Nasal Ulceration Research Articles

Bilateral Aggressive Mooren Ulcer in the Setting of Bilateral Pterygia and Pregnancy: A Unique Case.

To report an unusual case of bilateral aggressive Mooren ulcer that occurred in the setting of bilateral pterygia and showed a relentless course during pregnancy. A 39-year-old woman of Black African ethnicity, 36-week pregnant, presented to the eye casualty with bilateral nasal corneal ulcer and associated melt around preexisting pterygia. A detailed workup including microbial evaluation, culture and sensitivity, polymerase chain reaction for herpes simplex virus, varicella zoster virus, and cytomegalovirus, inflammatory blood profile, autoimmune markers, and human leucocyte antigen (HLA) screening was undertaken. Treatment was initiated in a stepwise approach. Infections and systemic autoimmune and rheumatologic conditions were ruled out. A diagnosis of bilateral Mooren ulcer was made by exclusion. The peripheral blood was positive for HLA DQ2. As the condition seemed refractory to medical management (topical steroids and intravenous pulse methylprednisolone followed by oral prednisolone and topical cyclosporine), urgent bilateral conjunctival resection with multilayered amniotic membrane transplantation was performed to reduce the inflammatory stimulus and keratolysis. Stabilization of the condition warranted the need for systemic immunosuppressive agents. Using a multidisciplinary approach, in liaison with Obstetricians and Rheumatologists, the patient was planned for an earlier elective Cesarean section and commencement of oral mycophenolate mofetil postpartum, which aided in successful control of the disease. Mooren ulcer could follow an aggressive course during pregnancy, especially in the setting of preexisting pterygium. The complex hormonal and immunological changes during pregnancy and the delivery of inflammatory mediators directly onto the cornea by pterygium could contribute to the severity. A well-planned, stepwise, and multidisciplinary management is pivotal for the treatment of this condition.

Comparison of helmet versus face mask interface for noninvasive ventilation in patients with acute cardiogenic pulmonary oedema— A randomized controlled trial

Introduction: Non-invasive ventilation (NIV) is strongly recommended in patients with acute cardiogenic pulmonary oedema (ACPE). Recently, helmet has been introduced as an interface for NIV. This study was planned to compare helmet and face mask interface for administering NIV. Methods: This was a prospective, randomized control trial conducted in patients with ACPE with respiratory failure treated with either face masks or helmet. Patients in Group H (Helmet) received minimum positive end expiratory pressure (PEEP) of 10, with a pressure support (PS) of 15. The cushion was inflated to 100 cm H20 and pressurization/ rise time was kept 0.1 seconds. Group F (Facemask) patients received pressure support with expiratory positive airway pressure (EPAP) of 8 and inspiratory positive airway pressure (IPAP) of 16 cm H20. EPAP & IPAP were adjusted according to tidal volume (TV) and respiratory rate (RR) respectively. Results: Patients using helmet as the interface had less failure rate (0.0%) as compared to facemask 9 (22.5%), Odds Ratio (OR)[95% Confidence Interval (CI)]- 0.04 (0.0, 0.71) (p= 0.001) and less complications such as nasal and skin ulcers 3 (8.6%) in Group H as compared to 16 (45.7%) in Group F, OR (95% CI) o--0.11 (0.03,0.43) (p= 0.01). Conclusion: Helmet was better than face mask in terms of reduced requirement of intubations, better patient tolerance and reduced complications. Keywords: intubation; mask; non-invasive ventilation; ulcers

Association of the Spectrum of Cutaneous Lupus Erythematosus with Disease Activity and Systemic Manifestations in Patients with Systemic Lupus Erythematosus.

Cutaneous involvement is common in systemic lupus erythematosus (SLE) patients and may be essential to the disease activity. This study aimed to describe cutaneous manifestations spectrum and determine the association of cutaneous lesions with the disease activity and systemic involvement among SLE patients in Malang, Indonesia. A cross-sectional study was conducted using 54 SLE patients from rheumatology outpatient clinic at Saiful Anwar General Hospital Malang, Indonesia. Cutaneous features were classified according to Gilliam and Sontheimer classification of cutaneous lupus. Disease activity and clinical manifestations were documented according to Mexican-SLE disease activity index (Mex-SLEDAI). Among 54 subjects, 50% of the patients had cutaneous manifestations. Subacute cutaneous lupus erythematosus (SCLE) was observed in 11.1% of patients, and malar rash in 20.4%. Subjects with cutaneous lesions had significantly higher Mex-SLEDAI scores, especially those who had SCLE (p<0.001), malar rash (p=0.002), alopecia (p=0.002), and photosensitivity (p=0.032). Six patients (11.1%) had skin infections with higher disease activity (9[8-11]vs.2[0-4];p<0.001). SCLE was significantly associated with malar rash (OR 11.7[1.8-76.5]), vasculitis (OR 43.0[4.1-445.6]), and fatigue (OR 15.0[2.1-108.8]). Malar rash was associated with photosensitivity (OR 8.4[1.6-44.0]), while oral or nasal ulcer was associated with fatigue (OR 8.6 [1.4-54.6]). Vasculitis (OR 5.9[1.0-35.1]) and nephritis (OR 11.7 [1.8-76.5]) were associated with the presence of skin infection. SCLE and malar rash are the most common cutaneous lesions among subjects. Subjects with cutaneous lesions have relatively higher disease activity. Several skin lesions are also associated with SLE patients' systemic manifestations.

Early Ear, Nose and Throat Manifestations in Eosinophilic Granulomatosis with Poliangioitis: Results from Our Cohort Group and Literature Review.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, systemic necrotizing vasculitis affecting small-to-medium-sized vessels. EGPA's clinical manifestations are heterogeneous, affecting different organs and systems, and the upper respiratory tract can be affected by ear, nose and throat (ENT) involvement. The aim of our study was to assess type manifestations at the time of diagnosis in a cohort of EGPA patients and correlate findings with baseline variables (sex, age, antineutrophil cytoplasmic antibodies-ANCA-status) and literature reports. The main ENT manifestations in our patients at the time of diagnosis were: chronic rhinosinusitis with nasal polyposis (CRSwNP) (52%), turbinate hypertrophy (48%), nasal swelling (40%), rhinorrhea (40%), chronic rhinosinusitis without nasal polyposis (CRSsNP) (32%), nasal bone deformities (32%), nasal crusts (20%), nasal mucosal ulcers (12%), corditis (12%), hoarseness/dysphonia (12%), hearing loss (12%), mucoceles (4%) and eosinophilic rhinitis (4%). No correlations were found between sex, age, ANCA status and ENT clinical manifestations. A polymorphic ENT involvement is often observed in the early stages of EGPA. The presence of nasal, sinus, ear and/or laryngeal manifestations in patients with asthma and hypereosinophilia, independently of sex, age or ANCA status, should raise an alert for further investigation and differential diagnosis for EGPA. ENT specialists should be aware of their leading position in this diagnostic race.

Freeze-dried amniotic membrane graft with a spongy layer in bilateral peripheral ulcerative keratitis: a case report

BackgroundPeripheral ulcerative keratitis (PUK) is a group of inflammatory corneal ulcers with stromal thinning and peripheral localization. Amniotic membranes (AM) are used for their anti-inflammatory and healing properties. A freeze-drying process now allows maintaining the AM viable for a long time at room temperature without altering its physical, biological, and morphologic characteristics. The effectiveness of spongy freeze-dried amniotic membrane (FD-AM) graft with multimodal imaging in the management of severe corneal thinning PUK has not been reported.Case presentationA 67-year-old Caribbean man histologically diagnosed with ulcerative colitis, was referred to our tertiary eye care center for a deep nasal juxtalimbal ulcer of the left eye. He was treated with topical steroids and antibiotics, methylprednisolone pulses, and oral prednisone. Due to continuous stromal thinning with 100 μm of residual corneal thickness, the decision was made to perform surgery. Conjunctival resection, inlay and overlay spongy FD-AM (Visio Amtrix® S, Tissue Bank of France, FR) were performed to preserve globe integrity. Despite tapering off oral steroids, PUK developed in the fellow eye on the 2 months follow-up. Treatment with human monoclonal antibody against tumor necrosis factor-alpha was initiated to control the active underlying inflammation. Six months following surgery, the ulcer was healed and corneal thickness in front of the former ulceration was measured at 525 μm on anterior segment-optical coherence tomography. Confocal microscopy confirmed the integration of the amniotic membrane between the corneal epithelium and the anterior stroma.ConclusionTransplantation of FD-AM with a spongy layer was associated with restoration of normal corneal thickness in the PUK area. It seems to be a safe, effective, and easily accessible solution for the surgical management of PUK with impending perforation.

ETU-Net: efficient Transformer and convolutional U-style connected attention segmentation network applied to endoscopic image of epistaxis.

Epistaxis is a typical presentation in the otolaryngology and emergency department. When compressive therapy fails, directive nasal cautery is necessary, which strongly recommended operating under the nasal endoscope if it is possible. Limited by the operator's clinical experience, complications such as recurrence, nasal ulcer, and septum perforation may occur due to insufficient or excessive cautery. At present, deep learning technology is widely used in the medical field because of its accurate and efficient recognition ability, but it is still blank in the research of epistaxis. In this work, we first gathered and retrieved the Nasal Bleeding dataset, which was annotated and confirmed by many clinical specialists, filling a void in this sector. Second, we created ETU-Net, a deep learning model that smartly integrated the excellent performance of attention convolution with Transformer, overcoming the traditional model's difficulties in capturing contextual feature information and insufficient sequence modeling skills in picture segmentation. On the Nasal Bleeding dataset, our proposed model outperforms all others models that we tested. The segmentation recognition index, Intersection over Union, and F1-Score were 94.57 and 97.15%. Ultimately, we summarized effective ways of combining artificial intelligence with medical treatment and tested it on multiple general datasets to prove its feasibility. The results show that our method has good domain adaptability and has a cutting-edge reference for future medical technology development.

Rapidly evolving nasal ulceration: a clinical challenge.

Rapidly evolving nasal ulceration: a clinical challenge.

Interim Analysis of STS101 Nasal Safety Data From the Phase 3 Open-Label ASCEND Migraine Study (P13-12.006)

<h3>Objective:</h3> To assess the long-term nasal safety and tolerability of STS101 in the acute treatment of migraine. <h3>Background:</h3> STS101 (dihydroergotamine nasal powder) is a novel investigational product with rapid and easy nasal delivery. The ASCEND study assesses the safety and tolerability of STS101 5.2 mg in the acute treatment of migraine with/without aura over 12 months. <h3>Design/Methods:</h3> ASCEND (NCT04406649) is a multi-center, multiple-dose, open-label study in adults (18–65 years) with migraine. Participants self-administered STS101 for ≤2 doses/24 hours and ≤12 doses/month for acute treatment of migraines for 12 months. This interim analysis included participants exclusively using the STS101 incorporating the second-generation nasal delivery device planned for commercialization. Nasal safety assessments included nasal treatment-emergent adverse events (TEAEs), subjective assessments of nasal irritation, and a smell test (SIT). Objective nasal assessments were done by trained study personnel on a 4-point severity scale to document nasal erythema, edema, rhinorrhea, bleeding, and nasal mucosa ulcerations. <h3>Results:</h3> This population included 344 subjects who treated 5,571 attacks with 6,918 doses of STS101 and was 40.4±10.9 years old (mean±SD), 85.8% female, and 87.5% Caucasian. Overall, 97 subjects (28.2%) reported nasal/local TEAEs; 8 of 344 subjects (2.9%) discontinued the study due to nasal/local TEAEs including nasal burning/discomfort (5), nasal bleeding (1), rhinitis (1), and throat tightness (1). Most frequently reported nasal/local related TEAEs were nasal discomfort (38 [11.0%] subjects; 338 [6.1%] attacks), dysgeusia (26 [7.6%]; 154 [2.8%]), and nasal congestion (14 [4.4%]; 198 [3.6%]). At 12 months, 99.5%, 95.4%, 93.5%, and 94.4% of subjects had no nasal bleeding/ulceration, edema, erythema, or rhinorrhea, respectively. No clinically relevant findings were seen from nasal examinations, subjective nasal irritation assessments, or smell tests. <h3>Conclusions:</h3> Nasal safety data from 5,571 treated attacks demonstrate the safety and tolerability of STS101 for the acute treatment of migraine. <b>Disclosure:</b> Dr. Spierings has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Manistee. Dr. Spierings has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Spierings has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lilly. Dr. Spierings has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Detlef Albrecht has received personal compensation for serving as an employee of Satsuma. Detlef Albrecht has stock in Satsuma. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie, Amgen, Biohaven, Cala Health, Satsuma, Teva Pharmaceutical Industries, Theranica, Xoc and Zosano. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie, Amgen, Biohaven, Lundbeck and Teva Pharmaceutical Industries. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews.

Methycillin-Resistant Staphylococcus Aureus (Mrsa) Pada Ulserasi Septum Nasi

Staphylococcus aureus is a gram-positive, which belongs to the Staphylococcus aureus family forming grape-like cluster. Staphylococcus aureus can be found in parts of the human body such as the skin, skin glands, mucous membranes, nose and intestines. Methycillin-resistant Staphylococcus aureus (MRSA) is a Staphylococcus aureus that has mutations in penicillin-binding protein (PBP), namely the mecA gene with decreased affinity for most penicillins. Reported one case of a 59-year-old man with MRSA in nasal septal ulceration. Diagnosis is based on anamnesis, physical examination and laboratory test like complete blood count and antibiotic culture test. The therapy in this case was giving tetracycline 4 x 500mg for 14 days.

Assessment and management of secondary bacterial infections complicating Mpox (Monkeypox) using a telemedicine service. A prospective cohort study.

During spring 2022, an outbreak of Monkeypox (mpox) emerged as an infection of concern in Europe. Due to the overlapping clinical features of mpox and bacterial infections, diagnosis of concomitant bacterial infection is challenging. In this prospective cohort study, we report the incidence, severity, and progression of patients with secondary bacterial infection complicating mpox infection. Data were collected via a bespoke mpox telemedicine service provided by Infection services at North Manchester General Hospital, UK. A diagnosis of secondary bacterial infection was based on the history (balanitis, surrounding erythema, purulent discharge and nasal ulceration) and review of patient-collected medical photography. Patient were reviewed face-to-face where necessary. Secondary bacterial infection was diagnosed in 15 of 129 (11.6%) patients with mpox. Three patients with secondary bacterial infection (3/129, 2.3%) required admission to hospital and one patient underwent surgical debridement. Median healing (thus, isolation) times were longer in those with bacterial infection. In this prospective cohort study of patients with mpox, secondary bacterial infection was infrequent and predominantly mild. The virtual ward and telemedicine follow up allowed for the prompt recognition of secondary bacterial infections and timely antibiotic administration. Due to concerns regarding nosocomial transmission, mild clinical course and limited inpatient bed capacity, we believe this model of outpatient management for mpox (Clade II B.1 lineage) could be replicated in other low risk populations where suitable home isolation facilities exist.

Are large diameter cannulas safe in nonsurgical rhinoplasty?

Are large diameter cannulas safe in nonsurgical rhinoplasty?

Diphtheria in asylum workers: forgotten but not gone!

Diphtheria in asylum workers: forgotten but not gone!

ASSESSMENT OF GROUNDWATER HEAVY METAL CONTAMINATION IN HADEJIA METROPOLIS, JIGAWA STATE, NIGERIA

Heavy metal content in groundwater sources is of growing concern, as they are known to be persistent in nature and have been found to bio-accumulate in animals and plants. They have been found to cause detrimental health effects to human beings; therefore these necessitate the need to assess level of heavy metals in water sources. This study was carried out to evaluation the quality of groundwater samples from twenty five selected boreholes in Hadejia and Atafi Districts of Hadejia Local Government Area, Jigawa State, Nigeria. Selected heavy metals:- Cadmium, Chromium, Iron, Manganese and Lead were determined using atomic absorption spectrophotometry. The results showed that concentrations of Cr(0243 – 0.358mg/L), and Fe(0.967 – 1.359mg/L) were found to be above the maximum permissible limit of Nigerian Standard for Drinking Water Quality and World Health Organization, while, Cd, Mn, and Pb concentrations are below or within the permissible limit in majority of the boreholes. The values for physicochemical variables pH, and TDS were found to be below or within the permissible limit set by the World Health Organization and Nigerian standard for Drinking Water Quality. There is a growing concern about the dangerous health implication of hexavalent chromium consumption in drinking water. It can cause skin and eye irritation, asthma, nasal ulcers, convulsions, acute gastroenteritis, and damage to the liver and kidneys. High iron in water content leads to an overload which can cause diabetes, hemochromatosis, stomach problem, and nausea, it can also damage the liver, pancreas, and heart.

Mineralização, ulceração e epistaxe em um cão com uremia causada por insuficiência renal crônica

ABSTRACT: Soft tissue mineralization and epithelial ulceration are common findings in dogs with uremia, being commonly reported in the gastrointestinal tract, lungs and pleura. This report described a case of nasal mucosal mineralization and ulceration contributing to recurrent epistaxis in a dog with chronic renal failure and uremia. A dog with recurrent epistaxis accompanied by elevated urea and creatinine was hospitalized. Platelet count and coagulation tests were within normal limits. Chronic renal failure was diagnosed, and the dog was euthanized. On necropsy, the kidneys were small, with an irregular capsular surface. The nasal conchae were slightly reddish. Histopathology revealed chronic glomerulonephritis, with gastric mineralization and bilateral parathyroid hyperplasia. Vascular and basal lamina mineralization, epithelial ulceration and hemorrhage were seen in the nasal conchae. The observed findings indicated that nasal mineralization and ulceration were caused by uremia. The severity of histopathological findings suggested that nasal mineralization/ulceration may have caused or at least contributed to epistaxis in this dog. We hope to stimulate further investigations into possible association between uremia, nasal mucosa mineralization/ulceration and epistaxis in dogs.

Recent advances in fluorescence chemosensors for ammonia sensing in the solution and vapor phases.

Developing low-cost and reliable sensor systems for the detection of trace amounts of toxic gases is an important area of research. Ammonia (NH3) is a commonly produced industrial chemical and a harmful colorless pungent gas released from various manufacturing and processing industries. Continuous exposure to NH3 vapor causes serious menace to human health, microorganisms, and the ecosystem. Exposure to relatively higher concentrations of NH3 severely affects the respiratory system and leads to kidney failure, nasal erosion ulcers, and gastrointestinal diseases. Excessive accumulation of NH3 in the biosphere can cause various metabolic disruptions. As a consequence of this, therefore, suitable sensing methods for selective detection and quantification of trace amounts of NH3 are of utmost need to protect the environment and living systems. Given this, there have been significant research advances in the preceding years on the development of fluorescence chemosensors for efficient sensing and monitoring of the trace concentration of NH3 both in solution and vapor phases. This review article highlights several fluorescence chemosensors reported until recently for sensing and quantifying NH3 in the vapor phase or ammonium ions (NH4+) in the solution phase. The wide variety of fluorescence chemosensors discussed in this article are systematically gathered according to their structures, functional properties, and fluorescence sensing properties. Finally, the usefulness and existing challenges of using the fluorescence-based sensing method for NH3 detection and the future perspective on this research area have also been highlighted.

Effect of Chromium on Human-Health: A Review

This review presents the health effects of chromium on the living organism based on previous studies. Chromium (Cr) belongs to the d-block element in the modern periodic table. Chromium has a wide range of oxidation states ranging from -2 to +6. Chromium mostly exists in the environment as trivalent (Cr3+) and hexavalent (Cr6+) states. Both trivalent and hexavalent states of chromiums are derived from the industrial effluents. Ingestion, dermal contact, and inhalation are the most common routes through which chromium enters the human body. Ion chromatography inductively coupled plasmamass spectrometry (IC-ICP-MS) is mostly used for the speciation analysis of metals. Hexavalent chromium is highly soluble and mobile in alkaline and slightly acidic soils, whereas trivalent chromium is less soluble, adheres to the coarse material on the soil, and precipitates as Cr(III) hydroxide. Hexavalent chromium is more detrimental as compared to trivalent chromium. The detrimental effects of chromium are bronchial asthma, lung cancer, nasal ulcers, skin allergies, carcinogenicity, and genotoxicity. To protect from these adverse effects, WHO has suggested a provisional guideline value of chromium as 0.05 mg/L until further information is available and revalued.

Reactive perforating collagenosis and systemic lupus erythematosus: A rare case report

Transepidermal clearance of altered collagen and excessive excretion of keratin are characteristics of a rare cutaneous disorder known as reactive perforating collagenosis (RPC). There are different forms of RPC; however, the acquired form is the most prevalent and inherited. Reactive perforating collagenosis is rarely described in autoimmune rheumatic diseases; instead, it is typically linked to systemic conditions such as renal failure or hepatic disease. A 31-year-old Saudi female patient who was initially diagnosed with undifferentiated connective tissue disease. She developed RPC with a severe diffuse itchy skin rash with numerous papules and nodules with central hyperkeratotic plugs over the lower limb, upper limb, and face. The patient tested positive for antinuclear antibody; however, a year later, patient developed Raynaud's phenomenon, oral and nasal ulcers, malar rash, fatigue, and lupus rash around her eyes, and systemic lupus erythematosus was diagnosed clinically. The patient was treated for reactive perforating collagenosis with systemic antihistamines (diphenhydramine 50 mg orally twice daily), topical steroid cream (betamethasone dipropionate cream), and oral isotretinoin (20 mg daily). The patient was advised to undergo phototherapy. A year later, she presented with symptoms of systemic lupus erythematosus and started taking oral hydroxychloroquine 200 mg twice daily for systemic lupus erythematosus. The patient is listed on follow-up. Variable skin rash can mimic systemic lupus erythematosus and vasculitis. Therefore, reactive perforating collagenosis is a skin condition that requires high clinical suspension for diagnosis, and it might be challenging to determine whether it is an association or a complication. Furthermore, the timing of the skin biopsy may be crucial for the diagnosis of reactive perforating collagenosis.

POST THYMECTOMY: AN EXAMPLE OF IMMUNE DYSREGULATION?

<h3>Introduction</h3> The thymus is essential for creating the T cell repertoire while maintaining self-tolerance. Systemic autoimmune diseases (AD's) such as Rheumatoid Arthritis, Systemic Lupus Erythematous (SLE), and Sjogren's Disease, may unveil many years after thymectomy in patients with Myasthenia Gravis. Immunoglobulin G4-Related Disease (IgG4-RD) characterized by dysregulation of immune system affecting a single or multiple organs, has not been described post thymectomy. <h3>Case Description</h3> Herein a 32-year-old female with history of Myasthenia gravis (MG) s/p thymectomy 24 years ago, SLE, suspected Mixed Connective Tissue Disease, and Chronic rhinosinusitis who, after a right nasal alae ulceration, was found with an anterior nasal septal perforation and subglottic tracheal edema. Biopsy of the nasal mucosa revealed an ulcer with underlying polyclonal plasma cell infiltrate, and immunohistochemistry analysis revealed focally high IgG4/IgG ratio. Total IgG was found at 1959 mg/dL, and Immunoglobulin G subclasses panel showed elevated counts for both IgG1(1271 mg/dL), and IgG4(89.8 mg/dL); other subclasses were within normal range. She was started on Prednisone 60 mg PO daily. The coexistence of multiple AD's raised the concern for a possible immunodeficiency. Nonetheless, Lymphocyte subset panel, and vaccine response were normal. Tuberculin and bacterial cultures were negative. <h3>Discussion</h3> This case portrays a rare presentation of IgG4-RD in a patient with multiple autoimmune conditions. The incidence of numerous AD's has been recognized in thymectomized patients; however, data is scarce regarding IgG4-RD. The role of thymectomy in the development of IgG4-RD remains to be elucidated.

Healing With Complication: An Unusual Case of Nasal Tip Ulceration in Leukocyte Adhesion Deficiency Type 1

A 2-month-old girl presented with a necrotizing lesion over the tip of the nose that started as redness. The lesion subsequently increased in size to form a vesicle and ruptured to form a chronic, progressive, nonhealing ulcer without pus discharge (Figure 1, A). The girl was born at term, birth weight 2.5 kg. There was a history of delayed separation of the umbilical cord at day 22 of life. She developed an episode of omphalitis and another episode of sepsis with pneumonia on days 6 and 20 of life, respectively.

Types and prevalence of adverse skin reactions associated with prolonged N95 and simple mask usage during the COVID‐19 pandemic

BackgroundAs the coronavirus 2019 (COVID‐19) pandemic persists on a global level, the chronic daily use of face masks within the healthcare system remains an important component of disease prevention and transmission. Increased use of personal protective equipment (PPE) may result in increased rates of occupational dermatoses and adverse skin reactions.ObjectivesThe purpose of this study is to explore how chronic, prolonged use of N95 masks or simple surgical masks affects the prevalence of adverse skin reactions in Healthcare Workers (HCWs).MethodsAn optional, quantitative, web‐based survey was administered to patient‐facing HCWs across six network hospitals in a large metropolitan city. Data were analysed to assess the types and sites of adverse skin reactions, and to evaluate correlations between single mask use duration and adverse skin reactions.ResultsA total of 230 HCWs responded with 192 endorsing occupational dermatoses. Among the healthcare responders, (n = 192, 83.5%) experienced at least one adverse skin reaction. The most common occupational adverse skin reactions were acne (n = 133, 57.8%), dryness (n = 108, 47.0%) and redness (n = 105, 45.7%). Anatomical areas most commonly affected included the nasal bridge (n = 92, 40.0%), cheeks (n = 92, 40.0%) and chin (n = 91, 39.6%). Acne (P = 0.002), dryness/scaling (P = 0.002), increased pore size (0.003), itch (P = 0.003), nasal bridge scarring (P < 0.001), redness (P < 0.001), frictional erosions (P = 0.001) and ulcerations (P = 0.002) showed a positive correlation to duration of mask use.ConclusionsProlonged, daily usage of PPE is associated with numerous adverse skin reactions among HCWs with acne being the most commonly seen adverse reaction. Many adverse reactions are associated with prolonged use of single mask.