A University of Cincinnati immunologist is recommending that individuals with contact dermatitis choose facial masks made without elastic or rubber that allow them to stay safe in the midst of COVID-19 while avoiding possible allergic reactions.
Yashu Dhamija, MD, a first-year fellow in the UC Division of Immunology, Allergy, and Rheumatology, presented his findings in an abstract while discussing a medically challenging case at the virtual American College of Allergy, Asthma and Immunology (ACAAI) scientific meeting held Nov. 13-15.
"How do you help patients manage a condition that puts them at risk for something like COVID-19?" asked Dhamija, who sees patients at UC Health and Cincinnnati VA Medical Center. "We definitely want our patients to use masks and apply social distancing. That's a must. But they can avoid elastic components and use face masks that use the knot tie method around the back of the head to keep the masks up."
Dhamija treated a patient who had been diagnosed with contact dermatitis, a reaction to allergens that touch or have contact with the skin. It is different from allergies to things such as dog or cat dander because with contact dermatitis the body's response is not immediate.
"What makes contact dermatitis tricky is that it can be delayed so you may expose your skin to something and a reaction may not occur until days later," said Dhamija. "Intermittent reactions can be tricky because you don't know what the patient is exposing themselves to and the allergen could be at work or home."
Contact dermatitis can affect up to 6% of the U.S. population.
"There are immune reactions to allergens that can be life-threatening but when it comes to contact dermatitis, it doesn't escalate that far. We can quickly identify the allergen and stop the offending agent. But, some cases can be severe," said Dhamija. "Treatment usually means avoiding the agent or we can use a topical or oral steroid if needed. It depends on how severe the reaction is and how much of the body is affected. We also take into account how it is impacting the patient's life or ability to work, for example."
"Patch testing is a tool we use to detect contact dermatitis," said Dhamija. "It's good to speak with your primary care doctor or ask for a referral to an allergist if you have concerns. Patch testing involves placing a compound we suspect is a problem to your skin. We have you return a few days later and we see if there is a reaction.
Dhamija said there is abundant literature documenting patients with contact dermatitis because of allergens such as elastic bands in FFP2 masks, N95 respirators, neoprene rubber masks and medical masks containing formaldehyde or rubber components using carbamates or thiurams.
Featured image at top of Yashu Dhamija, MD. Photo/Colleen Kelley/UC Creative + Brand