key: cord-0937394-5ybwxyc8
authors: Tabary, Mohammadreza; Araghi, Farnaz; Nasiri, Soheila; Dadkhahfar, Sahar
title: Dealing with skin reactions to gloves during the COVID-19 pandemic
date: 2020-05-08
journal: Infection control and hospital epidemiology
DOI: 10.1017/ice.2020.212
sha: 1183f1abb9a72bcd93809d8878bdcb091ba9685c
doc_id: 937394
cord_uid: 5ybwxyc8

nan

Recommendations for the prevention of allergic reactions to gloves are summarized in Fig. 1 . Urticaria can be treated with antihistamines and the elimination of the antigen. H 1,2 Blockers can be used before coming into contact with latex devices; however, latex avoidance is superior to this protocol. 4 Plastic gloves, considered as hypoallergenic polyvinylchloride (PVC) gloves, are also used among HCWs. Contact allergic reaction to PVC has also been reported as a result of allergy to many additives used in these gloves, including carba mix, mercaptobenzothiazole (MBT), thiuram mix, mixed dialkyl thioureas, and black rubber mix. 5 Allergic contact dermatitis has been reported in numerous case reports. Lesions may also become generalized in some patients. A patch test can be used to confirm the diagnosis. Topical corticosteroids are considered as the best choice of treatment; however, patients should be advised to use other types of gloves, 5 although allergic contact dermatitis may coexist with immediate hypersensitivity to Latex. 5 Nitrile, neoprene, and polyurethane are also used in plastic gloves. Hand dermatitis has been reported with these types of materials. The patch test is recommended in suspicious cases. Application of topical and oral steroids can mitigate the symptoms but the benefits should be weighed against the risks of side effects. 6 Glove-related hand urticaria should also be considered as a differential diagnosis; it is caused by dermographism upon the application of the glove. Pain, burning, and pruritus in the affected area, and systemic symptoms such as fever are not present in glove-related hand urticaria. Further, nitrile gloves are more likely to cause this phenomenon because they are rigid and less flexible. 7 Some types of powder used in gloves have been associated with an increased risk of skin roughness due to altering glove pH. 8 Glove powder has been reported to cause allergic reactions, and hand eczema has been reported to decrease significantly after using powder-free gloves. 9 Thus, the use of powder-free gloves is recommended in the current pandemic situation. HCWs are also encouraged to wear double gloves when handling COVID-19 patients' airways, blood, urine, and other body fluids. The outer glove should be the first equipment to be removed. 2 

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Perioperative care provider's considerations in managing patients with the COVID-19 infections

Natural rubber latex allergy

Latex allergy: diagnosis and management

Contact allergy to allergy to allyl glycidyl ether present as an impurity in 3-glycidyl-oxypropyl-trimethoxysilane, a fixing additive in silicone and polyurethane resins

Glove-related hand urticaria: an increasing occupational problem among healthcare workers

Glove powder affects skin roughness, one parameter of skin irritation

Glove powder in the hospital environment-consequences for healthcare workers

Acknowledgments.Financial support. No financial support was provided relevant to this article.

All authors report no conflicts of interest relevant to this article.