key: cord-0707036-rncrk9zd authors: Gupta, Mohit Kumar; Lipner, Shari R. title: Personal Protective Equipment Recommendations Based on COVID-19 Route of Transmission date: 2020-04-21 journal: J Am Acad Dermatol DOI: 10.1016/j.jaad.2020.04.068 sha: 949077049e569b44d42be49fa8f9bf9158c36b82 doc_id: 707036 cord_uid: rncrk9zd nan trial prevention of hand dermatitis was associated with increased hand hygiene compliance, or appropriate amount of sanitizing/hand washing by nurses. 4 Furthermore we would like to 50 emphasize that alcohol based sanitizers are a very effective antimicrobial agent, especially for 51 lipophilic enveloped viruses (e.g., SARS-Cov-2), and they are less frequently associated with 52 hand dermatitis than hand washing with soap and water. Thus alcohol based sanitiziers may 53 promote hand hygiene adherence and should be utilized more frequently by healthcare workers, 54 except when hands are visibly soiled. Additionally, it has been shown that the face rather than hands were the more frequent site of 56 skin damage in Chinese healthcare workers managing COVID-19, related to pressure from face 57 masks and goggles. 5 Healthcare workers may be tempted to touch their face following removal 58 of PPE (Figure 1) . Given the respiratory route of transmission, refraining from touching the face 59 during facial PPE application and removal is another recommendation that should be impressed 60 upon healthcare workers just as strongly as preventing hand dermatitis. Rational hand hygiene during COVID-19 pandemic Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease 66 Inhibitor SARS-CoV-2 68 receptor ACE2 and TMPRSS2 are primarily expressed in bronchial transient secretory cells Nurses' perceptions of 71 the benefits and adverse effects of hand disinfection: alcohol-based hand rubs vs. hygienic 72 handwashing: a multicentre questionnaire study with additional patch testing by the German 73 Contact Dermatitis Research Group Skin damage among healthcare workers managing 75 coronavirus disease-2019