Investigation of the incidence of Hand Eczema in Children During the Covid-19 Pandemic

Year 2023, Volume: 20 Issue: 1, 52 - 55, 27.04.2023

Velat Çelik , Hüseyin Tanrıverdi

https://doi.org/10.35440/hutfd.1133179

Abstract

Background: Hand cleaning is one of the most critical preventive methods against Coronavirus Disease-2019 cross-transmission. Frequent use of soap and hand washing can cause skin damage and lead to hand eczema. The aim of our study is to investigate the incidence of hand eczema in children and associated factors during the Coronavirus Disease-2019 pandemic.
Materials and Methods: We distributed a self-administered online survey to the families of the children in Adıya-man, Turkey. The survey included questions about hand eczema-associated symptoms and risk factors before and during the Coronavirus Disease-2019 pandemic. In order to question the hand eczema-associated symptoms, the presence of the following findings was questioned: Dryness, itching, erythema, desquamation, pain/burning, oozing. A participant was included in the hand eczema-associated symptoms group if he/she reported one or more these symptoms.
Results: One hundred thirty-three mothers answered the survey. The median age of the children was 12 (inter-quartile range=5-14.5) years, and 50.4% of the children were girls and 49.6% were boys. During the COVID-19 pandemic, the incidence of hand eczema-associated symptoms increased from 14.4% to 29.7% in children and from 32.3% to 46.6% in mothers (p<0.001 and p=0.007, respectively). Children with and without hand eczema-associated symptoms were compared to determine risk factors for occurrence of hand eczema-associated symp-toms in children. The hand eczema-associated symptoms in the mothers, employed mothers and use of hand disinfectant were higher in the children with hand eczema-associated symptoms group (p<0.001, p<0.001 and p=0.013, respectively). Then these three factors, which were statistically significant in univariate analyzes, were compared with the multivariate logistic regression test. The presence of hand eczema-associated symptoms in the mother was found to be only independent risk factor for the presence of hand eczema-associated symptoms in her children (p<0.001; odds ratio=30.42; confidence interval=5.41-170.99).
Conclusions: In our study, we found that the incidence of hand eczema-associated symptoms in children and their mothers increased during the Coronavirus Disease-2019 pandemic. Maternal hand eczema-associated symptoms were found to be only independent risk factor for increased incidence of hand eczema-associated symptoms in children. Proper education and preventive strategies for hand eczema are needed for both parents and children.

Key Words: Children, Covid-19, Hand eczema, Hand washing

Project Number

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Covid-19 Pandemi Sürecinde Çocuklarda El Egzama Sıklığının Araştırılması

Abstract

ÖZ
Amaç: Coronavirüs Hastalığı-2019 salgınında bulaşmayı önleyici tedbirlerin başında el temizliği gelmektedir. Sık sabun kullanımı ve el yıkama cilt hasarına yol açarak el egzamasına yol açabilir. Çalışmamızın amacı, Coronavirüs Hastalığı-2019 salgını sırasında çocuklarda el egzaması sıklığını ve ilişkili faktörleri araştırmaktır.
Materyal ve Metod: Çalışmamız, çevrimiçi anket kullanılarak yapılan kesitsel bir araştırmadır. Adıyaman ilinde ikamet eden çocukların ailelerine, kendilerinin dolduracakları çevrimiçi anket dağıtıldı. Anket, Coronavirüs Hastalığı-2019 pandemi öncesinde ve pandemi döneminde el egzaması ile ilişkili semptomlar ve risk faktörleri hakkında sorular içeriyordu. El egzaması ilişkili semptomları sorgulamak için şu bulguların varlığı sorgulandı: Kuruluk, kaşıntı, kızarıklık, pullanma/kabuklanma, ağrı/yanma, sulanma. Bu bulgulardan herhangi biri varsa el egzaması ile ilişkili semptomlar var olarak kabul edildi.
Bulgular: Çalışmaya 133 çocuk ve annesi katıldı. Çocukların yaş ortancası 12 (çeyrekler arası aralık=5-14,5) yıldı ve %50,4’ü kız, %49,6’sı erkek idi. COVID-19 pandemisi sonrası el egzaması ile ilişkili semptomların sıklığı çocuklarda %14,4'den %29,7'ye, annelerde %32,3'ten 46,6'ya yükselmişti (sırasıyla p<0,001 ve p=0.007). Çocuklardaki risk faktörlerini belirlemek için el egzaması ile ilişkili semptomlar olan ve olmayan çocuklar karşılaştırıldı. El egzaması ilişkisi semptomları olan çocukların annelerinde el egzaması ile ilişkili semptomlar daha yüksek oranda vardı (p<0,001), anneleri herhangi bir işte daha yüksek oranda çalışıyorlardı (<0,001) ve çocuklar daha yüksek oranda el dezenfektanı kullanmışlardı (p=0,013). Tek değişkenli analizlerde istatiksel olarak anlamlı çıkan bu üç faktör, çok değişkenli lojistik regresyon testi ile karşılaştırıldığında, sadece annede el egzaması ile ilişkili semptomlar bulunması, çocuklarında el egzaması ile ilişkili semptomlar bulunması için bağımsız risk faktörü olarak bulundu (p<0,001; odds oranı=30,42; güven aralığı=5,41-170,99).
Sonuç: Çalışmamızda, Coronavirüs Hastalığı-2019 salgını döneminde çocuklarda ve annelerinde el egzaması ile ilişkili semptomlar sıklıklarının arttığını bulduk. Çocuklarda el egzaması ile ilişkili semptomlar sıklığında artış için, annede el egzaması ile ilişkili semptomlar bulunması bağımsız risk faktörü olarak bulundu. Ebeveyn ve çocukların el egzaması konusunda birlikte eğitilmesi ve el egzaması gelişmesini önleyici stratejilerin geliştirilmesi önem arz etmektedir.

Keywords

covid-19, çocuk, el egzaması, el yıkama

Supporting Institution

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Project Number

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Thanks

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References

• WHO Interim guidance 19 March 2020. https://www.who.int/publications-detail/infection-prevention-and-control-during-health-carewhen-novel-coronavirus-(ncov)-infection-is-suspected-20200125. Accessed, May 31, 2020.
• Singh M, Pawar M, Bothra A, Choudhary N. Overzealous hand hygiene during the COVID 19 pandemic causing an increased incidence of hand eczema among general population. J Am Acad Dermatol. 2020;83(1):e37-e41.
• Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P, et al. Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis. 2008;59(1):43-7.
• Techasatian L, Thaowandee W, Chaiyarit J, Uppala R, Sitthikarnkha P, Paibool W, et al. Hand Hygiene Habits and Prevalence of Hand Eczema During the COVID-19 Pandemic. J Prim Care Community Health. 2021;12:21501327211018013.
• Celik V, Ozkars MY. An overlooked risk for healthcare workers amid COVID-19: Occupational hand eczema. North Clin Istanb. 2020;7(6):527-33.
• Erdem Y, Altunay IK, Aksu Cerman A, Inal S, Ugurer E, Sivaz O, et al. The risk of hand eczema in healthcare workers during the COVID-19 pandemic: Do we need specific attention or prevention strategies? Contact Dermatitis. 2020;83(5):422-3.
• Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T, et al. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol. 2020;183(1):190-2.
• Lan J, Song Z, Miao X, Li H, Li Y, Dong L, et al. Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020;82(5):1215-6.
• Hamnerius N, Ponten A, Bergendorff O, Bruze M, Bjork J, Svedman C. Skin Exposures, Hand Eczema and Facial Skin Disease in Healthcare Workers During the COVID-19 Pandemic: A Cross-sectional Study. Acta Derm Venereol. 2021;101(9):adv00543.
• Jindal R, Pandhi D. Effect of Hand Hygiene Practices in Healthcare Workers on Development of Hand Eczema during Coronavirus-19 Pandemic: A Cross Sectional Online Survey. Indian J Dermatol. 2021;66(4):440-4.
• Ahmed ZH, Agarwal K, Sarkar R. Hand Dermatitis: A Comprehensive Review with Special Emphasis on COVID-19 Pandemic. Indian J Dermatol. 2021;66(5):508-19.
• Alkhalifah A. Risk factors for hand eczema in the general population of Saudi Arabia during the COVID-19 pandemic: An internet-based cross-sectional study. JAAD Int. 2022;6:119-24.
• Borch L, Thorsteinsson K, Warner TC, Mikkelsen CS, Bjerring P, Lundbye-Christensen S, et al. COVID-19 reopening causes high risk of irritant contact dermatitis in children. Dan Med J. 2020;67(9).
• Simonsen AB, Ruge IF, Quaade AS, Johansen JD, Thyssen JP, Zachariae C. High incidence of hand eczema in Danish schoolchildren following intensive hand hygiene during the COVID-19 pandemic: a nationwide questionnaire study. Br J Dermatol. 2020;183(5):975-6.
• Simonsen AB, Ruge IF, Quaade AS, Johansen JD, Thyssen JP, Zachariae C. Increased occurrence of hand eczema in young children following the Danish hand hygiene recommendations during the COVID-19 pandemic. Contact Dermatitis. 2021;84(3):144-52.
• Otter JA, Donskey C, Yezli S, Douthwaite S, Goldenberg SD, Weber DJ. Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination. J Hosp Infect. 2016;92(3):235-50.
• Yuksel YT, Sonne M, Norreslet LB, Gundersen G, Fazli MM, Agner T. Skin barrier response to active chlorine hand disinfectant-An experimental study comparing skin barrier response to active chlorine hand disinfectant and alcohol-based hand rub on healthy skin and eczematous skin. Skin Res Technol. 2022;28(1):89-97.
• Balato A, Ayala F, Bruze M, Crepy MN, Goncalo M, Johansen J, et al. European Task Force on Contact Dermatitis statement on coronavirus disease-19 (COVID-19) outbreak and the risk of adverse cutaneous reactions. J Eur Acad Dermatol Venereol. 2020;34(8):e353-e4.
• Stutz N, Becker D, Jappe U, John SM, Ladwig A, Spornraft-Ragaller P, et al. Nurses' perceptions of the benefits and adverse effects of hand disinfection: alcohol-based hand rubs vs. hygienic handwashing: a multicentre questionnaire study with additional patch testing by the German Contact Dermatitis Research Group. Br J Dermatol. 2009;160(3):565-72.