key: cord-0730424-7ye0p6ue
authors: Xie, Zhen; Yang, Yu‐Xin; Zhang, Hao
title: Mask‐induced contact dermatitis in handling COVID‐19 outbreak
date: 2020-05-26
journal: Contact Dermatitis
DOI: 10.1111/cod.13599
sha: 880d83a1d9dd132da6b1ac29583785729545f786
doc_id: 730424
cord_uid: 7ye0p6ue

nan

An otherwise healthy 23-year-old woman presented with facial symmetrical erythema and slight itching lasting 4 days. Symptoms developed after wearing a KN95 (FFP2 equivalent) mask for 2 days to prevent contracting SARS-CoV-2. One day before, the patient had consulted the emergency department and a presumptive diagnosis of acute cutaneous lupus erythematosus by the general emergency doctors was made because of her gender and facial symmetrical erythema. However, the physical examination and medical history of the patient and her family were unremarkable. Blood and urine routine tests and the erythrocyte sedimentation rate were negative and normal, respectively. The specific autoantibodies and complement were also negative.

In our dermatology clinic, given the use of the mask and the shape of the lesion resembling that of the sponge strip on the contact sur- Tests were read on D2 and D4 according to ESCD guidelines and showed a positive reaction to the sponge (++) at D4, while no reaction was seen in three self-controls (D4) (Figure 2A ). Ten control volunteers were patchtested the same way with all negative results. The patient was then tested with the isocyanate series (Chemotechnique Diagnostics) and showed a positive reaction to toluene-2,4-diisocyanate (TDI) 2.0% pet., 4,4'-diaminodiphenylmethane (MDA) 0.5% pet., and hexamethylene diisocyanate (HDI) 0.1% pet. on day D2 (++) and D4 (++) ( Figure 2B ).

Polyurethanes, which are being used increasingly in the production of various products, including the sponge strip inside the mask, are † Contributed equally to this work.

F I G U R E 1 Symmetrical erythema centered on the nose bridge without blisters and scales. The highlighted area shows the same pattern of rash as the sponge strip on the contact surface of the mask

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A) Patch tests showed a positive reaction (++) to the sponge strip (b) and three negative results, including metal strip (a), blank control (c), and polypropylene spun bond non-woven fabric (d) on day 4. (B) On D4, positive patch test reactions to TDI 2.0% pet