Worsening of the skin diseases’ severity during SARS-CoV-2 pandemic is confirmed irrespective of the leading immune response pattern

Background: The SARS-CoV-2 pandemic can be considered a multifactorial event involving both the direct impact of the virus on the human body and a complex impact (through social, psychological, occupational, and behavioral changes) on the pathomorphosis of many diseases, including skin disorders. The analysis of the incidence, severity, and effectiveness of standard treatments for dermatoses in the new environmental model could be of value for the understanding of the mechanisms of skin disorders, improvement of the approaches to their treatment, development of rehabilitation and preventive tools. Aim: To asses an impact of the new coronavirus infection (SARS-CoV-2) on the severity and progression of non‐communicable inflammatory skin diseases depending on their immune response pattern. Methods: Adult patients with moderate to severe non‐communicable inflammatory skin diseases hospitalized to the Department of Dermatology of a multidisciplinary hospital from March 30, 2020, to March 15, 2023 were included into the study. All patients had SARS-CoV-2 infection in their history confirmed by polymerase chain reaction for SARS-CoV-2 RNA or computed tomography of the lungs. We retrospectively analyzed changes in clinical parameters on the Investigator's Global Assessment (IGA) scale and the number of exacerbations (mean value of each parameter over the year before SARS-CoV-2 infection and after its convalescent period). Also, the changes over time of the Dermatology Life Quality Index (DLQI) before and after SARS-CoV-2 infection were assessed. The patients were divided into the groups based on the dominant immune response pattern: lichenoid (group 1), eczematous (group 2), bullous (group 3), psoriatic (group 4), fibrogenic (group 5), granulomatous (group 6). Results: A total of 845 patients (518 (61,4%) women) aged 19 to 76 years (mean age, 53.8 ± 17.7 years) with the verified diagnosis of non‐communicable inflammatory skin disease and past history of SARS-CoV-2 infection participated in the study. Mean duration of the skin disease was 119.5 ± 103.1 months. Group 1 was represented by 59 patients with lichen ruber planus, discoid lupus erythematoides, and large plaque parapsoriasis; group 2, by 181 patients with atopic dermatitis, chronic eczema, and prurigo; group 3, by 41 patients with pemphigus vulgaris and bullous pemphigoid; group 4, by 366 patients with pustulous psoriasis, psoriasis and small plaque parapsoriasis; group 5, by 177 patients with localized sclerodermia, and group 6, by 21 patients with annular granuloma and rosacea. In all groups, there was a significant increase in the IGA, DLQI and the number of exacerbations of the non‐communicable inflammatory skin disease after SARS-CoV-2 infection. The assessment of the effectiveness of previously used treatment regimens and methods for the non‐communicable inflammatory skin disease showed the necessity to modify the therapeutic protocols in more than 45% of the cases in each group. Conclusion: The SARS-CoV-2 pandemic has contributed to significant worsening of the course of non‐communicable inflammatory skin diseases and deterioration of the patients’ quality of life, regardless of the immunopathogenesis of the dermatoses.