Adverse Skin Reactions Research Articles

Contact allergy investigations in healthcare workers with face mask-related skin disease.

During the COVID-19 pandemic, the use of face masks has increased among healthcare workers (HCWs). Questionnaire studies have shown a high frequency of self-reported facial adverse skin reactions. Case reports have been published on face mask-induced allergic contact dermatitis and urticaria. To describe the results of the contact allergy investigations in consecutive HCWs investigated for skin reactions to face masks during the COVID-19 pandemic and the results of the chemical investigations of face masks supplied by the hospital. Participants were patch tested with baseline series and chemicals previously reported in face masks not included in the baseline series. Face mask(s) brought by the HCW were tested as is and/or in acetone extract. Chemical analyses were performed on nine different face masks for potential allergens. Fifty-eight HCWs were investigated. No contact allergies were found to the face mask(s) tested. Eczema was the most common type of skin reaction, followed by an acneiform reaction. Colophonium-related substances were found in one respirator and 2,6-di-t-butyl-4-methylphenol (BHT) were found in two respirators. Based on this report, contact allergies to face masks is uncommon. Patch test with colophonium-related substances and BHT should be considered when investigating adverse skin reactions to face masks.

Treatment of pets with the active substance dexpanthenol in wound processes

Animal skin is a complex organ that directly perceives the influence of the external environment and performs a barrier-protective function, helps maintain the balance of the internal environment of the body. Disruption of each of the levels of the protective system leads to the development of inflammatory skin diseases. Treatment of wounds remains one of the most pressing scientific and practical problems of modern veterinary medicine. A number of researchers are searching for and developing new veterinary drugs for the treatment of wounds of various etiologies in small pets, but the use of drugs often causes adverse skin reactions. The purpose of this study was to evaluate the effectiveness of using a veterinary drug (ointment) in the treatment of wounds in domestic animals (dogs, cats, rabbits). The paper uses standard clinical, haematological, and biochemical research methods. The studies used a drug with the active substance dexpanthenol and excipients decamethoxine, Vaseline oil, emulsifier, glycerin, methylparaben, propylparaben, and purified water. The drug under study effectively reduced the wound surface area at all observation periods. It is proved that when using dexpanthenol-based ointment (10%), a complete wound-healing effect was observed in experimental animals on the 14th day of treatment: the area of wound surfaces decreased by 93.1±1.51%. The examined indicators were statistically substantially different from those in the group of untreated animals with skin wounds. The general clinical condition of domestic animals was examined, haematological and biochemical studies of animal blood were conducted under the conditions of applying an experimental drug to damaged skin areas. In animals with skin damage without treatment, the dynamic development of an acute inflammatory process in the body, the development of endogenous intoxication syndrome, signs of wound infection, pronounced exudation and slowing of contraction were observed. The developed veterinary drug with the active substance dexpanthenol simultaneously shows a pronounced antiinflammatory and wound-healing effect and provides a rapid therapeutic effect in wound processes in small pets

Nutritional and metabolic characteristics of critically ill patients admitted for severe toxidermia

Drug-induced toxidermia is an idiosyncratic adverse skin reaction that may become life-threatening in a small portion of patients, requiring intensive care unit (ICU) admission. The treatment recommendations are extrapolated from those of major burns, while prospective data remain sparse. The objective was to observe the application of these recommendations in patients treated in a burn ICU. Retrospective cohort study including patients requiring ICU between 2006 and 2020 in a tertiary university hospital. Age >18 years. Patients were categorized as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN), or other toxidermia. severity scores, body surface area (BSA) involvement, nutritional and metabolic variables, trace element status, outcome variables. Descriptive statistics: median [IQR]. Altogether 35 patients were included (27 SJS/TEN and 8 "other"), aged 58 [48; 69] years. Skin involvement was 45% [30; 60] of body surface, 17 patients required mechanical ventilation, and length of ICU stay was 16 [6.5; 26] days. Hospital mortality was 23%. Fluid resuscitation requirements were moderate, despite intense inflammation (admission CRP (144 [89; 218] mg/L). The first 2 weeks' energy and protein intakes were below recommendations (p<0.0001), lowest with oral feeding. Indirect calorimetry showed high energy expenditure in 11 patients (30.4 [23.9; 35.5] kcal/kg) resulting in negative energy balances (mean-245 kcal/day). Copper and zinc levels were below reference range during the first week, the low copper values being a novel finding. Trace elements should be monitored. The cohort was underfed with intakes lower than our ICU protocols, partly explained by short intubation times, and mucocutaneous involvement complicating the management and placement of feeding tubes. Oral feeding was least efficient and may become an indication for supplemental parenteral nutrition in the absence of an enteral feeding tube. gov Identifier: NCT05320653.

Abstract 1900: Radiotherapy-induced early adverse skin reactions: Comparative analysis of clinician- and patient-reported outcomes in a multi-racial/ethnic breast cancer population (WF-97609)

Abstract Background: Adjuvant radiotherapy (RT) following surgery significantly improves breast cancer survival. However, some patients, particularly minorities, develop early adverse skin reactions (EASRs) or skin toxicities that negatively impact the quality of life (QOL). We assess RT-related EASRs and QOL using clinician-reported outcomes (CROs) and patient-reported outcomes (PROs) in a large multi-racial/ethnic breast cancer population. Methods: This prospective study recruited 1,000 breast cancer patients undergoing RT through the Wake Forest NCI Community Oncology Research Program (NCORP) Research Base between 2011 and 2013. We used the Oncology Nursing Society (ONS) Skin Toxicity Criteria for CROs and Skindex-16 (SD-16) for PROs. Results: This study included 405 non-Hispanic whites (NHW), 277 black/African Americans (AA), 241 HW, 62 Asian/Pacific Islanders (ASPI), and 15 others. About 42% and 15% of patients developed RT-induced ONS grade 3+ and 4+ skin toxicities, respectively. RT-induced EASRs differed significantly by race/ethnicity at mid-RT, 1-month, and 2-month post-RT, but not at the end of RT. Total SD-16 scores differ by race/ethnicity at pre-RT, 1-month, and 6-month post-RT, but not at the end of RT. Overall, PROs have a moderate but significant correlation with CROs at the end of RT. Conclusion: RT-induced EASRs differed significantly by race/ethnicity. There was a moderate but significant correlation between PROs and CROs. However, PROs delineated a broader spectrum in capturing the impact of RT on patients’ QOL, which highlights the importance of integrating PROs in accessing RT-induced EASRs, particularly in minorities with worse RT-induced EASRs. Trial Registration: NCT01407770 (09/02/2011) Citation Format: James J. Urbanic, Edward G. Shaw, Cristiane Takita, Jean L. Wright, Edward H. Ip, Lingyi Lu, Luis Baez-Diaz, Doris R. Brown, Jon Strasser, Kathy Baglan, Mark Palmer, Anu Thakrar, Amarinthia E. Curtis, Glenn Lesser, Jennifer J. Hu. Radiotherapy-induced early adverse skin reactions: Comparative analysis of clinician- and patient-reported outcomes in a multi-racial/ethnic breast cancer population (WF-97609) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1900.

Abstract 2824: Metabolomics in radiotherapy-induced early adverse skin reactions in breast cancer patients

Abstract Background: Early adverse skin reactions (EASRs) are common side effects of postoperative adjuvant radiotherapy (RT) that significantly impact the quality of life (QOL) of breast cancer patients. This study used global metabolomics profiles of breast cancer populations to identify metabolic pathways and biomarkers that are significantly associated with RT-induced EASRs to identify potential targets for precision interventions. Methods: Using a frequency-matched study design, pre-RT urine samples from 60 female breast cancer patients receiving RT after breast-conserving surgery were metabolically profiled. Patients were recruited from the University of Miami Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital. Using MetaboAnalyst 3.0, we performed metabolomic data analysis, visualization, and interpretation on 84 candidate metabolites from a dataset of 478 total compounds. Student’s t-tests, correlation analyses, pathway enrichment, and topology analyses were conducted sequentially to identify metabolite biomarkers and pathways associated with RT-induced EASRs. Results: The study population consisted of 24 African American (40%), 18 non-Hispanic white (30%), 14 Hispanic white (24%), and 4 “other” (7%) patients with frequency matched by race/ethnicity and body mass index (BMI) categories (i.e., normal, overweight, and obesity) to have an equal number of high (n=30) and low (n=30) EASRs. Seven metabolic pathways were significantly associated with RT-induced EASRs, including alanine, aspartate, and glutamate metabolism; caffeine metabolism; pentose and glucuronate interconversions; glycine, serine, and threonine metabolism; beta-alanine metabolism; pantothenate and CoA biosynthesis; and glutathione metabolism. The alanine, aspartate, and glutamate metabolism pathway had the lowest false discovery rate (FDR)-adjusted p-value (p=0.0028) and the highest pathway impact value (0.60) of all enriched metabolic pathways. Thirteen metabolite biomarkers were significantly associated with RT-induced EASRs, including the principal compound of interest glutamate. Conclusions: In our study of breast cancer patients receiving adjuvant RT, alanine, aspartate, and glutamate metabolism had the highest impact value and significant FDR-adjusted p-value in predicting RT-induced EASRs. Our findings suggest that glutaminase inhibitors may have broader clinical applications in preventing RT-induced EASRs in addition to their potential enhancement of chemotherapy by triggering metabolic crises in tumor cells. Keywords: breast cancer, metabolomics, radiation therapy, and early adverse skin reactions. Citation Format: Alexandra N. McMahon, Cristiane Takita, Jean L. Wright, Eunkyung Lee, Joshua J. Kleinman, Isildinha M. Reis, Jennifer J. Hu. Metabolomics in radiotherapy-induced early adverse skin reactions in breast cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2824.

Adverse skin reaction due to ripasudil eye drops

Topical anti-glaucoma medications are the mainstay of therapy in Glaucoma. All anti-glaucoma medications are associated with adverse effects. As ripasudil hydrochloride hydrate 0.4% is a relatively new drug, we describe a series of patients who developed allergic contact dermatitis after the use of topical Ripasudil. Twelve eyes of seven patients treated with topical ripasudil that subsequently developed allergic contact dermatitis were included in the case series. All seven patients developed itchy, hyperpigmented lesions around periocular areas which got relieved after cessation of the drug.

A comparison of the efficacy and safety profiles of 10% salicylic acid and 10% urea creams in treating acanthosis nigricans in adolescents: a randomized double-blinded study.

Acanthosis nigricans is characterized by the presence of velvety hyperpigmentation of the skin over the neck and the flexural areas. Regardless of different modalities of treatment, none provides a definite standard cure. This study aims to assess the efficacy of topical 10% salicylic acid compared to 10% urea cream in treating acanthosis nigricans in adolescents. A randomized comparative, double-blind study is conducted on adolescents with acanthosis nigricans of the posterior neck. Treatment efficacy was assessed via a narrowband reflectance spectrophotometer at individual follow-up visits at weeks 2, 4, and 8, while the overall success rates were evaluated by the investigator-assessed and participant-assessed global evaluation scales (IGE and PGE). Acanthosis nigricans scoring chart (ANSC) and adverse effects are also assessed. A total of 39 participants with acanthosis nigricans enrolled and completed the study. Throughout the 8-week period of treatment, the use of 10% salicylic acid demonstrated strong effectiveness in treatment with 14.6 ± 10.6% improvement, while the 10% urea demonstrated 12.5 ± 10.9% improvement. Findings from the overall global evaluation scales were consistent with the results from the narrowband reflectance spectrophotometer. Treatment with 10% salicylic and 10% urea produced no serious local skin adverse reactions. Both medications improve neck hyperpigmentation associated with acanthosis nigricans in adolescents, in which the 10% salicylic acid and 10% urea cream demonstrate similar efficacy and safety profiles. Clinical Trials Registry: TCTR20201123003.

Analysis of the clinical characteristics of pembrolizumab-induced bullous pemphigoid.

Pembrolizumab, a programmed cell death protein 1 checkpoint inhibitor, is a novel drug used to treat a variety of advanced malignancies. However, it can also result in many immune-related adverse events, with cutaneous toxicities being the most frequent. Regarding pembrolizumab-induced skin adverse reactions, bullous pemphigoid (BP) has the worst effects on quality of life. Recently, there have been more and more reports of BP incidents resulting from pembrolizumab therapy in patients with cancer. This study aimed to define the clinical characteristics, diagnosis and management of pembrolizumab-induced BP and identify potential differences between classical BP and pembrolizumab-induced BP. Case reports, case series, and case analyses of pembrolizumab-induced BP up to 10 December 2022 were collected for retrospective analysis. Our study included 47 patients (33 males and 14 females) from 40 studies. The median age was 72 years (range 42-86 years). The median time to cutaneous toxicity was 4 months (range 0.7-28 months), and the median time to bullae formation was 7.35 months (range 0.7-32 months). The most common clinical features were tense bullae and blisters (85.11%), pruritus (72.34%), and erythema (63.83%) on the limbs and trunk. In 20 of the 22 cases tested, the serum anti-BP180 autoantibodies were positive. However, in 10 cases (91.90%, 10/11) the circulating autoantibodies of anti-BP230 were negative. 40 patients had skin biopsies and the skin biopsy revealed subepidermal bullae or blister eosinophil infiltration in 75.00% of patients with pembrolizumab-induced BP, 10.00% of patients with lymphocyte infiltration and 20.00% of patients with neutrophil infiltration. There were 20 patients (50%) with eosinophilic infiltration around the superficial dermis vessels, 8 patients (20.00%) with lymphocyte infiltration around the superficial dermis vessels, and 4 patients (10.00%) with neutrophil infiltration around the superficial dermis vessels. Direct immunofluorescence detected linear immunoglobulin G (IgG) IgG and/or complement C3 along the dermo-epidermal junction in 36 patients (94.74%) with BP. IgG positivity was detected by indirect immunofluorescence in 81.82% of patients with BP. All patients were in complete remission (95.65%,44/46) or partial remission (4.35%, 2/46) of BP, whereas 9/46 patients had a relapse or refractory. The majority of patients achieved BP remission after discontinuation of pembrolizumab with a combination of topically and systemically administered steroid treatments, or other medications. The median duration of BP remission was 2 months (range 0.3-15 months). A thorough diagnosis of pembrolizumab-induced BP should be made using clinical signs, biochemical markers, histopathological and immunopathological tests. Pembrolizumab-induced BP had similar clinical characteristics to classic BP. Temporary or permanent discontinuation of pembrolizumab therapy may be required in patients with perbolizumab-induced BP depending on the severity of BP and the response to medication. Pembrolizumab-induced BP may be effectively treated using topical and systemic steroid treatments in combination with other medications (e.g., doxycycline, niacinamide, dapsone, rituximab, intravenous immunoglobulins, dupilumab, cyclophosphamide, methotrexate, mycophenolate mofetil, and infliximab). Clinicians should provide better management to patients with BP receiving pembrolizumab to prevent progression and ensure continuous cancer treatment.

Characterisation of superficial corneocytes in skin areas of the face exposed to prolonged usage of respirators by healthcare professionals during COVID-19 pandemic

IntroductionDuring the COVID-19 pandemic healthcare workers (HCWs) have used respiratory protective equipment for prolonged periods, which has been associated with detrimental effects on the underlying skin. The present study aims to evaluate changes in the main cells (corneocytes) of the stratum corneum (SC) following prolonged and consecutive use of respirators. Methods17 HCWs who wore respirators daily during routine hospital practice were recruited to a longitudinal cohort study. Corneocytes were collected via tape stripping from a negative control site (area outside the respirator) and from the cheek which was in contact with the device. Corneocytes were sampled on three occasions and analysed for the level of positive-involucrin cornified envelopes (CEs) and the amount of desmoglein-1 (Dsg1), as indirect measurements of immature CEs and corneodesmosomes (CDs), respectively. These were compared to biophysical measurements (Transepidermal water loss, TEWL, and SC hydration) at the same investigation sites. ResultsA large degree of inter-subject variability was observed, with maximum coefficients of variation of 43% and 30% for the level of immature CEs and Dsg1, respectively. Although it was observed that there was not an effect of prolonged respirator usage on the properties of corneocytes, the level of CDs was greater at the cheek than the negative control site (p < 0.05). Furthermore, low levels of immature CEs correlated with greater TEWL values after prolonged respirator application (p < 0.01). It was also noted that a smaller proportion of immature CEs and CDs was associated with a reduced incidence of self-reported skin adverse reactions (p < 0.001). ConclusionsThis is the first study that investigated changes in corneocyte properties in the context of prolonged mechanical loading following respirator application. Although differences were not recorded over time, the levels of CDs and immature CEs were consistently higher in the loaded cheek compared to the negative control site and were positively correlated with a greater number of self-reported skin adverse reactions. Further studies are required to evaluate the role of corneocyte characteristics in the evaluation of both healthy and damaged skin sites.

A Case Study of Generalized Eczema Induced by Ginkgolide Injection

Objective: To analyze the clinical characteristics of adverse skin reactions (ADRs) caused by ginkgolide injection, and to provide reference for the post-marketing safety study of ginkgolide injection. Methods: By participating in the treatment of a patient with suspected adverse skin reactions caused by ginkgolide injection, The patient was given target ginkgolide injection 50mg intravenously once a day for two consecutive days due to cerebral infarction. Six days after drug withdrawal, the patient developed a rash on the buttocks, and then the rash quickly spread to the whole body, resulting in skin lesions with exudation tendency, itchy skin and extensive epidermal shedding. Combined with clinical medication and the clinical characteristics of this adverse reaction, the causes and mechanisms of adverse reactions caused by ginkgolide injection were analyzed from the ingredients of ginkgolide injection and the adverse reaction reports of ginkgolide extract. Consults: The adverse reaction was analyzed as severe skin allergy caused by ginkgolide injection. After oral administration of ebastine, injection of calcium gluconate and vitamin C, and topical dehumidification and itching-relieving ointment, the skin lesions basically healed after 2 weeks. Conclusions: Cases of skin allergic reactions caused by ginkgolide injection have been reported, but clinical trials on the safety of ginkgolide injection still lack the content of post-marketing safety studies. This adverse reaction is a detailed case analysis, in order to provide reference for the content of post-marketing safety of ginkgolide injection.

Prävalenz von Hautirritationen bei Pflegekräften durch das Verwenden von persönlicher Schutzausrüstung während der COVID-19-Pandemie

Prevention of adverse skin reactions among nursing staff through the use of personal protective equipment during the COVID-19 pandemic Objectives: The aim of the study was to investigate the prevalence and influencing factors for adverse skin reactions (ASR) due to occupational PPE use among nursing staff in Germany during the COVID-19 pandemic. Methods: The study uses a mixed methods design. A focus group was created with experts from the field of healthcare, and an online survey was then carried out among nursing staff. Influencing factors were identified using multivariate logistic regression via odds ratios with 95 % confidence intervals. Results: A total of 2274 nursing staff took part in the survey, with 1967 included in the analysis. The prevalence of ASR was 61 %, with the great majority of subjects reporting having developed at least one adverse skin reaction on the face (94 %). Statistically significant predictors of the more frequent developing of new adverse skin reactions were the wearing of FFP masks for four or more hours, being female and younger, and a known contact allergies. A pre-existing skin disease had a protective effect. Conclusions: The prevalence of PPE-related ASR underlines the necessity for targeted preventive measures for nursing staff during pandemic situation. Keywords: healthcare worker – COVID-19 – personal protective equipment (PPE) – adverse skin reactions – pandemic

The Effectiveness of Titanium Dioxide Sunscreen in Combination with Skin Defensil Plus® as an Anti-inflammatory Agent against Ultraviolet Radiation

BACKGROUND: Ultraviolet (UV) radiation can cause tanning and sunburn in the short-term; nevertheless, continued exposure to UV on unprotected skin will promote premature aging and gene mutation that leads to malignancy. Photoaging caused by sun exposure can happen through inflammation and reactive oxygen species pathway. Defensil plus® consists of natural plant ingredients that have an anti-inflammatory and anti-oxidant activity to protect the skin from UV exposure. Sunscreen with anti-oxidant and anti-inflammatory properties will reduce the unwanted effect of UV radiation, such as tanning and sunburn. AIM: The aim of the study was to determine the effectiveness of the combination of titanium dioxide (TiO2) sunscreen with defensil plus® against UV radiation. METHODS: This was an experimental research design with pre- and post-test design approaches. Twenty subjects consisting of ten males and ten females with an average age of 23 years old, participated in this study. We conducted an experimental study with two groups. Group A was the TiO2+ defensil plus® group; Group B was the TiO2 group. The skin protection effect was compared by examining the erythema and melanin indexes using Mexameter® on day 0, post-radiation days 1, 2, 3, 4, and 7. Data Analysis using an independent t-test if the data distribution is expected, while the Mann–Whitney test is used if it does not meet the normality assumption. Data were considered significant with p &lt; 0.05. RESULTS: Melanin index decreased significantly from day 1 to 7 in the group that was given TiO2 + defensil plus® compared to the group that was only given TiO2 (p = 0.003). The erythema index gradually decreased and significantly different in the group given TiO2 application (p = 0.036). + defensi plus® compared to the group given TiO2 after 3rd day of application (p = 0.036). CONCLUSION: Application of sunscreen with TiO2 + defensil plus® is effective in response to UV radiation, as demonstrated by lower erythema and melanin indexes than those treated with TiO2 sunscreen alone, thus could protect the skin from UV radiation. Many studies showed that green and black tea (polyphenols) ameliorate adverse skin reactions following UV exposure.

A multidisciplinary approach to verify and de-label of drug allergic histories in a university hospital in Thailand: a retrospective descriptive study

BackgroundMislabeling of drug allergic histories causes avoidable negative impacts on patients and healthcare system. Although multidisciplinary adverse drug reaction (ADR) services to verify and de-label drug allergic histories have been operated in particular hospitals in Thailand, their performances have not been reported. This research aimed to examine the effectiveness of verification of drug allergic history and de-labeling (VD) services of the physician-led multidisciplinary ADR clinic.MethodsThis research was a retrospective descriptive study. Medical charts of patients with at least one drug allergic history who received VD services at the multidisciplinary clinic between January 2017 to December 2018, were reviewed. Data on the history of drug allergy, VD services, and results were analyzed and presented using descriptive statistics.ResultsSeventy patients’ charts were reviewed, and 171 unconfirmed drug allergic histories were identified. 79.53% of the reported reactions involved skin and soft tissues. The most found adverse skin reactions were maculopapular rash, pruritic and erythematous rash, and angioedema. The remaining 20.47% were systemic reactions which included drug reaction with eosinophilia and systemic symptoms (DRESS), anaphylaxis, and nausea/vomiting was the most prevalent. Antituberculosis, beta-lactam antibiotics, and nonsteroidal anti-inflammatory drugs (NSAIDs) were the most reported suspected drugs. Drug allergic history reviewing by physicians or pharmacists could confirm and de-label for 3 and 20 reactions, respectively. Seven and one reactions were confirmed by enzyme‐linked immunospot assay and patch test, respectively. The provocation tests with the suspected or alternative drug were conducted in 64 reactions. Twelve reactions were confirmed, and 45 reactions were de-labeled. Totally, 65/171 (38.01%) allergic histories were successfully de-labeled, 23/171 (13.45%) were confirmed, and 83/171 (48.53%) were inconclusive.ConclusionsMore than half of drug allergic histories were successfully confirmed or de-labeled by the multidisciplinary ADR team. The collaborative activities of various healthcare professionals, consisting of physicians, nurse, and pharmacists as presented in the study were effective in VD services and should be implemented in other healthcare settings.

Mask‐related adverse skin reactions in orientals during COVID‐19: Prevalence, social‐psychological impacts and risk factors for acne exacerbation

COVID-19 pandemic has caused mask-related skin problems on health-care professions, yet very few studies have investigated the prevalence in oriental general population. To investigate the prevalence of mask-related adverse skin reactions in Orientals, to explore psychological influence, to identify risk factors for mask-related acne exacerbation. We performed a survey through social media. Participant demographics, skin condition before and after COVID-19, and the influence of adverse skin on social-psychological conditions were collected. We compared characteristics between individuals with or without acne exacerbation, and we performed a logistic regression to identify risk factors. Six hundred and six participants (62.3%) responded the survey and 23.3% complained their facial acnes become exacerbated since COVID-19. The social-psychological impact of acnes is more prevalent in women. Risk factors for mask-related acne exacerbation were occupation as health-care workers (OR=1.861, p=0.027), prolonged wearing of N95 masks (OR=3.167, p=0.001), and touching of acnes (OR=2.65, p=0.002). Sex, pre-existed acnes, and prolonged wearing time per day are also associated with acne exacerbation. Mask-related adverse skin reactions are common in Orientals, and could lead to negative social-psychological effects.

How to prevent mask-related adverse skin reactions

How to prevent mask-related adverse skin reactions

Adverse Skin Reactions to Personal Protective Equipment Among Healthcare Workers in Oman During the Coronavirus Disease 2019 Pandemic.

Background During the coronavirus disease 2019 (COVID-19) pandemic, healthcare workers (HCWs) were required to use personal protective equipment (PPE) for unusually prolonged periods of timein order to protect themselves. This study was conducted toassess the prevalence of adverse skin reactions to PPEamongHCWsfrom occupational and domestic exposure in Oman. Methods This was a cross-sectional study that used a self-administered questionnaire, modified based on the Nordic Occupational Skin Questionnaire, and was conducted in different categories of healthcare facilities in Oman from September to December 2020. This study involved 431 different categories of HCWs. Stata statistical software, version 12 (StataCorp, College Station, TX), was used to analyze the data, with a P value <0.05 indicating statistical significance. Results Findings indicated that 58.24% of HCWs reported new skin symptoms since the pandemic started, compared to 33.41% of HCWs who had skin symptoms before the pandemic (P<0.001). From the multivariate analysis, being female (odds ratio, or OR, 3.512; 95% confidence interval, or CI: 2.193-5.625), allergic rhinitis diagnosis (OR 2.420; 95% CI: 1.097-5.347), history of skin symptoms (OR 3.166; 95% CI: 1.856-5.400), and total glove use time (OR 1.160; 95% CI: 1.078-1.247) were associated with an increased risk of acquiring new skin symptoms. Conclusion This study demonstrates that there is some association between the prolonged use of PPE during an event such as a pandemic and a previous history of allergic rhinitis and skin symptoms. This study also emphasizes the importance of appropriate protective skin care before and after the use of PPE.

Mask-related adverse skin reactions and risk factors: A literature review

Mask-related adverse skin reactions and risk factors: A literature review

Expert consensus on the management of adverse events of CDK4/6 inhibitors in breast cancer

Cyclin-dependent kinases 4/6 (CDK4/6) inhibitors are anti-tumor agents for the treatment of hormone receptor-positive breast cancer. Palbociclib, abemaciclib and dalpiciclib have been approved for the treatment of breast cancer in China. Common adverse effects of CDK4/6 inhibitors include bone marrow suppression, gastrointestinal toxicities, liver dysfunction, and skin or subcutaneous tissue adverse reactions (AEs). The Breast Cancer Expert Group of Chinese Society of Clinical Oncology (CSCO) summarized the incidence, clinical manifestations, and grading of the AEs. This expert consensus reports measures of AE management on the basis of experience of clinical practice and the latest advances worldwide, aiming to guide clinical practice by the way of managing AE and help to choose the best treatment regimen.

Fixed drug eruption to aripiprazole, cetirizine, and hydroxyzine hydrochloride

A fixed drug eruption (FDE) is an adverse skin reaction consisting of recurrent lesions at the same site after exposure to antibiotics, NSAIDs, oral contraceptives, among others. The eruptions are round, dusky, erythematous macule, or plaque on cutaneous or mucosal surfaces often accompanied by burning or pruritus. Symptoms appear between 30 minutes and 8 hours after the ingestion of the offending agent. There may be a single or up to six lesions, and infrequently FDEs may be multifocal and can blister.

Jade material in vitro and in vivo: A study on the anti-inflammatory and repair efficacy of jade material on the skin.

The biological safety of natural jade materials and assembled jade-activated materials on cells and their anti-inflammatory and damage repair functions, as well as the repair function on sensitive skin, were studied utilizing in vitro cell biology and in vivo. Human skin fibroblasts were used as model cells to conduct cytotoxicity experiments in vitro, and the effects on the expression of inflammatory factors and growth factor-related genes in fibroblasts were explored. The gene expression values of inflammatory factors IL-1, IL-6, TNF-α and cytokines epidermal growth factors, fibroblast growth factors and COL1A1 in fibroblasts were measured by polymerase chain reaction test. Thirty women with sensitive skin were selected to apply a mask containing jade extract three times a week. After two weeks, non-invasive measures related to skin sensitivity were tested. We confirmed the presence of anti-inflammatory effects in both jade materials, with the effects of the assembled activated jade material being superior to that of the natural jade material. Jade extracts significantly increased the gene expressions of EGF, FGF and COL1A1 in HDF. The results of the in vivo study showed that the mask containing jade extract could significantly increase the skin hydration and decrease the rate of transepidermal water loss and skin lactic acid sting test scores after two weeks of use. Subjective evaluations confirmed improvements in skin dryness, smoothness and fineness. No new sensitization occurred in subjects, and the product was non-irritating. No adverse skin reactions were observed during the test. The jade materials were able to downregulate the expression of inflammatory factor genes, up-regulate the expression of growth factor genes, and improve the anti-inflammation and repair ability of skin. Furthermore, the test results of participants with sensitive skin after using the mask containing jade extract showed that the mask has repairing ability.