing factor (NMF) components that control skin hydration; shift of pH to acidic environment; normalization of thermoregulatory functions; enhancement of the photoprotective function; immune restructuring for antimicrobial protection; formation of a normal microbiome. The article describes the consequences of improper skin care of a newborn, using the example of diaper dermatitis, irritant dermatitis, prickly heat and vesiculopustulosis. The importance of using specialized children's cosmetics in caring for an infant is assessed. The basic recommendations for the choice of these products are presented, where the main emphasis is on the choice of products consisting of natural ingredients. Giving preference to natural cosmetics, everyone should carefully study the composition of these products and trust the manufacturers who can guarantee safety of care products for the youngest children.

Vulvar Lesions in the Pediatric Patient

Vulvar lesions are a common complaint for which pediatric patients seek medical attention. Please refer to the chapter on Prepubertal Vulvovaginitis for more details. A careful history and physical exam, including full skin exam should be performed when pediatric and adolescent patients present with vulvar complaints. The chief complaint and chronicity of the symptoms can narrow the differential. The chronicity and areas of dermatologic involvement can also be key to diagnosing a systemic condition versus a primary vulvar dermatosis. When the latter is assumed, a referral to an appropriate specialist such as a Pediatric and Adolescent Gynecologist or Dermatologist should be considered. Treatment for vulvar dermatoses should be etiology dependent with consideration of systemic treatment as appropriately indicated. Vulvar hygiene should be considered in all patients as restoring the skin barrier and removing potential irritants is imperative to healing and preventing further irritation. This review contains 1 figure, 2 tables, and 25 references. Keywords: vulva, vulva dermatosis, vulvovaginitis, lichen sclerosus, atopic dermatitis, psoriasis, streptococcus vulvovaginitis, irritant dermatitis, contact dermatitis

Vulvar Lesions in the Pediatric Patient

Vulvar lesions are a common complaint for which pediatric patients seek medical attention. Please refer to the chapter on Prepubertal Vulvovaginitis for more details. A careful history and physical exam, including full skin exam should be performed when pediatric and adolescent patients present with vulvar complaints. The chief complaint and chronicity of the symptoms can narrow the differential. The chronicity and areas of dermatologic involvement can also be key to diagnosing a systemic condition versus a primary vulvar dermatosis. When the latter is assumed, a referral to an appropriate specialist such as a Pediatric and Adolescent Gynecologist or Dermatologist should be considered. Treatment for vulvar dermatoses should be etiology dependent with consideration of systemic treatment as appropriately indicated. Vulvar hygiene should be considered in all patients as restoring the skin barrier and removing potential irritants is imperative to healing and preventing further irritation. This review contains 1 figure, 2 tables, and 25 references. Keywords: vulva, vulva dermatosis, vulvovaginitis, lichen sclerosus, atopic dermatitis, psoriasis, streptococcus vulvovaginitis, irritant dermatitis, contact dermatitis

Cutaneous Myiasis of the Scalp Presenting as Bilateral Orbital Edema

ABSTRACT Background Myiasis is the infestation of live human tissues by the larvae of flies, more commonly known as maggots. Wound myiasis occurs when fly larvae infest open wounds. This kind of infestation may be the result of facultative or obligatory parasites. Treatment with application of mineral oil and manual removal of maggots is the usual routine. Case description We report a case of 19-year-old female presenting with bilateral orbital edema. The differential diagnosis of eyelid erythema and edema is broad, ranging from benign, self-limiting dermatoses to malignant tumors and vision-threatening infections. History revealed that she had cutaneous myiasis of the scalp for which she was treated with mineral oil and maggots were removed manually a day prior to presentation. Irritant dermatitis by trickling of the mineral oil led to bilateral edema in this case. A definitive diagnosis usually can be made on physical examination of the eyelid, a careful evaluation of symptoms and history of exposure. Conclusion Detailed history and meticulous workup can be of great help in the differential diagnosis of bilateral orbital edema. How to cite this article Kaur M, Kaur I. Cutaneous Myiasis of the Scalp Presenting as Bilateral Orbital Edema. AMEI's Curr Trends Diagn Treat 2020;4(2):107-109.