key: cord-0771729-ps4nw3ot
authors: Murrell, Dedee F.; Rivera-Oyola, Ryan; Lebwohl, Mark
title: Reply to: “Biologics for psoriasis during COVID-19 outbreak”
date: 2020-04-10
journal: J Am Acad Dermatol
DOI: 10.1016/j.jaad.2020.04.014
sha: 100c05591569a533c124fe5978202dc2236fae19
doc_id: 771729
cord_uid: ps4nw3ot

nan

We thank Dr. Di Lernia for his commentary on the stratification planning of dermatology patients on biologics that has been adopted in Italy.(Di Lernia, 2020) As there are many patients on biologics and on immunosuppressants for psoriasis, hidradenitis, atopic dermatitis, pemphigoid, pemphigus and other conditions in Italy and other countries hit by the COVID-19 pandemic, hopefully we will soon have more information about whether the rate of respiratory decompensation in this population is greater or less than expected. Until then, all we can do is to make educated recommendations. Those advocated by Dr. Di Lernia and colleagues are logical. Suggestions that biologic therapies may abrogate the severe pneumonitis that kills many are hopeful but as speculative as suggestions made by others that biologics might worsen the course of Covid-19 infection.

As many biologics have long half-lives it is neither practical nor logical to cease these over a few weeks while this pandemic is upon us, as it is likely to last months. Furthermore, recent studies have shown that a significant portion of individuals affected by COVID-19 will be asymptomatic carriers and even those who eventually develop symptoms can transmit the virus to others prior to developing symptoms. (1, 2) In light of this, CDC announced the voluntary wearing of nose and mouth coverings, and we recommend that all patients taking biologics wear such coverings or masks when outside the home and practice social distancing.

Currently, there is evidence that supports the accuracy and cost-effectiveness of teledermatology. (3) Telehealth is now accepted in many countries by insurers to mitigate exposures for these patients. (4) 

Presumed Asymptomatic Carrier Transmission of COVID-19

Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany

Teledermatology: A Review and Update

Teledermatology: a useful tool to fight COVID-19