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皮肤科医生与 SARS-CoV-2:大流行对日常实践的影响。

Dermatologists and SARS-CoV-2: the impact of the pandemic on daily practice.

机构信息

Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy.

Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.

出版信息

J Eur Acad Dermatol Venereol. 2020 Jun;34(6):1196-1201. doi: 10.1111/jdv.16515.

Abstract

Since the first case of 'pneumonia of unknown aetiology' was diagnosed at the Wuhan Jinyintan Hospital in China on 30 December 2019, what was recognized thereafter as 'severe acute respiratory syndrome coronavirus 2' (SARS-CoV-2) has spread over the four continents, causing the respiratory manifestations of coronavirus disease-19 (COVID-19) and satisfying the epidemiological criteria for a label of 'pandemic'. The ongoing SARS-CoV-2 pandemic is having a huge impact on dermatological practice including the marked reduction of face-to-face consultations in favour of teledermatology, the uncertainties concerning the outcome of COVID-19 infection in patients with common inflammatory disorders such as psoriasis or atopic dermatitis receiving immunosuppressive/immunomodulating systemic therapies; the direct involvement of dermatologists in COVID-19 care for patient assistance and new research needs to be addressed. It is not known yet if skin lesions and derangement of the skin barrier could make it easier for SARS-CoV-2 to transmit via indirect contact; it remains to be defined if specific mucosal or skin lesions are associated with SARS-CoV-2 infection, although some unpublished observations indicate the occurrence of a transient varicelliform exanthema during the early phase of the infection. SARS-CoV-2 is a new pathogen for humans that is highly contagious, can spread quickly, and is capable of causing enormous health, economic and societal impacts in any setting. The consequences may continue long after the pandemic resolves, and new management modalities for dermatology may originate from the COVID-19 disaster. Learning from experience may help to cope with future major societal changes.

摘要

自 2019 年 12 月 30 日中国武汉金银潭医院首次诊断出“不明原因肺炎”病例以来,此后被确认为“严重急性呼吸综合征冠状病毒 2 型”(SARS-CoV-2)的病毒已在四大洲蔓延,引发了 2019 冠状病毒病(COVID-19)的呼吸道症状,并符合“大流行”的流行病学标准。目前正在发生的 SARS-CoV-2 大流行对皮肤科实践产生了巨大影响,包括面对面咨询明显减少,转而采用远程医疗;对于接受免疫抑制/免疫调节全身治疗的常见炎症性疾病(如银屑病或特应性皮炎)患者,COVID-19 感染的结果存在不确定性;皮肤科医生直接参与 COVID-19 患者的护理以及新的研究需求需要解决。目前尚不清楚皮肤损伤和皮肤屏障紊乱是否会使 SARS-CoV-2 更容易通过间接接触传播;虽然一些未发表的观察结果表明,在感染早期会出现短暂的水痘样疹,但仍有待确定是否存在与 SARS-CoV-2 感染相关的特定粘膜或皮肤损伤。SARS-CoV-2 是一种对人类具有高度传染性的新型病原体,能够迅速传播,并能够在任何环境中造成巨大的健康、经济和社会影响。大流行结束后,后果可能会持续很长时间,皮肤科可能会出现新的管理模式。从经验中学习可能有助于应对未来的重大社会变革。

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