The Prevalence of Dermatoses Among Resident Doctors and Medical Students During COVID-19 Pandemic: A Cross-Sectional Study

Rogério Nabor Kondo^1*, Ana Carolina Cechin Alves de Mello², Camila Medyk², Luis Felipe Stella Santos², Natalia da Silva Viotti³, Cássio Rafael Moreira¹, Airton dos Santos Gon¹

¹Dermatologist, Assistant Professor of Dermatology of University Hospital of the State University of Londrina, Paraná, Brazil
² Resident Doctor in Dermatology at the University Hospital of the State University of Londrina, Londrina, Paraná (PR), Brazil
³Medical student at the State University of Londrina, Londrina, Paraná (PR), Brazil

*Correspondence author: Rogério Nabor Kondo, MD, Dermatologist, Assistant Professor of Dermatology of University Hospital of the State University of Londrina, Paraná, Brazil; Email: [email protected]

Citation: Kondo RN, et al. The Prevalence of Dermatoses Among Resident Doctors and Medical Students During COVID-19 Pandemic: A Cross-Sectional Study. J Dermatol Res. 2025;6(1):1-6.

Copyright^© 2025 by Kondo RN, et al. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Table 2: Socioeconomic data among resident doctors.

We used Pearson’s non-parametric correlation coefficient to analyze socioeconomic status and dermatoses. There was an inverse correlation (-0.061 vs. -0.117) with dermatoses, but not significant (p=0.682 vs. 0.433), for the RD group and MS group, respectively.

The three most prevalent dermatoses in the RD group were hand Contact Dermatitis (CD) (46.8%), acne (42.5%) and Telogen Effluvium (TE) (38.2%), but without statistical difference with the MS group (Table 1). In both groups, CD was due to excessive hand washing or the use of alcohol gels. Table 3 compares all dermatoses in the two groups. Post-Inflammatory Hyperpigmentation (PIH) of the face, although not among the three most prevalent (the fifth most prevalent), was the only one with a statistical difference between the groups (17.0% vs. 2.1%, p=0.030).

Table 3: Main dermatoses (in percentage of cases) among Resident Doctors (RD) group and Medical Students (MS) group.

There were RD who moved house, which did not occur in the MS group (17% vs. 0%, p=0.005). There was no difference in the proportion of people infected with COVID in the two groups (p=0.208) (Table 1).

Discussion

The higher average age in the RD group compared to MS group (27.6 vs. 22.8 and p=0.001) was already expected because they were individuals who had already graduated, that is, they had more years of schooling and, consequently, were older chronological (Table 1, Fig. 1).

Although males were the most prevalent in the RD group (53.2% vs. 38.3%), there was no statistical significance (p=0.214). Dash, et al., also observed a higher prevalence of dermatoses in male doctors in their study in a tertiary hospital, which is partially in agreement with the literature, as our study also involved RD (graduated doctors) [4].

There was a higher prevalence of white race in both groups, but with statistical differences between them: [RD group =89.3% (95% CI: 76.8%-96.5%)] and [MS group =70.2% (95% CI: 55.1%-82.7%)] and p=0.038. The literature does not mention a difference in race between doctors and skin diseases [4,5], but one hypothesis for this difference by the authors would be the system of quotas by race in the selection process of MS at the university where the study took place (Table 1).

The literature correlates low socioeconomic status with some dermatoses [6]. In the present study, we used Pearson’s non-parametric correlation coefficient, which showed an inverse correlation (-0.061 vs. -0.117) with dermatoses, but not significant (p=0.682 vs. 0.433), for the RD group and MS group, respectively.

Dash, et al., observed, in health professionals (not just doctors), hand CD with excessive hand hygiene, due to damage to the skin barrier [4]. Dani, et al., verified “Maskne”, defined as acne secondary to the use of a mask that worsens even more with the use of a face shield, a facial protection shield (a PPE that was mandatory when caring for those infected in the first years of the pandemic) [5]. Current theories include that a combination of mechanical stress from the mask, lack of ventilation and imbalance of the skin’s microbiome would cause acne. This friction caused by PPE (also due to the time of use) and acne could also lead to PIH, which would explain the higher prevalence of this finding (post-inflammatory hyperpigmentation of the face) in the RD group compared to MS group who were not exposed to PPE (17.0% vs. 2.1%, p=0.030) (Table 3).

As for TE, studies have shown a causal relationship with COVID-19 infection, just as any other infection could trigger the abrupt end of the anagen phase and lead to premature entry into the telogen phase [7,8]. Physiological and emotional stress can also cause TE, which could have occurred both in the RD group (coping stress) and in the MS group (stress due to classes and remote assessments) [9].

The present study showed that the most prevalent dermatoses in the RD group were hand CD, acne and TE, but without statistical differences with the MS group (Table 1). The authors raise the hypothesis that in the MS group, in addition to the confirmed practice of constant hand washing and application of alcohol gels, they also used masks when leaving their homes and also experienced emotional stress, both conditions that could favor acne and TE [9,10].  Face PIH, with a significant difference for the RD group (Table 3), could be related both to the time of wearing masks and to more specific PPE, such as the face shield that could have caused more friction and local inflammation.

There were RDs who changed residence, which did not occur in the MS group (17% vs. 0%, p=0.005). The plausible hypothesis was that in the exposed group (RD), there were cases in which they required care to avoid the risk of infecting their family members, perhaps because they had comorbidities. In the MS group, as classes were online, there was no such concern (Table 1). There was no difference in the proportion of people infected with COVID-19 in the two groups (p=0.208), although it was expected that the MS group would have a lower infection rate. One hypothesis would be that the MSs became infected due to carelessness with the people closest to them, while the RDs maintained stricter precautions when attending to and caring for those infected (Table 1).

Our study has limitations related to selection bias, as it is a cross-sectional study with a small sample size. Other limitations include the self-reported nature of dermatologic conditions, potential underdiagnosis or misclassification of dermatoses, limited generalizability beyond the study population, confounding factors such as occupational stressors (e.g., work hours, patient exposure) that could influence skin conditions or additional demographic or lifestyle factors (e.g., diet, history of skin conditions, prior use of skin products). Future multicenter studies would help improve our limitations.

Conclusion

During the period of combating the new coronavirus of 2019, the RDs of our service presented, as the most prevalent dermatoses, CD of the hands, acne and TE, in addition to PIH of the face. Hand CD was related to hand hygiene habits and facial PIH could be related to the use of PPE.

Conflicts of Interest

The authors have carried out the work on their own and the ICMJE form for Disclosure of Potential Conflicts of Interest have been submitted and none were declared.

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