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Increased occurrence of hand eczema in children during Covid-19

A study conducted at the Copenhagen University Hospital in Denmark found that the implementation of an intensive hygiene regimen, as a preventive measure against Covid-19, has resulted in a high proportion of young children developing hand eczema.

The study led by the Department of Dermatology and Allergy at Copenhagen University Hospital was published online ahead of print in the journal Contact Dermatitis (Oct. 21, 2020).

In the paper, the authors note that during the first wave of the coronavirus pandemic, Denmark was one of the first countries to introduce lockdown measures, which included the closure of all daycare centres on Mar. 16, 2020. Following the re-opening of daycares in Denmark on Apr. 15, 2020, the Danish Health Authorities implemented a mandatory intensive hand hygiene regimen.

The regimen included children being instructed to wash their hands for 45 to 60 seconds with water and soap at least every two hours. Further, children were told to wash their hands upon arrival at the daycare centre, before and after meals, after visiting the bathroom and after coughing or sneezing into their hands. They were also instructed to wash whenever their hands were visibly dirty.

In an effort to examine the consequences of the intensive hand hygiene regimen implemented when daycare centres re-opened, researchers conducted a study evaluating 6,858 children between the ages of zero and seven.

The study investigators asked the heads of 1,667 daycare centres in Denmark to forward a link to a questionnaire to parents of the children attending the daycare centre.

Among 6,858 children studied, 12.1% had hand eczema prior to the reopening of daycare centres. Of the participants in the study, 38.3% reported hand eczema after returning to daycare.

Of the children who previously did not have hand eczema, 28.6% developed hand eczema after returning to daycare. Researchers found the risk of hand eczema was significantly associated with atopic dermatitis, female gender, older age and frequency of handwashing.

“Prophylactic measures should have been implemented along with the hand hygiene regimen, including instructions on how to perform correct handwashing with an emphasis on the use of hand sanitizers as a gentler hygiene measure, and the use of emollient cream following handwashing,” the study’s authors concluded.

The researchers added that it remains unknown to what degree the intensive hand hygiene regimen among Danish children attending daycare may have prevented coronavirus transmission.

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