Treatment of irritant contact dermatitis in healthcare settings during the COVID19 pandemic: The emollient Dermol 500 exhibits virucidal activity against influenza A virus and SARS-CoV-2

  1. Christine T. Styles
  2. Michael Vanden Oever
  3. Jonathan Brown
  4. Sweta Rai
  5. Sarah Walsh
  6. Finola M. Ryan
  7. Wendy S. Barclay
  8. Rachel S. Edgar

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Abstract

Objectives

To investigate whether the antimicrobial emollient Dermol 500 and its active components, benzalkonium chloride (BAK) and chlorhexidine dihydrochloride (CD), exhibit virucidal activity thus informing whether Dermol 500 is a suitable soap substitute for use during the COVID19 pandemic, to combat the increased incidence of work-related contact dermatitis in clinical settings that we report here.

Methods

Inactivation of influenza A virus and SARS-CoV-2 by Dermol 500 and the independent and combined virucidal activity of the Dermol 500 components BAK and CD was assessed by influenza A virus and SARS-CoV-2 infectivity assays. Viruses were treated with concentrations of BAK and CD comparable to Dermol 500, and lower, and infectivity of the viruses assessed by titration.

Results

Dermol 500 exhibits comparable virucidal activity to alcohol-based sanitisers against influenza A virus and SARS-CoV-2. In addition, the Dermol 500 components BAK and CD exhibit independent and synergistic virucidal activity against influenza A virus and SARS-CoV-2, the causative agent of COVID19.

Conclusions

The synergistic virucidal activity of the Dermol 500 components BAK and CD makes Dermol 500 suitable as a soap substitute to treat and prevent work-related contact dermatitis in healthcare settings.

KEY MESSAGES

  • What is already known about this subject?

    • Work-related contact dermatitis is a prominent issue among healthcare workers, and likely exacerbated by the enhanced hand hygiene and personal protective equipment required to control infection during the COVID19 pandemic.

    • The antimicrobial lotion Dermol 500 is frequently prescribed as an emollient and soap substitute to help prevent and treat dermatitis, but its use during the COVID19 pandemic was not advised as its capacity to inactivate viruses was unknown.

  • What are the new findings?

    • Increased incidence of irritant contact dermatitis was recorded amongst healthcare workers at King’s College Hospital NHS Foundation Trust in 2020 compared to 2019.

    • Dermol 500 lotion and its antimicrobial components, benzalkonium chloride (BAK) and chlorhexidine dihydrochloride (CD), exhibit virucidal activity against influenza A virus and SARS-CoV-2, the virus responsible for COVID19 pandemic.

  • How might this impact policy or clinical practice in the foreseeable future?

    • Our results demonstrate that Dermol 500 can be safely used as a soap substitute to treat work-related contact dermatitis in clinical care settings during the COVID19 pandemic.

    • Employers can meet their obligations under COSHH to eliminate workplace exposure to a harmful substance and substitute with an alternative product for hand hygiene.

    • Article activity feed

    1. ScreenIT

      SciScore for 10.1101/2021.02.12.21251419: (What is this?)

      Please note, not all rigor criteria are appropriate for all manuscripts.

      Table 1: Rigor

      Institutional Review Board Statementnot detected.
      Randomizationnot detected.
      Blindingnot detected.
      Power Analysisnot detected.
      Sex as a biological variablenot detected.
      Cell Line Authenticationnot detected.

      Table 2: Resources

      Experimental Models: Cell Lines
      SentencesResources
      Cell culture: Madin-Darby Canine Kidney (MDCK) cells and VeroE6 cells were routinely cultured at 37°C with 5% CO2 in Dulbecco’s modified Eagle’s Medium (DMEM; Gibco-Life Technologies) supplemented with 10% FCS, 1% penicillin/streptomycin and either Glutamax (MDCK) or NEAA (Vero E6)(Gibco-Life Technologies).
      MDCK
      suggested: CLS Cat# 602280/p823_MDCK_(NBL-2, RRID:CVCL_0422)
      Vero E6 cells were seeded into 96-well plates in supplemented DMEM for confluence the next day.
      Vero E6
      suggested: None
      Software and Algorithms
      SentencesResources
      Statistical analysis: All data was analysed using GraphPad Prism and presented as mean ± standard deviation (mean±SD).
      GraphPad Prism
      suggested: (GraphPad Prism, RRID:SCR_002798)

      Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

      Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

      Results from TrialIdentifier: No clinical trial numbers were referenced.

      Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

      Results from JetFighter: We did not find any issues relating to colormaps.

      Results from rtransparent:
      • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
      • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
      • No protocol registration statement was detected.

      About SciScore

      SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

    2. Version published to 10.1101/2021.02.12.21251419 on medRxiv