Recommendations from the EADV Contact Dermatitis Task Force

Anna Balato1, Fabio Ayala2, Ana Maria Giménez Arnau3.
1. Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy
2. Professor Emeritus of Dermatology, University of Naples Federico II, Italy
3. Department of Dermatology, Hospital del Mar. Universitat Autònoma de Barcelona, Spain

Among the basic protective measures against COVID-19, it is well established that there is the need to wash hands frequently and to regularly use alcohol-based hand sanitizers. This is a general recommendation for the whole population. COVID-19 is an emergency and the complete population is at risk and should be involved on its elimination.

Healthcare workers taking care of COVID-19 patients have to wear personal protective equipment (PPE) daily for many hours and also accomplish general preventive measurements outside the work. Some cutaneous adverse events can develop inducing skin impairment that needs to be prevented, identified and therapeutically managed (1).

What are the skin complications from PPE usage?

PPE requirement and its use is not so simple and not so safe, but absolutely necessary.
The adherence to appropriate PPE may be influenced by the risk derived from the epidemic itself, the education of PPE use and working experience. Promoting education on proper PPE and restriction duration of wearing would help to avoid cutaneous adverse events.
Recommendations regarding hand hygiene and gloves use in order to minimize adverse cutaneous reactions for both healthy citizen as well as healthcare practitioners in general and particularly in Covid units are summarized in the following table.

Recommendations for hand hygiene to minimize the risk of adverse reactions

• Hand rubs should only be applied to dry and clean skin
• Hand rubs should be rubbed until the skin is dry, approximately 30 seconds
• Hands should not be washed immediately after the hand disinfection
• Between applications of hand rubs, hands should be washed only when they are visibly soiled
• A mild, non-alkaline soap should be used
• Water for hand washing should be cold
• The duration of hand washing should remove visible contamination being as short as possible
• Residual soap should be rinsed off completely
• Brushes should not be used
• Skin care lotions and creams should be used between hand hygiene procedures
• Hands should be dry before gloves are put on
• Do not wear finger rings at work

Recommendations for gloves use to minimize the risk of adverse reactions

• Protective gloves should be used appropriately as short as possible
• Protective gloves should be intact, clean and dry inside

References

Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T, Song J, Liu D, Chen L, Shi Y, Jiang S, Liu Q, Xie J , Chen H, Duan
Y, Xia Y, Zhou Y, Mei Y, Zhou X, Wu J, Fang M, Meng Z, Li H. Adverse skin reactions among
healthcare workers during the Coronavirus Disease 2019. Outbreak: A survey in Wuhan and its
surroundings regions. Accepted paper doi:10.111/bjd.19089
WHO guidelines on hand hygiene in health care. ISBN 978 92 4 159790 6. WHO Press, World
Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.