Professional Documents
Culture Documents
To cite this article: Robabeh Abedini, Narges Ghandi, Vahideh Lajevardi, Maryam Ghiasi &
Maryam Nasimi (2020): Dermatology Department: What we could do amidst the pandemic of
COVID-19?, Journal of Dermatological Treatment, DOI: 10.1080/09546634.2020.1773381
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Name of authors:
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Robabeh Abedini1, MD, Narges Ghandi1, MD, Vahideh Lajevardi1, MD, Maryam Ghiasi1, MD,
Dear Editor,
Since December 2019, a new coronavirus (COVID-19) was recognized as a cause of pneumonia
and death in Wuhan, China. It has become the most serious medical crisis that occurs in the
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human society in the 21st century. In few weeks after China, Japan, South Korea, Iran and Italy
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were severely affected. The recent virus quickly becomes a worldwide health challenge due to
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rapid human to human transmission. Contact transmission and respiratory droplets are two main
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routs of COVID-19 spread and physical distancing is considered an effective measure to disrupt
emergent clinics and cancelling the elective and cosmetic surgeries. During the outbreak
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progression, some dermatologists have temporarily closed their private clinics to reduce the risk
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of transmission. However, strategies were taken for delivering limited care in special and
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emergency situations. From the very first days of infection in Iran, outpatient 24 hours urgent
consultations were provided by Razi hospital exclusively for patients with complicated skin
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problems, skin rash due to COVID-19, and drug reactions, by ensuring self-protection for health
workers and triage of patients before dermatology consultation by monitoring the body
temperature and getting history of fever and respiratory symptoms. If the high body temperature
was detected, patient was referred to the infectious clinic for further evaluation. Moreover,
faculty members and residents pf dermatology, voluntarily relocated for visiting patients infected
The out-patients clinics reduced from 9 to 3 clinics and visited about 300 patients daily (form
nearly 1500 visit each day). Laser clinic was completely closed and some other clinics like
tumor, alopecia areata, psoriasis, and pemphigus, were joined to general clinics with limited
number of patients. Patients with scheduled appointment for cosmetic procedures, were
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contacted by cell phone and the appointments have postponed [2, 3]. The waiting room designed
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carefully to isolate patients from each other. All the equipment and surfaces that have contact
with patients, sterilized immediately after the visit and procedure. All staffs were checked
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routinely at the beginning and end of daily work and our infectious disease specialist was in
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access to evaluate the staff for any hidden or proved COVID-19 infection. The dermatology
residents, attending, and hospital staff in direct contact with patients wore protective clothes and
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gloves, protective mask, and face shield or protective glasses. It was recommended for patients
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to wear protective masks and clean their hands with water and soap or by hand rub products in
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the entry part of the surgery rooms for the emergency procedures.
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infection, provides an opportunity for not only dermatology patients’ management, but also for
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education purpose for undergraduate and postgraduate students [4]. Dermatology residents made
calls to patients with critical skin disease and whom were candidate for inpatient biologic
injection to change and postpone the already planned treatment. All the attending professors
were actually on-call and dermatology residents took their opinion for the patients plan
considering the risk of infection and severity of dermatology problems. For any unexpected
situation and questions a 24 hours responsive phone number and email address were assigned,
respectively.
In the context of COVID-19, a clinic for infectious and respiratory disease was established to
handle suspected cases of COVID-19 in an attempt to have a role in fight against the pandemic.
An infectious disease specialist and a dermatology resident were active in this clinic.
Dermatology residents were trained how to approach the patients with suspicious presentations
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due to developed protocols. All patients with COVID-19 high suspicion were referred to special
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corona centers in the city. Patients with mild disease were educated how to manage the disease in
their home. Moreover, an isolated inpatient ward was set in the case of need for hospitalization
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of COVID-19 positive Dermatology patients during the emergency. Psychologic training
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materials were prepared by psychiatrition of the hospital, and the clinic was active for
to the health staffs of other hospitals in case of cutaneous difficulties due to protective
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instruments and hand dermatitis of frequent hand washing. Multidisciplinary consultations for
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admitted patients in other hospitals were provided firstly by sending pictures and onsite visit in
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Information about COVID-19 pandemics protocols were provided in WhatsApp groups for
faculty members and residents. This social media was a good platform for sharing the
experiences, news, asking questions about complicated patients, and even minor conferences for
educational purposes. The education of dermatology residents and undergraduate students was
continued during pandemic by the facilities available for distance learning Such as journal clubs,
CPC, case presentation and dermatology procedures using online platforms, as the traineeship of
dermatology for medical students was suspended and the number of dermatology residents and
attending reduced significantly to ensure reducing the risk of contamination. We used a virtual
platform provided from Virtual faculty of TUMS, for uploading PowerPoints with voice
recorded on them for dermatology students. Activities and examinations were also provided in
this platform.
Some research proposals were designed and accepted for evaluating the dermatologic patients in
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COVID-19 pandemics, using remote tools. Some scientific papers were accepted for publication
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affiliated to our hospital, which were about the best approach for different dermatologic diseases
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Strategies by reducing office based services and increasing the teledermatology facilities is a
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precious potential to provide effective dermatology services without endangering health staff and
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society. This can keep dermatology patients away from the emergency clinics that the risk of
References:
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Journal of the European Academy of Dermatology and Venereology. 2020 Mar 22.
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4. Pathoulas JT, Stoff BK, Lee KC, Farah RS. Ethical Outpatient Dermatology Care During
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5. Zheng Y, Lai W. Dermatology staff participate in fight against Covid‐ 19 in China.
Journal of the European Academy of Dermatology and Venereology. 2020 Mar 23.
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preventing and controlling nosocomial infection of 2019 novel coronavirus: implications
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for the dermatology department. British Journal of Dermatology. 2020 Mar 5.
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