Diagnosis of Stress-Associated Dermatologic Conditions in New York City Safety-Net Hospitals During the COVID-19 Pandemic

    Kristy Tefft, Sarah Balboul, Bijan Safai, Abigail Cline, Shoshana Marmon
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    TLDR During the COVID-19 pandemic, more people were diagnosed with stress-related skin conditions like acne and temporary hair loss.
    The study investigated the rate of diagnosis of stress-associated dermatologic conditions during the COVID-19 pandemic in a large safety-net hospital system in New York City. The study analyzed data from 23,757 pre-pandemic and 26,213 pandemic patients. The prevalence of acne increased by 15% and telogen effluvium (a form of temporary hair loss) increased by 166% during the pandemic. Among patients with COVID-19, the majority of stress-related conditions had significantly increased: acne (54%), telogen effluvium (266%), urticaria (111%), and herpes zoster (250%). The study suggests that the physiological stress of infection may have weakened immunologic defenses, enabling the expression of underlying cutaneous disease. However, the study also acknowledges potential selection bias and changes in health-seeking behavior during the pandemic as limitations.
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