Navigating Immunosuppression in a Pandemic: A Guide for the Dermatologist from the COVID Task Force of the Medical Dermatology Society and Society of Dermatology Hospitalists

Niaki, Omid Zahedi; Anadkat, Milan J.; Chen, Steven T.; Fox, Lindy P.; Harp, Joanna; Micheletti, Robert G.; Nambudiri, Vinod E.; Pasieka, Helena B.; Shinohara, Michi M.; Rosenbach, Misha; Merola, Joseph F.

Abstract: Dermatologists treating immune-mediated skin disease must now contend with the uncertainties associated with immunosuppressive use in the context of the SARS-CoV-2 pandemic. Though the risk of infection with many commonly used immunosuppressive agents remains low, direct data evaluating the safety of such agents in COVID-19 are scarce. This article reviews and offers guidance based upon currently available safety data, and the most recent COVID-19 outcome data, in patients with immune-mediated dermatologic disease. The interdisciplinary panel of experts emphasize a stepwise, shared decision-making approach in the management of immunosuppressive therapy. The goal of this article is to help providers minimize the risk of disease flares while simultaneously minimizing the risk of iatrogenic harm during an evolving pandemic.