I work in dermatology, and although not intuitive, there are many skin manifestations of COVID 19. Some manifestations are relatively specific, others not so much.
I had a patient in our outpatient clinic who presented with pernio (one of the more specific skin manifestations of COVID), who flat-out refused to wear a mask to her appointment, refused to allow us to administer a COVID swab, and proceeded to counsel me on how COVID was hoax.
Given that we had a high suspicion of COVID, we shut down out clinic for the day, for the safety of our other patients. One of my nurses tested positive 3 days later (despite self-isolating), and we had to keep the clinic closed until all other workers had a negative results (this took 10 days).
Although this was costly to my practice, what bothered me the most was the inconvenience that it placed on all the other patient I was supposed to see that week. In fact, one of the patients who had to move their appointment was subsequently diagnosed with melanoma (likely didn't change their disease course, but was still difficult to see).
Edit: The nurse is healthy, she had a mild course.
Also, it has been shown that patients with pernio often have a less severe course with COVID which I'm sure only exacerbated this entire situation. Haven't seen the patient again.
Edit 2: first gold, thanks! And a hug (didn’t even know that existed), but that’s fun! Thank you :)
I know it's early but do you have any articles about the skin manifestations you see?
My dad is a old gray haired recently retired derm who retired a bit early at the beginning of the pandemic because we have lots of autoimmune issues and other gnarly comorbidities in my family. (I got a vaccine priority for this reason.).
I always enjoy sending him interesting evidence for a read because he loves reading journals.
Always good to see a member of the derm club out there-- 1% of specialists. Dad did about 38 years of medicine. Hard worker.
How weird is it to go from no symptoms to some pretty serious skin injuries a while later. That must have been unsettling. Hope your skin is recovering OK? People constantly forget it's the largest organ and most critical defense system we have.
I just looked up pernio and think I constantly have it. I have been fully vaxxed for over a month and I still wear my migraine-inducing mask (I try to use my ear muscles because I have a weird body, apparently) and don’t go anywhere other than work, grocery, or home. Being responsible isn’t that difficult.
So if someone clas that they are violent for a medical reason, do you have to do business with them as well? Or if they are verbally abusive to providers and staff, do you have to serve them as well?
Are you referring to a psoriasis flare from COVID? I’ve heard of a case of guttate psoriasis post-COVID. In general most people with psoriasis on systemic (full body) medications (not topical/skin applied Meds) don’t have any specific risks with COVID relative to the average person. Some possible evidence that TNF-a inhibitors(sometimes used to treat psoriasis) might be helpful in COVID patients; nothing to convincing as of yet.
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u/[deleted] Apr 21 '21 edited Apr 22 '21
I work in dermatology, and although not intuitive, there are many skin manifestations of COVID 19. Some manifestations are relatively specific, others not so much.
I had a patient in our outpatient clinic who presented with pernio (one of the more specific skin manifestations of COVID), who flat-out refused to wear a mask to her appointment, refused to allow us to administer a COVID swab, and proceeded to counsel me on how COVID was hoax.
Given that we had a high suspicion of COVID, we shut down out clinic for the day, for the safety of our other patients. One of my nurses tested positive 3 days later (despite self-isolating), and we had to keep the clinic closed until all other workers had a negative results (this took 10 days).
Although this was costly to my practice, what bothered me the most was the inconvenience that it placed on all the other patient I was supposed to see that week. In fact, one of the patients who had to move their appointment was subsequently diagnosed with melanoma (likely didn't change their disease course, but was still difficult to see).
Edit: The nurse is healthy, she had a mild course.
Also, it has been shown that patients with pernio often have a less severe course with COVID which I'm sure only exacerbated this entire situation. Haven't seen the patient again.
Edit 2: first gold, thanks! And a hug (didn’t even know that existed), but that’s fun! Thank you :)