ORIGINAL ARTICLE   Free access

Italian Journal of Dermatology and Venereology 2022 October;157(5):419-23

DOI: 10.23736/S2784-8671.22.07246-2

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Masks trigger facial seborrheic dermatitis and psoriasis: evidence from a multicenter, case-control study during COVID-19 pandemic

Giovanni DAMIANI ^{1, 2, 3} ✉, Renata FINELLI ⁴, Khalaf KRIDIN ⁵, Alessia PACIFICO ⁶, Alessandra BUJA ⁷, Nicola L. BRAGAZZI ⁸, Piergiorgio MALAGOLI ⁹, Paola SAVOIA ¹⁰, Laura C. GIRONI ¹¹, Ayman GRADA ¹², Rosalynn R. CONIC ¹³, Dennis LINDER ¹⁴, Giuseppe MICALI ¹⁵, Paolo D. PIGATTO ^{1, 2} Young Dermatologists Italian Network

¹ Clinical Dermatology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy; ² Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; ³ Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy; ⁴ Gamma Analisi Cliniche S.r.l., Caserta, Italy; ⁵ Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; ⁶ Clinical Dermatology Department, IRCCS S. Gallicano Dermatological Institute, Rome, Italy; ⁷ Unit of Hygiene and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy; ⁸ Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Canada; ⁹ Unit of Dermatology, San Donato Milanese Hospital, San Donato Milanese, Milan, Italy; ¹⁰ Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; ¹¹ Maggiore della Carità University Hospital, Novara, Italy; ¹² Department of Dermatology, Boston University School of Medicine, Boston, MA, USA; ¹³ Department of Family Medicine and Public Health, University of California, San Diego, CA, USA; ¹⁴ University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria; ¹⁵ Dermatology Clinic, University of Catania, Catania, Italy

BACKGROUND: Wearing masks is an optimal preventive strategy during COVID-19 pandemic, but it may increase facial sebum production. However, few case reports have described seborrheic dermatitis (SeBD) and psoriasis (PsO) flares due to masks. Hence, we conducted a multicenter study to clarify the possibility of increased SeBD and PsO flares in association with mask wearing during the COVID-19 pandemic.
METHODS: This multicenter study enrolled patients with a diagnosis of facial SeBD and PsO. All dermatological consultations were conducted in teledermatology at baseline (T0) and after 1 month (T1) Of >6 hours/day wearing mask. PsO patients were assessed using PsO Area and Severity Index (PASI) and self-administered PASI (SAPASI), whilst SeBD patients with symptom scale of seborrheic dermatitis’ (SSSD) and seborrheic dermatitis area and severity index (SEDASI).
RESULTS: A total of 33 (20 males, 13 females, average age 43.61±9.86) patients with PsO and 33 (20 males, 13 females, average age 44.00±8.58) with SeBD were enrolled. After 1 month, PsO patients displayed higher values of both PASI and SAPASI (P<0.0001), while SeBD patients experienced a flare, as testified by the increment of both SSSD and SEDASI (P<0.0001). Mask type did not seem to influence the flare severity.
CONCLUSIONS: Masks remain an optimal preventive strategy during COVID-19 pandemic, but patients with PsO and SeBD may experience facial flares. Thus, therapeutic approach should be more aggressive in these groups of patients to counteract the triggering effect of masks.

KEY WORDS: Masks; Psoriasis; Dermatitis, seborrheic; COVID-19; Preventive medicine