Among the basic protective measures against COVID-19, the need to wash hands frequently and in a prolonged way using soap and to regularly use alcohol-based hand sanitizers is well established for the whole population. Healthcare workers in general, and particularly those involved in the direct care of COVID-19-infected patients, have to wear personal protective equipment (PPE) daily for many hours and also accomplish general preventive measurements outside their work. Cutaneous adverse reactions can develop that need to be prevented, identified and therapeutically managed. According to the data reported by Lin et al.,1 based on the experience from healthcare workers in Wuhan, adverse skin reactions were reported in 74% of responders (n = 376) to a general survey. The most commonly reported types of eruptions were skin dryness or desquamation (68.6%), papules or erythema (60.4%) and maceration (52.9%). Hands, cheeks and nasal bridge were the top three most commonly affected areas. Adverse skin reactions showed in the univariate analysis a significant association with sex, epidemic level, working place, duration of full-body PPE use, getting soaking wet after work and frequency of handwashing. The multivariate analysis showed an increased number of reactions in females, who work at the hospitals, in inpatient wards and use full-body PPE for over 6 h per day. Similar results were reported from Chengdu, with 198 of 404 (49.0%) respondents to an online survey from the healthcare sector reporting mask-related skin reactions, mostly, in 169, in the face following prolonged use of N95 and medical-grade masks. Of note, worsening of pre-existing facial skin problems such as acne or rosacea was frequently reported.2 This scenario is certainly similar to what the health care personnel is suffering nowadays in Europe.3 The identification of these cutaneous reactions, how to prevent and treat them is the objective of this document.
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