Comment on the flare up of immune-mediated inflammatory dermatoses during coronavirus disease 2019 pandemic: a cross–sectional study in a tertiary care hospital
Year: 2026
Type: article
Abstract: To the Editor, The original article ‘The flare up of immune-mediated inflammatory dermatoses during coronavirus disease 2019 (COVID-19) pandemic: a cross–sectional study in a tertiary care hospital’ published in the Egyptian Journal of Dermatology and Venereology, is a valuable contribution [1]. The study’s objective was to assess the impact of the COVID-19 pandemic on the course and management of chronic immune-mediated inflammatory skin diseases [1]. I agree with the rationale of the study that during the pandemic period, many patients presented simultaneously with a skin infection and it was not quite certain whether it was a direct skin infection or due to the impact of COVID-19 infection on pre-existing skin lesions. I thoroughly read the article and have some critical observations and suggestions to improve the overall quality of the research article. To start with, there is no scientific justification for why 500 patients were included in the present study [1]. To improve the scientific robustness of the article and to have better clinical implications, it is a must that sample size should be determined using a mathematical formula [2]. The next essential step that is missing from the study is the use of a sampling method to include patients in the study, and while doing so, we must ensure that the selected samples are representative of the study population [3]. I presume that the authors have used purposive sampling (nonprobability sampling) as no other explanation has been provided. The inclusion and exclusion criteria were specified well, and study variables have also been mentioned [1]. However, there are multiple concerns with the questionnaire that has been used in the study, as no information has been provided about the type of questionnaire (structured/semi-structured/unstructured), who designed it, how it was designed, validation of the questionnaire (how it was done, number of involved experts, language validation, etc.), pilot-testing of the tool, reliability of the tool, etc [4,5]. Regarding statistical analysis, the version of the software is missing and the authors have not mentioned anything about the statistical tests used, and the diagrams used for data representation [1,6]. After going through the results, it is evident that the authors used only descriptive statistics (frequency and percentages), and pie and bar diagrams were used for representation [1]. Whenever the methodology section is written, it has to be self-explanatory, which should enable readers to replicate the study within their settings [6]. The descriptive distribution of disease-wise results has been represented well by the authors in the Results section [1]. I would have been happy had the authors used the χ2 test to study the association between disease flare-ups and patients who were diagnosed with COVID-19 (n=75) and those who were not (n=425). This would have given the readers plenty of useful insights. The Discussion section is written to ‘discuss’ study results and cite reasons for similar or contrasting findings after comparing with other studies [7]. I feel that the authors have not optimally utilized the discussion section, and this could be because of the paucity of literature. However, I was extremely happy to note that the authors have mentioned self-identified limitations, which is an important aspect of writing a research paper [1,7]. To summarize, the current study adds useful information about the distribution of flaring up of different chronic immune-mediated inflammatory skin diseases. However, the findings of the study would be more valid if the authors had been systematic in their approach in providing details on sample size, sampling method, the data collection tool, and statistical analysis. Acknowledgments Contribution details: S.R.S. contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed on all aspects of the work. Conflicts of interest There are no conflicts of interest.
Author: Saurabh RamBihariLal Shrivastava
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7119470707