The flare up of immune-mediated inflammatory dermatoses during COVID-19 pandemic—a cross sectional study in a tertiary care hospital

Abstract

Background and aim COVID-19 disease raises many critical issues in dermatology and dermatological care. Addressing these issues is necessary, yet also challenging, because there are only a few direct data available. We attempted a study to provide a better understanding regarding the impact of COVID-19 pandemic on the course and management of chronic immune-mediated inflammatory skin disease during COVID-19 pandemic. Methods A Questionnaire based study was conducted on patients with chronic immune-mediated inflammatory skin diseases started on immunosuppressant therapy before COVID period and questioned regarding the treatment taken for skin disease, follow up, COVID-19 infection and vaccination status, flare up of skin disease, management of the disease flare up. The data collected are tabulated and analyzed in epi-info software/MS excel. Result Among 500 patients, 462 (92.4%) discontinued the treatment which was mainly due to their inability to reach the hospital (99.5%) and remaining 0.5% were afraid of taking immune suppressants during pandemic. 385 (83.3%) of 462 patients who discontinued the drug had disease flare up. 75 (15%) out of 500 patients turned COVID–19 positive. 50 (66.6%) out of 75 COVID-19 (+) patients developed disease flare up. 293 (58.6%) out of 500 patients were vaccinated, among which 12 patients (4%) had flare up. Conclusion COVID-19 infection as well as vaccination has both direct and indirect influence in disease progression/flare up of preexisting inflammatory dermatoses. Knowledge regarding the course and management of chronic inflammatory skin conditions during this pandemic helps in providing better quality of life.