Skin Manifestations Associated with Personal Protective Equipment (PPE) in Health Care Professionals during COVID 19 Pandemic

Abstract

Objective: To determine the frequency and characteristics of skin manifestations among healthcare workers
using PPE during COVID-19 pandemic.
Methods: This cross sectional study was carried out at department of Dermatology unit1, Jinnah hospital,
Lahore. A total of 102 health care professionals including doctors and nurses working in Jinnah hospital
Lahore and using PPE including masks, gloves, and full body protective suits for more than 4 hours per day
were enrolled in the study. After informed consent data regarding age, sex, duration of wearing PPE, and
history of previous skin disease was noted. Patients were asked about any skin problem related to use of PPE
and those with a positive response were examined by a dermatologist and skin lesions noted. All information
was recorded on a predesigned proforma.
Results: The mean age of the participants was 28.5+ 3.2 years. There were 33 (32.4%) males and 69 (67.6%)
females. Among these 88 (86.2%) were doctors and 14 (13.8%) were nurses. Adverse skin reactions
associated with use of PPE were reported in 99 (97%) participants. Those using masks and full body
protective suits reported skin manifestations in 97% and 90 % respectively while only 34.3% of those
wearing gloves had any skin problem. Common skin manifestations due to use of masks were acne (56.8%),
ear soreness and fissuring (54.9%), pressure bruises (32.3%), frictional dermatitis (26.4%) and contact
dermatitis(22.5%). Contact dermatitis to gloves was reported in 33.3%. Problems associated with full body
protective suit were excessive sweating (82.3%), folliculitis (6.8%) miliaria (3.9%) and intertrigo (1.96 %).
Conclusion: The use of PPE is associated with high rates of adverse skin reactions. There is a need to devise
guidelines to prevent or minimize these skin problems and to encourage awareness among health care
workers of the role of dermatologists in their care