Impact of the COVID-19 pandemic on skin cancer diagnosis: A Single-Center Study

Öz

Objectives: The COVID-19 pandemic has had a profound impact on healthcare workers worldwide, including in dermatology and pathology. Under these conditions, admitted patient numbers, excision/biopsy numbers, and malignant/benign ratios were influenced. This study aimed to analyze the differences in the diagnoses of the radically excised skin tumors or skin biopsies. Methods: A cross-sectional study was performed between September 2018 and August 2021. Of the 11,501 total cases, 7602 were established during the non-COVID-19 period (September 2018- March 2020) and 3899 cases were established during the COVID-19 period (March 2020-August 2021). Malignant cases were classified as squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM). Results: During the non-COVID-19 period, 592 (7.8%) out of 7602 cases were malignant; in the COVID-19 period, 439 (11.3%) out of 3899 cases were malignant. However, the total percentages of malignant cases were significantly increased during the COVID-19 period when compared with non-COVID-19 period (p < .001) despite the reduction in the case numbers. When the pre- and post-pandemic periods were compared, a statistically significant difference was found between the number of cases diagnosed with both SCC and BCC (both p < .001). However, for MM, there was no significance (p = .656). Conclusions: Even in pandemics conditions clinicians and pathologists, who are interested in dermatological lesions, should be aware and sensitive about dermatological malignancies. It is also important to raise awareness of the public with more sensitive health policies because any delay during the diagnosis and treatment period may cause fatal consequences or permanent damages for the patients. Keywords: Dermatopathology, COVID-19, Malignant melanoma, Basal cell carcinoma, Squamous cell carcinoma

Anahtar Kelimeler

• dermatopathology
• COVID-19
• malignant melanoma
• basal cell carcinoma
• squamous cell carcinoma

COVID-19 pandemisinin deri kanseri tanısına etkisi: Tek Merkezli Çalışma

Öz

Amaç: COVID-19 salgını, dermatoloji ve patoloji dahil olmak üzere dünya çapındaki sağlık çalışanları üzerinde derin bir etkiye sahip olmuştur. Bu koşullar altında, başvuran hasta sayıları, eksizyon/biyopsi sayıları ve malign/benign oranları etkilenmiştir. Bu çalışma, radikal olarak eksize edilen deri tümörleri veya deri biyopsilerinin tanılarındaki farklılıkları analiz etmeyi amaçlamıştır. Materyal ve Metod: Eylül 2018 ile Ağustos 2021 arasında kesitsel olarak yapıldı. Toplam 11.501 vakanın 7602'si COVID-19 olmayan dönemde (Eylül 2018- Mart 2020) ve 3899 vaka COVID-19 döneminde (Mart 2020-Ağustos 2021) belirlendi. Malign vakalar skuamöz hücreli karsinom (SCC), bazal hücreli Karsinom (BCC) ve malign melanom (MM) olarak sınıflandırıldı. Bulgular: COVID-19 dışı dönemde 7602 vakanın 592'si (%7,8) malign idi; COVID-19 döneminde 3899 vakanın 439'u (%11,3) malign idi. Bununla birlikte, vaka sayılarındaki azalmaya rağmen, toplam malign vaka yüzdeleri COVID-19 döneminde, COVID-19 olmayan döneme kıyasla önemli ölçüde arttı (p <.001). Pandemi öncesi ve sonrası dönemler karşılaştırıldığında, hem SCC hem de BCC tanılı vaka sayıları arasında istatistiksel olarak anlamlı fark bulundu (her ikisi de p <.001). Ancak MM için anlamlılık yoktu (p =.656). Sonuç: Pandemi koşullarında bile dermatolojik lezyonlarla ilgilenen klinisyen ve patologların dermatolojik maligniteler konusunda bilinçli ve duyarlı olmaları gerekmektedir. Teşhis ve tedavi sürecindeki herhangi bir gecikme, hastalarda ölümcül sonuçlara veya kalıcı hasarlara neden olabileceğinden, daha duyarlı sağlık politikaları ile toplumun bilinçlendirilmesi de önemlidir.

Anahtar Kelimeler

• dermatopatoloji
• COVID-19
• malign melanom
• bazal hücreli karsinom
• skuamöz hücreli karsinom

Kaynakça

1. Refereans1. World Health Organization (WHO) Coronavirus (COVID-19) Dashboard. [(accessed on 7 April 2021)]; Available online: https://covid19.who.int/
2. Refereans2. Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J of Invest Dermatol, 2014;134(6):1527-1534.
3. Refereans3. Dinmohamed AG, Visser O, Verhoeven RHA, Louwman MWJ, van Nederveen FH, Willems SM, et al. Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. The Lancet Oncol. 2020;21(6), 750-751.
4. Refereans4. Ricci F, Fania L, Paradisi A, Di Lella G, Pallotta S, Sobrino L, et al. Delayed melanoma diagnosis in the COVID-19 era: Increased breslow thickness in primary melanomas seen after the COVID-19 lockdown. Journal of the European Academy of Dermatology and Venereology: JEADV. 2020.
5. Refereans5. Yuka A, Nguyen P, Timothy PH. "Impact of the COVID-19 pandemic on skin cancer diagnosis: A population-based study." PloS one 2021;16.3:e0248492.
6. Refereans6. Cocuz IG, Cocuz ME, Niculescu R, Șincu MC, Tinca AC, Sabău AH, et al. The Impact of and Adaptations Due to the COVID-19 Pandemic on the Histopathological Diagnosis of Skin Pathologies, Including Non-Melanocyte and Melanoma Skin Cancers—A Single-Center Study in Romania. Medicina 2021;57(6),53