Department of Dermatology, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2020 Sep;49(9):674-676.
Coronavirus disease 2019 (COVID-19) pandemic continues to spread globally at a staggering speed. At present, there is no effective treatment or vaccine for COVID-19. Hand disinfection is a cost-effective way to prevent its transmission. According to the Centres for Disease Control and Prevention (CDC) guidelines, we should wash our hands with soap and water for at least 20 seconds. If soap and water are not readily available, alcohol-based hand rubs (ABHRs) with at least 60% alcohol are the alternative. With diligent hand disinfection reinforced during COVID-19, there is an increased prevalence of contact dermatitis. This commentary highlights the fact that contact dermatitis is a readily treatable condition and should not cause any deviation of proper hand hygiene. In irritant contact dermatitis (ICD), the management strategies are selection of less irritating hand hygiene products, frequent use of moisturisers to rebuild the skin barrier, and education on proper hand hygiene practices. In allergic contact dermatitis (ACD), the identification and avoidance of the contact allergen is the key to treatment. However, ACD is less common and only accounts for 20% of the cases. The identified allergens in hand cleansers are predominantly preservative excipients and ACD attributable to ABHR are very uncommon. Alcohol-free hand rubs are widely available on the market but it is not a recommended alternative to ABHRs by the CDC.
2019 年冠状病毒病(COVID-19)大流行继续以惊人的速度在全球范围内蔓延。目前,COVID-19 没有有效的治疗方法或疫苗。手部消毒是预防其传播的一种具有成本效益的方法。根据疾病控制与预防中心(CDC)的指南,我们应该用肥皂和水洗手至少 20 秒。如果没有肥皂和水,含有至少 60%酒精的酒精类手部消毒剂(ABHR)是替代方法。由于 COVID-19 期间加强了手部消毒,接触性皮炎的患病率有所增加。本评论强调了一个事实,即接触性皮炎是一种易于治疗的疾病,不应导致任何适当的手部卫生措施的偏差。在刺激性接触性皮炎(ICD)中,管理策略是选择刺激性较小的手部卫生产品、频繁使用保湿剂来重建皮肤屏障,以及进行正确的手部卫生实践教育。在过敏性接触性皮炎(ACD)中,确定和避免接触过敏原是治疗的关键。然而,ACD 较少见,仅占病例的 20%。在手部清洁剂中鉴定出的过敏原主要是防腐剂赋形剂,而由于 ABHR 引起的 ACD 非常罕见。市面上有很多无酒精的洗手液,但 CDC 不建议将其作为 ABHR 的替代品。