Ibrahima Traoré, MD, of the Gamal Abdel Nasser University of Conakry, Guinea, presented results of recent studies exploring whether the skin could be a route of viral transmission for COVID-19.
[Experts speak about how crowdsourcing has gained new momentum during COVID-19, and how it may reshape future medical research. Read more.]
The viral receptor for COVID-19 is the angiotensin 2 converting enzyme. For COVID-19 to penetrate and infect a cell, the cell must harbor this enzyme on its surface. Angiotensin 2 converting enzyme is expressed strongly on keratinocytes. Certain dermal cells, as well as subcutaneous tissues, express angiotensin 2 converting enzyme. The stratum corneum has not been shown to express angiotensin 2 converting enzyme. The probable lack of this enzyme in the stratum corneum explains the maintenance of the integrity of the skin barrier in COVID-19 infection.
However, when the stratum corneum is destroyed by skin lesions, the skin can serve as a transmission route through other layers of the epidermis. Dr. Traoré stated that percutaneous transmission by COVID-19 does not seem to be possible except for those with skin disorders with epidermal destruction in which the angiotensin 2 converting enzyme receptor is expressed in other layers of the skin.
What have we learned about the cutaneous manifestations of the virus and the vaccines? Read more in this month’s DermWorld.
DermWorld Insights and Inquiries: Holiday greeting 2021
We have all needed to adjust to new realities both personally and professionally. I have surprised myself with some pandemic-related changes — I would rather take a nature hike with my wife than watch the Phillies or Eagles (perhaps that is because they mostly have not been worth watching this year anyway). We have even enjoyed a new Saturday night habit of viewing the Hallmark channel. Perhaps the predictability of the same story line (boy meets girl — they’re mutually attracted but with angst — they start a relationship, but an old flame gets in the way, being misunderstood by the aggrieved party, only to be happily reconciled by the end with a kiss) reassures me that life can work out for the best. Keep reading!
As part of Anthem’s updated virtual visits policy, effective Jan. 1, 2022, Anthem will continue to allow payment for professional and facility telehealth visits between patients and physicians when they are not in the same location unless provider, state, or federal contracts or regulations indicate otherwise. Learn more.
No Surprises Act takes effect Jan. 1, 2022
The No Surprises Act (NSA) takes effect on Jan. 1, 2022. The NSA provides patients with new billing protections against surprise billing and excessive cost sharing responsibilities when receiving emergency care, non-emergency care from out-of-network physicians or non-physician clinicians (NPC) at in-network facilities, and air ambulance services from out-of-network (OON) physicians/NPCs. It shifts the burden of responsibility from the patient to physicians and payers.
By Jan. 1, 2022, at minimum, have notices ready for patients, familiarize yourself with generating good-faith estimates (GFE), and educate yourself about your state-specific laws, as these may be stricter than the NSA in which case they will supersede the NSA requirements. Learn more.
An emerging preservative allergen?
In a study published inContact Dermatitis, authors sought to determine whether a new preservative allergen was replacing the recent epidemic of contact allergy to methylisothiazolinone (MI). Contact allergy to MI reached a peak of 9.39% in 2013 and decreased to 1.98% in 2019.
A significant increase was noted in the prevalence of contact allergy to benzisothiazolinone (BIT) from 0.26% in 2014 to 3.42% in 2019. BIT is a preservative commonly found in industrial products to preserve the water content of paints, varnishes, adhesives, and sealants. It can also be found in household cleaning products, but it is not permitted in personal care products.
The most common dermatitis distribution was generalized, which was noted in 26% of patients. Household cleaning products, including laundry detergent, were identified as the culprit in 45% of the BIT-positive cases. There was no significant increase in contact allergies to other preservatives tested.
Read more about the 2021 allergen of the year inDermWorld.
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