Are the Increased Frequency of Hand Washing After the COVID-19 Pandemic and Xerosis on the Hands Associated with the Occurrence of Hand Warts?

Year 2024, Volume: 6 Issue: 2, 171 - 177, 16.05.2024

Zeynep Utlu , Çağrı Turan , Nurcan Metin

https://doi.org/10.37990/medr.1401996

Abstract

Aim: The COVID-19 pandemic has changed hand-washing habits. Exposure to water more frequently and time than normal causes dryness, dermatitis, and damage to the skin barrier. We aimed to investigate the relationship between the frequency and duration of exposure to water on the hands, obsession with hand washing, and warts on the hands.
Material and Method: A questionnaire was administered to hand warts group (n=94), plantar warts group (n=46), and healthy volunteers (n=30) questioning the factors that predispose to wart formation, hygiene behaviors, hand moisturizing habits, and hand washing obsession. The presence of warts, localization, number, and clinical type, presence of xerosis, and hand dermatitis were recorded. Data from the hand warts group were compared with control groups of healthy volunteers with plantar warts.
Results: The total exposure time of the hands to water per day was significantly higher in hand warts group than in the plantar warts group and healthy ones (<0.001, both). While xerosis was observed in 51.1% of the hand warts group, further clinical evaluation was recommended with the suspicion of handwashing obsession in 26.6%. The suspicion of handwashing obsession was reinforced by bilateral warts, hand dorsum involvement, more than one anatomical region involvement, and a high number of warts (p=0.039, p=0.048, p=0.027, p=0.018; respectively).
Conclusion: Water exposure might be a novel unrecognized risk factor for hand warts. Patients with hand warts should be evaluated regarding OCD and the need for moisturizer by questioning the frequency of handwashing.

Keywords

Wart, hand washing, xerosis, nail-biting, obsessive-compulsive disorder

References

• Goldsmith LA, Katz SI, Gilchrest BA, et al. Fitzpatrick’s Dermatology. in General Medicine. 8nd edition. McGrawHill Medical, 2012;2421-9.
• Ghorzang E, de Koning MNC, Bouwes Bavinck JN, et al. HPV type-specific distribution among family members and linen in households of cutaneous wart patients. J Eur Acad Dermatol Venereol. 2022;36:119-25.
• Ghadgepatil SS, Gupta S, Sharma YK. Clinicoepidemiological study of different types of warts. Dermatol Res Pract. 2016;2016:7989817.
• Magalhães GM, Vieira ÉC, Garcia LC, et al. Update on human papilloma virus-part I: epidemiology, pathogenesis, and clinical spectrum. An Bras Dermatol. 2021;96:1-16.
• Egawa N, Egawa K, Griffin H, et al. Human papillomaviruses; epithelial tropisms, and the development of neoplasia. Viruses. 2015;7:3863-90.
• Konishi L, Alfredo CH, Silva-Junior JS. Hand warts among butchers in a supermarket in São Paulo. Rev Bras Med Trab. 2018;16:451-6.
• Sterling JC, Handfield-Jones S, Hudson PM. Guidelines for the management of cutaneous warts. Br J Dermatol. 2001;144:4-11.
• Mulhem E, Pinelis S. Treatment of nongenital cutaneous warts. Am Fam Physician. 2011;84:288-93.
• Halteh P, Scher RK, Lipner SR. Onychophagia: a nail-biting conundrum for physicians. J Dermatolog Treat. 2017;28:166-72.
• World Health Organization. Interim recommendations on obligatory hand hygiene against transmission of COVID-19. https://www.who.int/publications/m/item/interim-recommendations-on-obligatory-hand-hygiene-against-transmission-of-covid-19 access date 01.04.2020.
• Loh EW, Yew YW. Hand hygiene and hand eczema: a systematic review and meta-analysis. Contact Dermatitis. 2022;87:303-14.
• Metin N, Turan Ç, Utlu Z. Changes in dermatological complaints among healthcare professionals during the COVID-19 outbreak in Turkey. Acta Dermatovenerol Alp Pannonica Adriat. 2020;9:115-22.
• Meding B, Anveden Berglind I, Alderling M, et al. Water exposure–challenging differences between occupations. Contact Dermatitis. 2016;74:22-8.
• Mavrogiorgou P, Bader A, Stockfleth E, Juckel G. Obsessive-compulsive disorder in dermatology. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2015;13:991-1000.
• De Koning M, Quint K, Bruggink S, et al. High prevalence of cutaneous warts in elementary school children and the ubiquitous presence of wart-associated human papillomavirus on clinically normal skin. Br J Dermatol. 2015;172:196-201.
• Smit H, Burdorf A, Coenraads P. Prevalence of hand dermatitis in different occupations. Int J Epidemiol. 1993;22:288-93.
• Kavli G, Angell E, Moseng D. Hospital employees and skin problems. Contact Dermatitis. 1987;17:156-8.
• Meding B, Swanbeck G. Epidemiology of different types of hand eczema in an industrial city. Acta Derm Venereol. 1989;69:227-33.
• Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15:53-63.
• Osland S, Arnold PD, Pringsheim T. The prevalence of diagnosed obsessive compulsive disorder and associated comorbidities: a population-based Canadian study. Psychiatry Res. 2018;268:137-42.
• García-Soriano G, Rufer M, Delsignore A, et al. Factors associated with non-treatment or delayed treatment seeking in OCD sufferers: a review of the literature. Psychiatry Res. 2014;220:1-10.
• Sheikhmoonesi F, Hajheidari Z, Masoudzadeh A, et al. Prevalence and severity of obsessive-compulsive disorder and their relationships with dermatological diseases. Acta Med Iran. 2014;52:511-4.
• Pacan P, Grzesiak M, Reich A, Szepietowski JC. Onychophagia as a spectrum of obsessive-compulsive disorder. Acta Derm Venereol. 2009;89:278-80.
• Richert B, André J. Nail disorders in children: diagnosis and management. Am J Clin Dermatol. 2011;12:101-12.
• Kampf G, Ennen J. Regular use of a hand cream can attenuate skin dryness and roughness caused by frequent hand washing. BMC Dermatol 2006;6:1.
• Symanzik C, Kezic S, Jakasa I, et al. Effects of skin washing frequency on the epidermal barrier function and inflammatory processes of the epidermis: an experimental study. Contact Dermatitis. 2022;87:241-6.