LAUSR

hand dermatitis and 42% with facial eruptions. Facial eruptions reported were related to irritation from PPE, occlusive acne and worsening facial eczema in patients with existing atopic dermatitis. In the initial cohort, all patients responded to topical therapies and were discharged from review. Repeat analysis was performed of a recent cohort from March 2021 to November 2021 (n = 39). There was a decreased frequency of referrals over the time period in comparison to the initial surge. Interventions with skin care advice posters were distributed to frontline clinical areas following the initial pandemic surge, which may have contributed to fewer dermatology referrals from hospital occupational health. Changes were seen in the theme analysis of conditions and treatments. At this later stage, hand dermatitis represented 61% of referrals. One patient required referral for ultraviolet B therapy and one patient, with a background of atopic eczema, required systemic therapy. Facial eruptions represented a smaller proportion of referrals (33%) during this phase. Over a third of these patients presented with acne exacerbated by PPE. Eighty per cent of these patients required treatment with oral isotretinoin having failed topical treatments and tetracycline courses. This suggests patients are now presenting with recalcitrant, more severe PPE-related acne as pandemic measures continue. Analysis was performed on the economic burden of dermatoses in healthcare. Twentythree per cent of patients required an alteration to their work environment, such as deployment to nonclinical areas. Approximately 20% of patients required time off work related to their occupational dermatosis. This accounted for 298 days of work lost and an average monetary loss of approximately £24 000 over 8 months. The current urgent new-patient waiting list is 81 weeks; however, the fast-track service meant patients waited for an average of 3.8 weeks. The role of a fast-track occupational health dermatology clinic is therefore paramount in ensuring timely assessment, to reduce burden of occupational dermatosis during the COVID-19 pandemic.