A systematic analysis of the global burden of skin disease: lesions learned

Abstract

BackgroundSkin diseases are some of the most common human illnesses across geographies and time. Despite this, there are surprisingly few large epidemiological studies that provide accurate data on cutaneous disease incidence and prevalence or estimates of the global burden of skin disease. The overall aim of this study was to estimate the global burden of disease attributable to 15 categories of skin disease from 1980 to 2010 for 187 countries, by age and sex, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2010. MethodsFor each of the following diseases we performed systematic literature reviews and analysed the resulting data using a negative binomial Bayesian meta-regression tool: eczema, psoriasis, acne vulgaris, pruritus, alopecia areata, decubitus ulcer, urticaria, scabies, fungal skin diseases, impetigo, abscess and other bacterial skin diseases, cellulitis, viral warts, molluscum contagiosum, and non-melanoma skin cancer. Once estimates of disease prevalence were generated, we determined appropriate disability attributable to that disease and applied GBD 2010 disability weights to determine non-fatal burden. FindingsThree skin conditions are in the top ten most prevalent diseases worldwide, and eight fall into the top 50. When considered collectively, skin conditions range from being the second to the 11th leading causes of years lived with disability at the country level for 2010 and from the third to the 28th leading causes of disability-adjusted life-years. InterpretationUsing more data than have ever been used previously, novel methods, and a more parsimonious choice of disease categories, we found that skin conditions are widespread, and the burden due to these diseases is enormous. Such a burden is particularly large for a field that receives relatively little attention in global health. These results suggest an urgent need for the inclusion of skin disease prevention and treatment in future global health efforts. FundingBill & Melinda Gates Foundation.