COVID-19 NICE Guidance - patients with dermatological conditions

The purpose of this guideline is to maximise the safety of children and adults who have dermatological conditions treated with drugs affecting the immune response during the COVID-19 pandemic.

     1. Communicating with patients and minimising risk

• Communicate with patients, their families and carers, and support their mental health and wellbeing to help alleviate any anxiety and fear they may have about COVID-19. Signpost to sources of online information such as the British Association of Dermatologists patient hub.
• Some patients will have received a letter telling them they are at high risk of severe illness from COVID-19. Inform them or their parent or carer to follow the advice on shielding from the UK government
• Inform patients if they have been advised to self-isolate, they should follow the UK government stay at home guidance
• Minimise face-to-face contact
  

  2. Supplying medicines

• Think about the resources that are available to make treatment changes during the COVID-19 pandemic and how these changes will be delivered
• Prescribe usual quantities of medicines to meet the patient’s clinical needs
  

  
  3. Patients not known to have COVID-19

• If patients need to attend hospital appointments, minimise their potential exposure to the virus by:
• Encouraging them not to arrive early
• Texting them when staff are ready to see them, so that they can wait outside the building for example in their car
• Providing a clean route through the hospital to the department
• Reducing and ideally eliminating, the time they spend in waiting areas through the careful scheduling
• Delivering investigations, procedures and treatment promptly and in 1 stop when feasible
• Ensuring prescriptions are dispensed rapidly and ideally without visiting hospital pharmacies.
• When deciding whether to start or continue treatment with a drug that affects the immune system, discuss the risks and benefits with the patients, their parents or carer
• Assess whether it is safe to increase the time interval between blood tests for drug monitoring in patients who are stable on treatment
  

  4. Patients known or suspected to have COVID-19

• Be aware that patients taking drugs that affect the immune system may have atypical presentations of COVID-19
• If patients with known or suspected COVID-19 need to attend the dermatology department, follow appropriate UK government guidance on infection prevention and control
• If COVID-19 is later diagnosed in a patient not isolated from admission or presentation, follow UK government guidance
• If a patient is prescribed topical treatments continue
• If a patient known or suspected COVID-19 and who are on systemic treatment:
• Do not suddenly stop oral corticosteroids
• Continue hydroxychloroquine, chloroquine, mepacrine, daspone or sulfasalazine
• Consider temporarily stopping all other oral immunosuppressive therapies.
• When deciding whether to stop treatment, discuss the risks and benefits with the patient, or their parent or carer