Q&A Dermatology in the COVID-19 pandemic

Read below the answers to your questions

I do not think so, but sure it is more difficult to have published case reports or series, because the reviewers are more critical now than during the first wave…

Teleconsultation may be very important for consultation of patients with skin manifestation in COVID Units.

Aswered by Prof. Paolo Gisondi

I suggest continuing with systemic treatments, to prefer televisits whenever possible, to encourage vaccination and to pay attention of safety measures.

Thanks for the question.

Aswered by Prof. Paolo Gisondi

This depends from country to country, and depends on the activity of the pandemic waves. The only reason why surgery needs to be interrupted is because operating rooms or recovery wards are not available (perhaps respirators are being used for COVID patients, or there are no physicians or nurses available). If the system is not completely broken down, the only changes that COVID has brought is the requirement for PCR or TMA testing, and this should apply only to patients who require intubation or sedation, because this might put them at risk if they were infected. For surgical staff/nurses, adequate individual protection equipment is required, but operation should not be denied to anyone testing positive, or require testing, as a matter of fact, unless there is a high risk of aerosol emission (e.g. intubation or ENT procedures). Of course this may be subject to local variations.

Aswered by Lluis Puig, MD (Hon), PhD

They are different from typical perniosis; chilblain-like lesions observed during the COVID-19 pandemic seem to represent manifestations of a viral-induced type I interferonopathy, with often increased D-dimer levels. Nevertheless, actual proof of ongoing SARS-Cov-2 infection is missing in most cases and were are not seeing many of those cases in subsequent local outbreaks of the pandemic.

Aswered by Lluis Puig, MD (Hon), PhD

Limited access to health care providers and STS clinics may have decreased screening performance* and timely treatment of post-exposure prophylaxis, but no publications from Spain have appeared yet, to my knowledge.

*Simões D, Stengaard AR, Combs L, Raben D; EuroTEST COVID-19 impact assessment consortium of partners. Impact of the COVID-19 pandemic on testing services for HIV, viral hepatitis and sexually transmitted infections in the WHO European Region, March to August 2020. Euro Surveill. 2020 Nov;25(47):2001943.

Aswered by Lluis Puig, MD (Hon), PhD

Registry data have been very informative for clinical, research and patient communities in the pandemic, and these data have informed national and international clinical care guidelines in a timely manner. Numerous COVID-19 registries were set up early in the pandemic to rapidly collect outcome data e.g. PsoProtect for psoriasis, SECURE-AD for atopic dermatitis, SECURE-IBD for inflammatory bowel disease and the Global Rheumatology Alliance for rheumatic diseases. International societies have been vital in promoting these registries and encouraging involvement and contributions from the clinical community. Patient reporting registries such as PsoProtectMe have been important in understanding the experiences of patients in the pandemic, and have been supported by patient organisations. The registries are great examples of effective collaborative international research efforts during this challenging time.  

Aswered by Satveer Mahil, MB BChir, PhD

Registry data have been

Although many dermatological manifestations have been described in association with COVID-19 (e.g. https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.19163), there is a lack of reports of any skin manifestations following SARS-CoV and MERS-CoV infections. Please see the following publication for further discussion:https://onlinelibrary.wiley.com/doi/10.1111/jdv.16738.  

Aswered by Satveer Mahil, MB BChir, PhD

Outbreaks of a Kawasaki-like multisystem inflammatory syndrome have been described among children and adolescents that may be related to SARS-CoV-2. This condition occurs in the context of recent SARS-CoV-2 infection and has some of the signs and symptoms of Kawasaki disease, as described in the following publications: https://www.bmj.com/content/369/bmj.m2094 – https://jamanetwork.com/journals/jama/fullarticle/2767209

Aswered by Satveer Mahil, MB BChir, PhD