Department of Family Medicine and Primary Care, The University of Hong Kong and Queen Mary Hospital, Pokfulam, Hong Kong.
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong.
Int J Dermatol. 2020 Dec;59(12):1468-1474. doi: 10.1111/ijd.15227. Epub 2020 Oct 11.
An association between wearing protective gear and eosinophilic folliculitis has not been reported. We aimed to investigate such during the COVID-19 pandemic.
In three outpatient clinics, we hand-reviewed records of all patients having consulted us during a Study Period (90 days) in the early phase of the pandemic. Our inclusion criteria for Study Subjects were: (i) clear clinical diagnosis, (ii) dermoscopic confirmation, (iii) differential diagnoses excluded, (iv) eosinophilia, (v) protective gear worn during sanitation services, (vi) temporal correlation, (vii) distributional correlation, (viii) physician-assessed association, and (ix) patient-assessed association. Control Periods in the same season were elected.
Twenty-five study subjects fulfilled all inclusion criteria. The incidence was significantly higher than in the control periods (IR: 3.57, 95% CI: 1.79-7.43). Male predominance was significant (P < 0.001). Such for patients in the control periods were insignificant. Study subjects were 21.2 (95% CI: 11.0-31.4) years younger than patients in the control periods. For the study subjects, the distribution of erythematous or skin-colored folliculocentric dome-shaped papules and pustules were all compatible with body parts covered by the gear. Lesional biopsy performed on two patients revealed eosinophilic dermal infiltrates within and around the pilosebaceous units. Polarized dermoscopy revealed folliculitis with peri-/interfollicular vascular proliferation. Lesion onsets were 6.4 (SD: 2.1) days after wearing gear. Remissions were 16.7 (SD: 7.5) days after ceasing to wear gear and treatments.
Wearing protective gear in volunteered sanitizing works could be associated with eosinophilic folliculitis. Owing to the significant temporal and distributional correlations, the association might be causal.
佩戴防护装备与嗜酸性滤泡炎之间的关联尚未被报道。我们旨在调查新冠疫情期间是否存在这种关联。
在三个门诊诊所，我们对疫情早期的研究期间（90 天）就诊的所有患者的记录进行了回顾性分析。我们纳入研究对象的标准为：（i）明确的临床诊断，（ii）皮肤镜检查确认，（iii）排除其他鉴别诊断，（iv）嗜酸性粒细胞增多，（v）在卫生服务中佩戴防护装备，（vi）时间相关性，（vii）分布相关性，（viii）医生评估的相关性，（ix）患者评估的相关性。选择同一季节的对照期。
25 例研究对象均符合所有纳入标准。其发病率明显高于对照期（IR：3.57，95%CI：1.79-7.43）。男性占优势，差异具有统计学意义（P<0.001）。而对照期患者的发病率无统计学差异。研究对象比对照期患者年轻 21.2 岁（95%CI：11.0-31.4）。对于研究对象，红斑或肤色的毛囊中心性半球状丘疹和脓疱的分布均与装备覆盖的身体部位相符。对两名患者进行的皮损活检显示，在毛囊皮脂腺单位内及周围有嗜酸性真皮浸润。偏光皮肤镜检查显示，滤泡炎伴有毛囊间/滤泡间血管增生。发病时间为佩戴装备后 6.4 天（SD：2.1）。停止佩戴装备和治疗后 16.7 天（SD：7.5）皮损缓解。
在自愿进行卫生消毒工作时佩戴防护装备可能与嗜酸性滤泡炎有关。由于时间和分布上的显著相关性，这种关联可能具有因果关系。
