Br J Dermatol. 2020 Jun;182(6):e195. doi: 10.1111/bjd.19074.
Since cases first emerged in December 2019, COVID-19 (a type of coronavirus) has rapidly become pandemic. This fast-tracked paper (published quickly) from China on COVID-19 is written by dermatologists at the epicentre of the outbreak in Wuhan. Dermatology clinic staff may be at risk because protective equipment is not routinely available, and skin lesions might possibly transmit the virus indirectly. These authors suggest preventive measures based on experience in this and previous coronavirus outbreaks. Online consultation for non-urgent patients reduces the numbers of patients attending clinics. Nurse-led triage, to identify patients with possible COVID-19, at the entrances of hospital and skin clinics directs patients with a cough or fever to a specific COVID-19 area and a dermatologist is consulted if the fever might be related to skin disease. Clinic staff wear N95 masks and observe hand hygiene during consultations. Patients are admitted to a ward only if routine blood tests and chest CT scans exclude COVID-19. Triage will not detect patients who are showing no symptoms but who are developing the disease, so the hospital should provide an on-call expert team to discuss inpatients suspected or diagnosed with COVID-19 and refer them to radiology, respiratory or intensive care colleagues as required. Confirmed cases are managed following local policies. Skin disorders in COVID-19 inpatients can usually be managed remotely using photographs, email and teleconferencing. If necessary a multidisciplinary team (a team of medical staff from different specialties) can meet in the clean area of the isolation ward. If the dermatologist must see the patient, all records should be provided in advance to minimise exposure time. With these precautions, as of 20th February 2020 no infected patients were detected in the Wuhan Dermatology Department. This is a summary of the study: Emergency management for preventing and controlling nosocomial infection of 2019 novel coronavirus: implications for the dermatology department.
自 2019 年 12 月首次出现病例以来，COVID-19（一种冠状病毒）迅速成为大流行。这篇来自中国的关于 COVID-19 的快速发表的论文，由武汉疫情爆发中心的皮肤科医生撰写。由于防护设备通常不可用，皮肤科诊所的工作人员可能面临风险，而且皮肤损伤可能间接传播病毒。这些作者根据此次疫情和以往冠状病毒爆发的经验提出了预防措施。对于非紧急患者的在线咨询减少了到诊所就诊的人数。在医院和皮肤科诊所的入口处，由护士进行分诊，以识别可能患有 COVID-19 的患者，如果患者咳嗽或发烧，将其引导至特定的 COVID-19 区域，如果发烧可能与皮肤病有关，则咨询皮肤科医生。诊所工作人员在咨询期间佩戴 N95 口罩并注意手部卫生。只有在常规血液检查和胸部 CT 扫描排除 COVID-19 后，患者才会被收治到病房。分诊不会发现没有症状但正在发病的患者，因此医院应提供一个随叫随到的专家团队，讨论疑似或确诊 COVID-19 的住院患者，并根据需要将其转介给放射科、呼吸科或重症监护科的同事。确诊病例按照当地政策进行管理。COVID-19 住院患者的皮肤疾病通常可以通过照片、电子邮件和电话会议进行远程管理。如有必要，多学科团队（来自不同专业的医务人员团队）可以在隔离病房的清洁区开会。如果皮肤科医生必须见患者，所有记录都应提前提供，以尽量减少暴露时间。采取这些预防措施后，截至 2020 年 2 月 20 日，武汉皮肤科未发现感染患者。这是对该研究的总结：预防和控制 2019 年新型冠状病毒医院感染的紧急管理：对皮肤科的启示。
