Global Burden of Skin Disease: Inequities and Innovations

In the paper

“In 2013, skin conditions contributed 1.79% to the total global burden of disease measured in DALYs across 306 diseases and injuries.”

What the sources say

• Not checked yetcites [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

In the paper

“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”

What the sources say

• Not checked yetcites [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

In the paper

“Dermatitis (encompassing atopic, seborrheic, and contact types) resulted in the greatest burden of the skin conditions, costing 9.3 million DALYs”

What the sources say

• Not checked yetcites [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

In the paper

“Melanoma causes the greatest burden in resource-rich regions such as Australia and North America”

What the sources say

• Not checked yetcites [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

In the paper

“teasing can have devastating long-term effects on mental health, predisposing children to anxiety disorders and social phobias”

What the sources say

• Not checked yetcites [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

In the paper

“We know that living in close quarters predisposes one to infection”

What the sources say

• Not checked yetcites [20] Harrison LH, Dwyer DM, Maples CT, Billmann L. Risk of meningococcal infection in college students. JAMA. 1999;281(20):1906–10. source

In the paper

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

What the sources say

• Not checked yetcites [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

In the paper

“Musculoskeletal and connective tissue disorders (including skin diseases) comprised 3.7% of the total cost burden.”

What the sources say

• Not checked yetcites [23] Dror DM, van Putten-Rademaker O, Koren R. Cost of illness: evidence from a study in five resource-poor locations in India. 2008.

In the paper

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

What the sources say

• Not checked yetcites [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

In the paper

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

What the sources say

• Not checked yetcites [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 .

In the paper

“The effects of skin conditions on QoL in resource-replete settings is profound and well-documented”

What the sources say

• Not checked yetcites [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 yetcites [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 yetcites [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

In the paper

“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.”

What the sources say

• Not checked yetcites [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 yetcites [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 yetcites [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

In the paper

“Women reported greater impact on self-esteem, clothing choice, treatment problems and clothing choice in the South African study.”

What the sources say

• Not checked yetcites [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

In the paper

“dermatologic diseases are receiving more attention and have increasingly been included on the WHO List of Essential Medicines”

What the sources say

• Not checked yetcites [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

In the paper

“Infectious skin conditions are prevalent among disenfranchised people. The homeless, prisoners, and victims of violence are disproportionately affected in these settings”

What the sources say

• Not checked yetcites [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 yetcites [21] Raoult D, Foucault C, Brouqui P. Infections in the homeless. Lancet Infect Dis. 1(2):77–84. source

In the paper

“dermatitis has the highest DALY rate in Sub-Saharan Africa”

What the sources say

• Not checked yetcites [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

In the paper

“Without international guidelines, healthcare professionals in already resource strapped settings may be pushed to rely on unvalidated information, leading to patient harm”

What the sources say

• Not checked yetcites [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 yetcites [32] Oxman AD, Lavis JN, Fretheim A. Use of evidence in WHO recommendations. Lancet. 2007;369(9576):1883–9. source
• Not checked yetcites [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

In the paper

“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.”

What the sources say

• Not checked yetcites [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

In the paper

“Mortality due to melanoma was found to be 4.7 times higher in resource-rich countries compared to resource-poor in 2010”

What the sources say

• Not checked yetcites [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

In the paper

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

In the paper

“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”

What the sources say

• Not checked yetcites [35] Wootton R. Telehealth in the developing world. IDRC; 2009. 336 p.

In the paper

“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”

What the sources say

• Not checked yetcites [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 yetcites [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

In the paper

“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”

What the sources say

• Not checked yetcites [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 yetcites [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 yetcites [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

In the paper

“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”

What the sources say

• Not checked yetcites [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 yetcites [45] Yager P, Domingo GJ, Gerdes J. Point-of-care diagnostics for global health. Annu Rev Biomed Eng. 2008;10:107–44. source

In the paper

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

In the paper

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

What the sources say

• Not checked yetcites [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

In the paper

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

What the sources say

• Not checked yetcites [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 yetcites [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

In the paper

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

In the paper

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

What the sources say

• Not checked yetcites [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