Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
The Effects of Changing Lifestyle and Daily Behaviours in the First Months of COVID-19 Outbreak on Dermatological Diseases: Retrospective Cross-Sectional Observational Study
COVID-19 Salgınının İlk Aylarında Değişen Yaşam Tarzı ve Günlük Davranışların Dermatolojik Hastalıklar Üzerindeki Etkileri: Retrospektif Kesitsel Gözlemsel Çalışma
Şule GÖKŞİNa, Işıl Göğem İMRENa, Hülya CENKa, Nida KAÇARa, Şeniz DUYGULUa
aDepartment of Dermatology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
Turkiye Klinikleri J Dermatol. 2022;32(1):47-55
doi: 10.5336/dermato.2021-86574
Article Language: EN
Full Text
ABSTRACT
 Objective: COVID-19 disease caused panic, fear of death, anxiety in people at the beginning of pandemic. This situation has dramatically changed people's lifestyle and daily behavior. The aim of our study was to determine the effects of changing lifestyle and daily behaviours on dermatological diseases in the first months of outbreak. Material and Methods: The diagnosis of the first patient with COVID- 19 in Turkey was established on 11 March 2020.In the same period, between 11 March and 30 April of 2020 and 2019, 454 versus 2.903 patients were admitted to the dermatology outpatient clinic and included in the study. The rates of dermatological diseases were compared. Pearson's chi-square test was used for statistical analysis. Results: Most of the patients were women (59.2 and 64.8%), and the average ages of the patients were 36.6±17.5 and 35.1±18.2 years for these time periods. Although admission to the hospital for those under 20 years of age due to curfew was decreased (16.8-10.1%), acne frequency increased (18.6- 21.1%, p=0.198). The frequency of psoriasis among papulosquamous diseases significantly increased (p=0.016). Urticaria (4.33-9.47%, p<0.001), drug eruptions (0.17-1.32%, p<0.001), and dermatitis and eczema (25.52-30.44%, p=0.025) significantly increased. The frequency of alopecia areata among hair disorders significantly increased (p=0.005). Rosacea (1.59-0.44%, p=0.05), bacterial infections (1.45- 0.44%, p=0.046), fungal infections (5.29-3.3%,p=0.042) and xerosis cutis (6.26-1.1%, p=0.025) significantly decreased. Admissions due to benign skin diseases (1.38-0%, p=0.012) significantly decreased. Conclusion: We consider that this study will contribute to providing the needed-evidence for the prevention and treatment of dermatological comorbidities by helping to identify the effects of changing lifestyles and daily behaviours on dermatological diseases because of the novel experimental environment created by the COVID‐19 outbreak.

Keywords: COVID-19; dermatology; lifestyle; daily behaviours; outpatient
ÖZET
 Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], pandeminin başlangıcında insanlarda paniğe, ölüm korkusuna, kaygıya neden oldu. Bu durum, insanların yaşam tarzlarını ve günlük davranışlarını önemli ölçüde değiştirmiştir. Çalışmamızın amacı, salgının ilk aylarında değişen yaşam tarzı ve günlük davranışların dermatolojik hastalıklar üzerindeki etkilerini belirlemektir. Gereç ve Yöntemler: Türkiye'de ilk COVID-19 hastasının tanısı, 11 Mart 2020 tarihinde konulmuştur. 2019 ve 2020 yıllarında 11 Mart-30 Nisan tarihleri arasında dermatoloji polikliniğine başvurmuş 2.903 ve 454 hasta çalışmamıza dâhil edildi. Dermatolojik hastalıkların oranları karşılaştırıldı. İstatistiksel analiz için Pearson ki-kare testi kullanıldı. Bulgular: Hastaların çoğu kadın (%59,2 ve %64,8) olup; hastaların yaş ortalaması 36,6±17,5 ve 35,1±18,2 yıldı. Sokağa çıkma yasağı nedeniyle 20 yaş altı hastaların hastaneye başvuruları azalmasına (%16,8-%10,1) rağmen akne sıklığı arttı (%18,6-%21,1, p=0,198). Papüloskuamöz hastalıklar arasında psöriyazis sıklığı anlamlı olarak arttı (p=0,016). Ürtiker (%4,33-%9,47, p<0,001), ilaç döküntüleri (%0,17- %1,32, p<0,001) ile dermatit ve ekzema (%25,52-%30,44, p=0,025) anlamlı olarak arttı. Saç hastalıkları arasında alopesi areata sıklığı anlamlı olarak arttı (p=0,005). Rozasea (%1,59-%0,44, p=0,05), bakteriyel enfeksiyonlar (%1,45-%0,44, p=0,046), mantar enfeksiyonları (%5,29-%3,3, p=0,042) ve kserozis kutis (%6,26-%1,1, p=0,025) önemli ölçüde azaldı. İyi huylu cilt hastalıkları nedeniyle başvurular anlamlı olarak azaldı (%1,38-%0,0, p=0,012). Sonuç: Bu çalışmanın, COVID-19 salgınının yarattığı yeni deneysel ortam nedeniyle değişen yaşam tarzı ve günlük davranışların, dermatolojik hastalıklar üzerindeki etkilerinin belirlenmesine yardımcı olarak dermatolojik komorbiditelerin önlenmesi ve tedavisi için gerekli kanıtların sağlanmasına katkıda bulunacağını düşünüyoruz.

Anahtar Kelimeler: COVID-19; dermatoloji; yaşam tarzı; günlük davranışlar; ayaktan tedavi
REFERENCES:
  1. Falcone D, Richters RJH, Uzunbajakava NE, van Erp PEJ, van de Kerkhof PCM. Risk factors associated with sensitive skin and potential role of lifestyle habits: a cross-sectional study. Clin Exp Dermatol. 2017;42(6):656-8. [Crossref]  [PubMed] 
  2. Leonardi-Bee J, Ellison T, Bath-Hextall F. Lifestyle factors of smoking, BMI and alcohol on the risk of Non-Melanoma Skin Cancer in adults: a systematic review. JBI Libr Syst Rev. 2012;10(6):352-98. [Crossref]  [PubMed] 
  3. Wolkenstein P, Machovcová A, Szepietowski JC, Tennstedt D, Veraldi S, Delarue A. Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol. 2018;32(2):298-306. [Crossref]  [PubMed] 
  4. Lee EB, Wu KK, Lee MP, Bhutani T, Wu JJ. Psoriasis risk factors and triggers. Cutis. 2018;102(5S):18-20. [PubMed] 
  5. Taheri R, Behnam B, Tousi JA, Azizzade M, Sheikhvatan MR. Triggering role of stressful life events in patients with alopecia areata. Acta Dermatovenerol Croat. 2012;20(4):246-50. [PubMed] 
  6. Wolkenstein P, Misery L, Amici JM, Maghia R, Branchoux S, Cazeau C, et al. Smoking and dietary factors associated with moderate-to-severe acne in French adolescents and young adults: results of a survey using a representative sample. Dermatology. 2015;230(1):34-9. [Crossref]  [PubMed] 
  7. Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol. 2018;32(10):1631-7. [Crossref]  [PubMed] 
  8. Abokwidir M, Feldman SR. Rosacea management. Skin Appendage Disord. 2016;2(1-2):26-34. [Crossref]  [PubMed]  [PMC] 
  9. Olutoyin OO, Onayemi O, Gabriel AO. Risk factors associated with acquiring superficial fungal infections in school children in South Western Nigeria: a comparative study. Afr Health Sci. 2017;17(2):330-6. [Crossref]  [PubMed]  [PMC] 
  10. Lenefsky M, Rice ZP. Hyperhidrosis and its impact on those living with it. Am J Manag Care. 2018;24(23 Suppl):S491-5. [PubMed] 
  11. Ruocco V, Ruocco E, Lo Schiavo A, Brunetti G, Guerrera LP, Wolf R. Pemphigus: etiology, pathogenesis, and inducing or triggering factors: facts and controversies. Clin Dermatol. 2013;31(4):374-81. [Crossref]  [PubMed] 
  12. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912-20. [Crossref]  [PubMed]  [PMC] 
  13. Ko SH, Chi CC, Yeh ML, Wang SH, Tsai YS, Hsu MY. Lifestyle changes for treating psoriasis. Cochrane Database Syst Rev. 2019;7(7): CD011972. [Crossref]  [PubMed]  [PMC] 
  14. Kamiya K, Kishimoto M, Sugai J, Komine M, Ohtsuki M. Risk factors for the development of psoriasis. Int J Mol Sci. 2019;20(18):4347. [Crossref]  [PubMed]  [PMC] 
  15. Kamen DL. Environmental influences on systemic lupus erythematosus expression. Rheum Dis Clin North Am. 2014;40(3):401-12, vii. [Crossref]  [PubMed]  [PMC] 
  16. Bergqvist C, Ezzedine K. Vitiligo: a review. Dermatology. 2020;236(6):571-92. [Crossref]  [PubMed] 
  17. Schaefer P. Urticaria: evaluation and treatment. Am Fam Physician. 2011;83(9):1078-84. [PubMed] 
  18. Schaefer P. Acute and chronic urticaria: evaluation and treatment. Am Fam Physician. 2017;95(11):717-24. [PubMed] 
  19. Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;183(1):71-7. [Crossref]  [PubMed]  [PMC] 
  20. Iizaka S. Skin hydration and lifestyle-related factors in community-dwelling older people. Arch Gerontol Geriatr. 2017;72:121-6. [Crossref]  [PubMed] 
  21. Abtahi-Naeini B. Frequent handwashing amidst the COVID-19 outbreak: prevention of hand irritant contact dermatitis and other considerations. Health Sci Rep. 2020;3(2):e163. [Crossref]  [PubMed]  [PMC] 
  22. Patruno C, Nisticò SP, Fabbrocini G, Napolitano M. COVID-19, quarantine, and atopic dermatitis. Med Hypotheses. 2020;143:109 852. [Crossref]  [PubMed]  [PMC] 
  23. Dessinioti C, Katsambas A. Seborrheic dermatitis: etiology, risk factors, and treatments: facts and controversies. Clin Dermatol. 2013;31(4):343-51. [Crossref]  [PubMed] 
  24. Berg M. Epidemiological studies of the influence of sunlight on the skin. Photodermatol. 1989;6(2):80-4. [PubMed] 
  25. Shenefelt PD. Psychodermatological disorders: recognition and treatment. Int J Dermatol. 2011;50(11):1309-22. [Crossref]  [PubMed] 
  26. Baker BS, Powles A, Fry L. Peptidoglycan: a major aetiological factor for psoriasis? Trends Immunol. 2006;27(12):545-51. [Crossref]  [PubMed] 
  27. Aschoff R, Kempter W, Meurer M. Seborrhoisches Ekzem [Seborrheic dermatitis]. Hautarzt. 2011;62(4):297-307. German. [Crossref]  [PubMed] 
  28. Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011;8(1):97-104. [Crossref]  [PubMed]  [PMC] 
  29. Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, et al. Effect of handwashing on child health: a randomised controlled trial. Lancet. 2005;366(9481):225-33. [Crossref]  [PubMed] 
  30. Zeytun E, Tilki E, Doğan S, Mumcuoğlu KY. The effect of skin moisture, pH, and temperature on the density of Demodex folliculorum and Demodex brevis (Acari: Demodicidae) in students and staff of the Erzincan University, Turkey. Int J Dermatol. 2017;56(7):762-6. [Crossref]  [PubMed] 
  31. Yazısız H, Çekin Y, Koçlar FG. The presence of Demodex mites in patients with dermatologic symptoms of the face. Turkiye Parazitol Derg. 2019;43(3):143-8. [Crossref]  [PubMed] 
  32. Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, Li F. Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. J Sport Health Sci. 2020;9(2):103-4. [Crossref]  [PubMed]  [PMC] 
  33. Frankel HC, Han J, Li T, Qureshi AA. The association between physical activity and the risk of incident psoriasis. Arch Dermatol. 2012;148(8):918-24. [Crossref]  [PubMed]  [PMC] 
  34. Bhatia BK, Millsop JW, Debbaneh M, Koo J, Linos E, Liao W. Diet and psoriasis, part II: celiac disease and role of a gluten-free diet. J Am Acad Dermatol. 2014;71(2):350-8. [Crossref]  [PubMed]  [PMC] 
  35. Meding B, Alderling M, Wrangsjö K. Tobacco smoking and hand eczema: a population-based study. Br J Dermatol. 2010;163(4):752-6. [Crossref]  [PubMed] 

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