الفهرس 
Epidemiology of Skin Diseases in EgyptOnly 14 pages are availabe for public view
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Abstract
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OVID-19 pandemic had a great impact on pattern of skin diseases in Egypt. Studying and exploring such pattern may provide us with some indices to evaluate community development and the quality of the provided healthcare.
To the best of our knowledge, only few studies, beside ours, have discussed such impact. We observed a significant huge decline of the patients’ attendance at dermatology clinics during the pandemic. The main components of the pattern of dermatoses was preserved compared to a year earlier. Infection was the most common group. Bacterial and fungal were the most common subgroup.
Few minimal changes were observed in some diseases, especially COVID-related dermatoses. A relative increase was observed in some dermatoses; such as herpes zoster, while others showed relative decline as urticaria and chilblains.
Recommendations
Although community-based studies would be more representative and valuable, we did our best to get the best use of the available resources in order to provide the healthcare management with a useful tool to revise and update the healthcare strategies. In this context, we recommend the followings:
• Healthcare programs should target infectious diseases and methods of transmission.
• Appropriate health awareness to improve community hygiene and living conditions.
• Training primary care physicians and providing them with the appropriate equipment and resources.
• Telemedicine; especially teledermatology, should be encouraged through training programs and appropriate equipment, to help in management of skin diseases in similar situations.
• Planning for future community-based studies and preparing all required resources to support such important realistic studies.
• Supporting research work on vaccination technologies to be prepared for future pandemics.
Summary
COVID-19 was declared by the WHO as a pandemic on 2020. Several restrictions were applied during the pandemic. Egypt imposed a curfew and Egyptian government made a decision to close restaurants, cafes, nightclubs and other public places throughout the country. Schools and universities were suspended and electronic distance learning was encouraged. Some hospitals were assigned as quarantine units for COVID-19 patients. Most patients avoided going to hospitals because of the fear of COVID-19 infection and there was marked reduction of face-to-face consultations in favor of teledermatology.
COVID-19 had subsequent remarkable changes in different aspects of medical practice including dermatology. The pattern of diseases including dermatologic conditions did change in the era of COVID-19 pandemic.
The aim of this study was to explore and study the effect of COVID-19 on the pattern of skin diseases. This study was conducted in Samanod hospital, Gharbia governorate, Egypt. Analyzed data included date, age, sex, and diagnoses, which were recorded in the registry files of dermatology clinics. Patients’ data were collected during COVID-19 pandemic and one year earlier.
This study comprised data of 20509 patients (14353 in pre-COVID year and 6156 in COVID year) ranging in age from 0.67 to 90 years. We observed a significant decline in patients’ attendance in dermatology clinics from 14353 to 6156 patients (>50%). COVID-19 pandemic also influenced age and sex distribution of patients. The most common age group in both pre-COVID and COVID years was young adults. Teenagers and adults became significantly higher during the pandemic, while younger children became significantly lower. Although female patients’ predominance persisted in COVID year, female to male ratio changed, slightly, in favor of males (from 1.61:1 to 1.51:1).
In parallel to the general decline in patients’ attendance, all disease groups and subgroups were decreased in comparison with pre-COVID year. We carried out relative comparisons to overcome such difference in magnitude of presentation and study the pandemic impact on the pattern of dermatoses.
Infections relatively increased, while hypersensitivity relatively decreased. Bacterial and fungal infections continued, as pre-COVID year, to represent the most common subgroups. Papular urticaria and impetigo continued to prevail. Such pattern is, unfortunately, expected in developing countries. As regards COVID-19-related dermatoses, we could not detect a general significant increase, except for herpes zoster, which showed a relative increase.
In general, some dermatoses showed relative significant increase during the pandemic, including impetigo, furunculosis, warts, abscess, and herpes zoster. While some others showed relative significant decline such as acne, candidiasis, tinea capitis, urticaria, herpes simplex, pityriasis alba, pityriasis rosea, tinea corporis, xerosis, chilblains.
We have to take into consideration that presentation of diseases at hospitals may be different from actual prevalence in community. In other words, many diseases may be prevalent but not represented at hospital. Moreover, pandemic, expectedly, may enhance such attitude. Community-based studies may be needed to clarify such apparent discrepancy that may be encountered in hospital-based studies.
Studying the changes in the pattern of skin diseases during COVID-19 pandemic may help healthcare systems to be prepared better for future pandemics in securing appropriate medications, supplies and training the medical teams.