CoChat
Sign Up
Cited by 366Global Health and SurgeryDermatology and Skin DiseasesDermatological diseases and infestations

Global Burden of Skin Disease: Inequities and Innovations

Open access
Seth, Divya, Cheldize, Khatiya, Brown, Danielle, Freeman, Esther E.·2017·Current Dermatology Reports
DOI 10.1007/s13671-017-0192-7PMC PMC5718374
Open this paper in CoChat — free account

Abstract

Purpose of review We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings.Recent findings The Global Burden of Disease project has shown that skin diseases continue to be the 4 th leading cause of nonfatal disease burden world-wide. However, research efforts and funding do not match with the relative disability of skin diseases. International and national efforts, such as the WHO List of Essential Medicines, are critical towards reducing the socioeconomic burden of skin diseases and increasing access to care. Recent innovations such as teledermatology, point-of-care diagnostic tools, and task-shifting help to provide dermatological care to underserved regions in a cost-effective manner.Summary Skin diseases cause significant non-fatal disability worldwide, especially in resource-poor regions. Greater impetus to study the burden of skin disease in low resource settings and policy efforts towards delivering high quality care are essential in improving the burden of skin diseases.

Integrity signals

Registry

Crossref · 10.1007/s13671-017-0192-7

Cites

57 of 57 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 88 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    Seniors were much more likely to experience disability due to a skin condition.

    “Seniors were much more likely to experience disability due to a skin condition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Jobanputra R, Bachmann M. The effect of skin diseases on quality of life in patients from different social and ethnic groups in Cape Town. South Africa Int J Dermatol. 2000;39(11):826–31. source

      Not checked in the free run.

  • Premisecitation

    GBD skin disease burden estimates are likely underestimated because dermatological manifestations of systemic illnesses are not individually categorized, e.g., lupus burden is included under musculoskeletal disease.

    “the dermatological manifestations of systemic illnesses are not necessarily individually categorized; the burden of lupus erythematosus is therefore entirely included under that of musculoskeletal disease”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] • Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol. 2014;134(6):1527–34. Epidemiological study based on the 2010 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

  • Premisecitation

    Far fewer studies examine quality of life in patients with skin conditions in resource-poor settings than in resource-replete settings.

    “Far fewer studies exist examining the QoL of patients with skin conditions in the resource-poor world”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [9] Jobanputra R, Bachmann M. The effect of skin diseases on quality of life in patients from different social and ethnic groups in Cape Town. South Africa Int J Dermatol. 2000;39(11):826–31. source

      Not checked in the free run.

    • cites [13] Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen TL, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;155(5):957–64. source

      Not checked in the free run.

  • Premisecitation

    Many dermatologic medicines from the WHO List of Essential Medicines are not available in hospital pharmacies.

    “many dermatologic medicines from this list are not available in hospital pharmacies”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Narwane S, Patel T, Shetty Y, Chikhalkar S. Drug utilization and cost analysis for common skin diseases in dermatology OPD of an Indian tertiary care hospital-a prescription survey. 2011. source

      Not checked in the free run.

  • Premisecitation

    In Ugandan patients, there is a significant burden of depressed mood and poor self-image secondary to pruritus.

    “a study of QoL in Ugandan patients found a significant burden of depressed mood and poor self-image secondary to pruritus”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen TL, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;155(5):957–64. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 13
  • May combine two claims. 17

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 2013, skin conditions accounted for 1.79% of total global DALYs across 306 diseases and injuries.

    “In 2013, skin conditions contributed 1.79% to the total global burden of disease measured in DALYs across 306 diseases and injuries.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] •• Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, et al. Global skin disease morbidity and mortality: An Update From the Global Burden of Disease Study 2013. JAMA Dermatol [Internet]. 2017 Mar 1. Epidemiological study based on the 2013 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Skin and subcutaneous disorders ranked fourth among causes of nonfatal disease burden globally in 2010 and 2013.

    “skin and subcutaneous disorders were the 4th leading cause of nonfatal disease burden worldwide in 2010 and 2013”
    • Also stated in: § Summary and Recommendations · plain
      “skin diseases were the 4th leading cause of non-fatal morbidity worldwide in 2010 and 2013”
    • Also stated in: § Recent Findings · plain
      “skin diseases continue to be the 4th leading cause of nonfatal disease burden world-wide”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] • Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol. 2014;134(6):1527–34. Epidemiological study based on the 2010 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Dermatitis caused the greatest burden among the assessed skin disease categories, at 9.3 million DALYs.

    “Dermatitis (encompassing atopic, seborrheic, and contact types) resulted in the greatest burden of the skin conditions, costing 9.3 million DALYs”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] •• Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, et al. Global skin disease morbidity and mortality: An Update From the Global Burden of Disease Study 2013. JAMA Dermatol [Internet]. 2017 Mar 1. Epidemiological study based on the 2013 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Melanoma causes the greatest skin disease burden in resource-rich regions such as Australia and North America.

    “Melanoma causes the greatest burden in resource-rich regions such as Australia and North America”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] •• Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, et al. Global skin disease morbidity and mortality: An Update From the Global Burden of Disease Study 2013. JAMA Dermatol [Internet]. 2017 Mar 1. Epidemiological study based on the 2013 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Teasing can have devastating long-term effects on mental health, predisposing children to anxiety disorders and social phobias.

    “teasing can have devastating long-term effects on mental health, predisposing children to anxiety disorders and social phobias”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] McCabe RE, Antony MM, Summerfeldt LJ, Liss A, Swinson RP. Preliminary examination of the relationship between anxiety disorders in adults and self-reported history of teasing or bullying experiences. Cogn Behav Ther. 2003;32(4):187–93. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Living in close quarters predisposes one to infection.

    “We know that living in close quarters predisposes one to infection”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Harrison LH, Dwyer DM, Maples CT, Billmann L. Risk of meningococcal infection in college students. JAMA. 1999;281(20):1906–10. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Ugandan patients with itch were younger, more likely to have HIV, and less impacted by itch compared to German patients.

    “Ugandan patients with itch were younger, more likely to have HIV, and less impacted by itch when compared to German patients.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen TL, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;155(5):957–64. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Musculoskeletal and connective tissue disorders, including skin diseases, comprised 3.7% of the total cost burden in India.

    “Musculoskeletal and connective tissue disorders (including skin diseases) comprised 3.7% of the total cost burden.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Dror DM, van Putten-Rademaker O, Koren R. Cost of illness: evidence from a study in five resource-poor locations in India. 2008.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    German patients were older, more likely to have end-stage renal disease, and more impacted by itch.

    “German patients were older, more likely to have end-stage renal disease, and more impacted by itch.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen TL, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;155(5):957–64. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In the United States, the direct and indirect cost of skin disease in 2013 was $75 billion and $11 billion, respectively.

    “In the United States, the direct and indirect cost of skin disease in 2013 was $75 billion and $11 billion, respectively”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Lim HW, Collins SAB, Resneck Jr JS, Bolognia JL, Hodge JA, Rohrer TA, et al. The burden of skin disease in the United States. J Am Acad Dermatol [Internet]. Available from: http://www.sciencedirect.com/science/article/pii/S0190962217300166 .

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Effects of skin conditions on quality of life in resource-replete settings are profound and well-documented.

    “The effects of skin conditions on QoL in resource-replete settings is profound and well-documented”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [4] • Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol. 2014;134(6):1527–34. Epidemiological study based on the 2010 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

    • cites [10] Basra M, Fenech R, Gatt R, Salek M, Finlay A. The Dermatology Life Quality Index 1994–2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008;159(5):997–1035.

      Not checked in the free run.

    • cites [12] Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol. 2006;155(1):145–51. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Clinical severity measured by clinicians using formal grading scales does not always correlate with patients' perceptions of severity, and the discrepancy appears disease-specific.

    “clinical severity, as measured by clinicians using formal grading scales, does not always correlate with patients’ perceptions of their condition’s severity. The discrepancy appears to be disease-specific.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [16] Mosam A, Vawda NB, Gordhan AH, Nkwanyana N, Aboobaker J. Quality of life issues for South Africans with acne vulgaris. Clin Exp Dermatol. 2005;30(1):6–9. source

      Not checked in the free run.

    • cites [17] Hariram P, Mosam A, Aboobaker J, Esterhuizen T. Quality of life in psoriasis patients in KwaZulu Natal, South Africa. Indian J Dermatol Venereol Leprol. 2011;77(3):333–4. source

      Not checked in the free run.

    • cites [18] Aghaei S, Moradi A, Ardekani G. Impact of psoriasis on quality of life in Iran. Indian J Dermatol Venereol Leprol. 2009;75(2):220. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the South African study, women reported greater impact on self-esteem, clothing choice, and treatment problems.

    “Women reported greater impact on self-esteem, clothing choice, treatment problems and clothing choice in the South African study.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Jobanputra R, Bachmann M. The effect of skin diseases on quality of life in patients from different social and ethnic groups in Cape Town. South Africa Int J Dermatol. 2000;39(11):826–31. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Dermatologic diseases are receiving more attention and have increasingly been included on the WHO List of Essential Medicines.

    “dermatologic diseases are receiving more attention and have increasingly been included on the WHO List of Essential Medicines”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Laing R, Waning B, Gray A, Ford N, t Hoen E. 25 years of the WHO essential medicines lists: progress and challenges. Lancet. 5;361(9370):1723–9. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Infectious skin conditions are prevalent among disenfranchised people; the homeless, prisoners, and victims of violence are disproportionately affected.

    “Infectious skin conditions are prevalent among disenfranchised people. The homeless, prisoners, and victims of violence are disproportionately affected in these settings”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Worth C, Heukelbach J, Fengler G, Walter B, Liesenfeld O, Feldmeier H. Impaired quality of life in adults and children with scabies from an impoverished community in Brazil. Int J Dermatol. 2012;51(3):275–82. source

      Not checked in the free run.

    • cites [21] Raoult D, Foucault C, Brouqui P. Infections in the homeless. Lancet Infect Dis. 1(2):77–84. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Dermatitis has the highest DALY rate in Sub-Saharan Africa.

    “dermatitis has the highest DALY rate in Sub-Saharan Africa”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] •• Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, et al. Global skin disease morbidity and mortality: An Update From the Global Burden of Disease Study 2013. JAMA Dermatol [Internet]. 2017 Mar 1. Epidemiological study based on the 2013 Global Burden of Disease project that measures the burden of skin diseases worldwide, with burden of individual skin diseases measured in DALYs. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Without international guidelines, healthcare professionals in resource-strapped settings may rely on unvalidated information, leading to patient harm.

    “Without international guidelines, healthcare professionals in already resource strapped settings may be pushed to rely on unvalidated information, leading to patient harm”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [31] Paul S, Evans R, Maurer T, Muhe LM, Freeman EE. Treatment of dermatological conditions associated with HIV/AIDS: the scarcity of guidance on a global scale. AIDS Res Treat. 2016;2016:e3272483.

      Not checked in the free run.

    • cites [32] Oxman AD, Lavis JN, Fretheim A. Use of evidence in WHO recommendations. Lancet. 2007;369(9576):1883–9. source

      Not checked in the free run.

    • cites [33] Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Pruritus had an adverse effect on quality of life in both primary dermatoses and systemic disorders, though primary dermatoses were more commonly associated with poor self-image.

    “Pruritus had an adverse effect on QoL in both primary dermatoses and systemic disorders, though primary dermatoses were more commonly associated with poor self-image.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen TL, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;155(5):957–64. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 2010, melanoma mortality was 4.7 times higher in resource-rich countries than in resource-poor countries.

    “Mortality due to melanoma was found to be 4.7 times higher in resource-rich countries compared to resource-poor in 2010”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Boyers LN, Karimkhani C, Naghavi M, Sherwood D, Margolis DJ, Hay RJ, et al. Global mortality from conditions with skin manifestations. J Am Acad Dermatol. 2014;71(6):1137–43.e17. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationnone given

    Due to few high-quality trials in resource-poor settings, there is little data on the true impact of dermatological conditions in these regions.

    “Due to few high-quality trials in resource-poor settings, there is little data on the true impact of dermatological conditions in these regions.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: There is a dearth of high-quality trials on treatment approaches for skin conditions such as HIV-associated skin conditions.

  • May combine two claims.

    Premisecitation

    Teledermatology can help overcome gaps in care, allowing better access to a trained dermatologist, reduced travel and waiting times, and support for local staff.

    “Teledermatology can help to overcome these gaps in care, allowing for better access to a trained dermatologist, reduced travel and waiting times, and support for local staff”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [35] Wootton R. Telehealth in the developing world. IDRC; 2009. 336 p.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In HIV/AIDS, task shifting has been deemed imperative with evidence that nurses can prescribe antiretroviral treatments just as effectively as physicians.

    “In the field of HIV/AIDS, task shifting has been deemed imperative with evidence that nurses can prescribe antiretroviral treatments just as effectively as physicians”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [50] Eholié S-P, Aoussi FE, Ouattara IS, Bissagnéné E, Anglaret X. HIV treatment and care in resource-constrained environments: challenges for the next decade. J Int AIDS Soc [Internet]. 2012 Aug 22 [cited 2017 Apr 5];15(2) Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494167/ . source

      Not checked in the free run.

    • cites [51] Sanne I, Orrell C, Fox MP, Conradie F, Ive P, Zeinecker J, et al. Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial. Lancet Lond Engl. 2010;376(9734):33–40. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Mobile teledermatology uses cell phones to transmit images, allows more versatility than store-and-forward, and has good concordance with face-to-face visit outcomes.

    “Mobile teledermatology uses cell phones to transmit images, allows for more versatility than its often more unwieldy store-and-forward counterpart, and has good concordance with the outcomes of a face-to-face visit”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [36] Osei-tutu A, Shih T, Rosen A, Amanquah N, Chowdhury M, Nijhawan RI, et al. Mobile teledermatology in Ghana: sending and answering consults via mobile platform. J Am Acad Dermatol. 2013;69(2):e90–1. source

      Not checked in the free run.

    • cites [37] Azfar RS, Lee RA, Castelo-Soccio L, Greenberg MS, Bilker WB, Gelfand JM, et al. Reliability and validity of mobile Teledermatology in human immunodeficiency virus-positive patients in Botswana: a pilot study. JAMA Dermatol. 2014;150(6):601–7. source

      Not checked in the free run.

    • cites [38] Tran K, Ayad M, Weinberg J, Cherng A, Chowdhury M, Monir S, et al. Mobile teledermatology in the developing world: implications of a feasibility study on 30 Egyptian patients with common skin diseases. J Am Acad Dermatol. 2011;64(2):302–9. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Governments of India, Nepal, and Bangladesh pledged to eliminate visceral leishmaniasis by 2015, which along with improved treatment access prompted development of a simple point-of-care diagnostic tool detecting antibody agglutination.

    “The governments of India, Nepal, and Bangladesh pledged to eliminate visceral leishmaniasis by 2015, which along with improved treatment access, prompted the development of a simple point-of-care diagnostic tool which detects antibody agglutination”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [43] Mabey D, Peeling RW, Ustianowski A, Perkins MD. Tropical infectious diseases: diagnostics for the developing world. Nat Rev Microbiol. 2004;2(3):231–40. source

      Not checked in the free run.

    • cites [45] Yager P, Domingo GJ, Gerdes J. Point-of-care diagnostics for global health. Annu Rev Biomed Eng. 2008;10:107–44. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The devastating social stigma associated with skin diseases means that many patients are not actually seen by research trials and international organizations.

    “The devastating social stigma associated with skin diseases means that many patients are not actually “seen” by research trials and international organizations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Regional Dermatology Training Center in Tanzania was established in 1992 to provide dermatologic training for nurses in the Sub-Saharan region.

    “The Regional Dermatology Training Center in Tanzania was established in 1992 to provide dermatologic training for nurses in the Sub-Saharan region”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Hu J, McKoy K, Papier A, Klaus S, Ryan T, Grossman H, et al. Dermatology and HIV/AIDS in Africa. J Glob Infect Dis. 2011;3(3):275–80. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Teledermatology has been validated in both infectious conditions such as HIV-associated skin conditions and chronic conditions such as atopic dermatitis.

    “Teledermatology has been validated in both infectious conditions such as HIV-associated skin conditions and chronic conditions, such as atopic dermatitis”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [37] Azfar RS, Lee RA, Castelo-Soccio L, Greenberg MS, Bilker WB, Gelfand JM, et al. Reliability and validity of mobile Teledermatology in human immunodeficiency virus-positive patients in Botswana: a pilot study. JAMA Dermatol. 2014;150(6):601–7. source

      Not checked in the free run.

    • cites [40] Armstrong AW, Johnson MA, Lin S, Maverakis E, Fazel N, Liu F-T. Patient-centered, direct-access online care for management of atopic dermatitis: a randomized clinical trial. JAMA Dermatol. 2015;151(2):154–60. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    Resource-poor areas are more likely to suffer the burden of infectious skin conditions, while resource-rich areas shoulder the burden of malignancies.

    “resource-poor areas more likely to suffer the burden of infectious skin conditions, while resource-rich areas shoulder the burden of malignancies”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Improving access to care is not the same as increasing access to high quality care.

    “Improving access to care is not the same as increasing access to high quality care”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] • Scott KW, Jha AK. Putting quality on the global health agenda. N Engl J Med. 2014;371(1):3–5. Perspective that emphasizes that access to high-quality care is an important goal when addressing global health need. source

      Not checked in the free run.

29 of 29

  • The paper relies on this without support.

    Little is known about the socioeconomic burden of skin disease in resource-poor settings, and studies examining the cost of skin care in these settings are rare.

    “Little is known about the socioeconomic burden of skin disease in resource-poor settings. Studies examining the cost of skin care in these settings are rare.”

  • The paper relies on this without support.

    There is a shortage of literature addressing the development of innovative diagnostic tools for dermatology in resource-poor settings.

    “There is a shortage of literature that addresses the development of innovative diagnostic tools for dermatology in resource-poor settings.”

  • The paper relies on this without support.

    There is a dearth of high-quality trials on treatment approaches for skin conditions such as HIV-associated skin conditions.

    “There is a dearth of high quality trials on treatment approaches for skin conditions, such as HIV-associated skin conditions.”

  • The paper relies on this without support.

    GBD estimates for skin and subcutaneous diseases in Sub-Saharan Africa are based on only 53 studies, while estimates for the United States are based on 62 studies.

    “the GBD estimates for skin and subcutaneous diseases in Sub-Saharan Africa, a designation that encompasses 46 independent nations, are based on only 53 studies, while estimates for the United States alone, with a population of approximately 1/3rd the size, are based on 62 studies”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Limited specialist access exists in primary care settings where most skin conditions are initially evaluated.

    “Given limited specialist access in primary care settings where most skin conditions are initially evaluated56,57”

    From A Multimodal Vision Foundation Model for Clinical Dermatology (2025) · cites this paper as [56]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Eight diseases are listed as seven

    Minor

    The sentence says seven skin diseases were underrepresented, but the parenthetical list contains eight.

1 of 1

Cites

Flagged first, then by citations

2 of the 59 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Seth, D., Cheldize, K., Brown, D., & Freeman, E. E.
Affiliations
  • Case Western Reserve University (US)
  • Massachusetts General Hospital (US)
Corresponding author
Freeman, Esther E.
ORCID
Venue
Current Dermatology Reports
Publisher
Springer Science and Business Media LLC
Published
2017-08-07
Volume
6
Issue
3
Pages
204-210
ISSN
2162-4933 (ISSN-L)
DOI
10.1007/s13671-017-0192-7
PMC
PMC5718374
OpenAlex
W2742893201
Cited by
366
References
59
Citations by year
2026: 37 · 2025: 55 · 2024: 63 · 2023: 61 · 2022: 50 · 2021: 44 · 2020: 39 · 2019: 12 · 2018: 4
FWCI
14.12
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • Current Dermatology Reports (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Allergy and Infectious Diseases (P30AI060354)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Infectious Diseases › Dermatological diseases and infestations
Keywords
skin diseases, global burden of disease, disability burden, quality of life, socioeconomic burden, access to dermatologic care, resource-limited settings, teledermatology, point-of-care testing, task shifting, health disparities

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review