Clinical Scorecard: Skin Lesions Associated with Personal Protective Equipment Use Among Healthcare Workers in Lima, Peru During the COVID-19 Pandemic: A Cross-Sectional Analysis

At a Glance

Key Highlights

• 77% of surveyed healthcare workers reported skin lesions related to PPE use, with erythema (44%), comedones (18%), and erosions (15%) being most frequent.
• Nasal bridge (62%) and cheeks (28%) were the most common anatomical locations for skin lesions.
• Working in intensive care units, shifts longer than 12 hours, and experiencing burning or dryness sensations were associated with higher likelihood of skin lesions.

Guideline-Based Recommendations

Diagnosis

• Identify skin lesions such as erythema, comedones, and erosions in healthcare workers using PPE.
• Assess anatomical sites prone to lesions, especially nasal bridge and cheeks.
• Evaluate associated symptoms like burning sensations and skin dryness.

Management

• Implement preventive measures such as use of adhesive tape or bandages to reduce skin damage.
• Encourage regular skin care to maintain skin barrier integrity.
• Limit prolonged continuous PPE use when possible to reduce pressure and friction.

Monitoring & Follow-up

• Conduct continuous biosafety monitoring of healthcare workers’ skin health during PPE use.
• Monitor for development of secondary skin infections or worsening lesions.
• Track working hours and PPE usage patterns to identify high-risk periods.

Risks

• Prolonged PPE use (>12 hours) increases risk of skin lesions.
• Working in intensive care units is associated with higher prevalence of skin lesions.
• Skin lesions may impair healthcare workers’ comfort and ability to safely perform duties, potentially increasing infection risk.

Patient & Prescribing Data

Healthcare workers in hospital settings using PPE during COVID-19 pandemic

Preventive use of adhesive tape or bandages was reported by 39% of workers, with 58% of these using adhesive methods to prevent skin lesions.

Clinical Best Practices

• Educate healthcare workers on skin care and preventive strategies to minimize PPE-related skin damage.
• Optimize PPE fit and material to reduce pressure and friction on vulnerable skin areas.
• Schedule breaks and limit continuous PPE wear duration when feasible to allow skin recovery.
• Implement occupational health monitoring programs focusing on skin health during infectious disease outbreaks.

References

• Peruvian Ministry of Health COVID-19 PPE guidelines
• Study on PPE-related skin lesions prevalence and mechanisms
• Occupational skin diseases in healthcare workers during COVID-19