Teledermatology and hygiene practices during the COVID-19 pandemic.

To the Editor,

Coronavirus disease 2019 (COVID‐19) is an acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). First isolated in 2019 in China, the virus rapidly spread globally and was declared a global pandemic in March 2020. Italy is one of the countries with the highest number of positive patients, hospitalizations, and deaths and, on March 12th, was been declared “red zone” with the application of severe disease containment measures.

Although San Gallicano Dermatological Institute, a primary referral hospital for dermatological diseases, has not been declared COVID center, Medical Hospital Direction decided to maintain services for patients who cannot avoid having therapy during the COVID‐19 emergency or need urgent visits. In order to continue to assist non‐urgent dermatological patients, a telemedicine service has been set up. To date we have screened the requests from 461 patients, received between March and April 2020, highlighting that 28 of 461 consultations revealed the presence of bilateral hand dermatitis. Among these, 64.3% (18 patients) were female and 7.1% (2 patients) had a known history of atopic dermatitis. When grading the disease severity utilizing the Physician Global Assessment (PGA) scale, which consists of four levels (1 = almost clear, 2 = mild, 3 = moderate, and 4 = severe), we observed 13 patients with mild disease, 12 patients with moderate disease, and 3 patients with severe disease. Teledermatology is now a way of improving the management of cutaneous diseases and it may increase the number of diagnoses of several skin conditions, even during this pandemic when patients cannot easily access the healthcare system because of contact restrictions.

In conclusion, during the COVID‐19 pandemic, a higher incidence of irritant contact dermatitis (ICD) has been observed. This is due to increased hand hygiene to prevent the direct spread of SARS‐CoV‐2 both through the use of soap and water and/or alcohol‐based sanitizers. Given the importance of reducing non‐emergency visits in dermatology, it is crucial to recommend the use of skin products that can help to maintain a healthy skin barrier and prevent the development of ICD. Teledermatology may represent a useful diagnostic tool, since clinical images together with anamnestic data, in the majority of cases, allow the formulation of a correct diagnostic hypothesis as well as proper treatment recommendations.

AUTHOR CONTRIBUTIONS

Antonio Cristaudo: Conceptualization; methodology; project administration. Flavia Pigliacelli: Investigation; software. Alessia Pacifico: Writing‐review and editing. Giovanni Damiani: Writing‐review and editing. Paolo Iacovelli: Visualization. Aldo Morrone: Conceptualization; project administration; resources.

CONFLICT OF INTEREST

The authors have declared no conflicts.