Skin Diseases A Major Cause of Disability Worldwide Interview with:

Chante Karimkhani, MD University Hospitals Case Western Medical Center, Cleveland, Ohio now with Department of Dermatology University of Colorado, Denver

Dr. Karimkhani

Chante Karimkhani, MD
University Hospitals Case Western Medical Center, Cleveland, Ohio
now with Department of Dermatology
University of Colorado, Denver What is the background for this study? What are the main findings?

Response: Ranging from benign inflammatory to infectious, autoimmune, and malignant conditions, skin diseases cause significant disfigurement, pain, and psychological morbidity. The Global Burden of Disease (GBD) Study 2013 is a large-scale epidemiological assessment of burden from 306 diseases in 195 countries, both sexes, and 14 age groups. Disease burden is measured by combining morbidity and mortality into a single metric of disability-adjusted life years (DALYs), where one DALY is equivalent to one year of healthy life lost. Skin diseases contributed 1.79% of the total global burden from all diseases.

The skin diseases arranged in order of decreasing global DALYs are: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma (basal and squamous cell carcinomas), decubitus ulcer, and alopecia areata. Younger populations had the greatest burden from infectious skin conditions, while acne caused the greatest burden in the second and third decades of life. Elderly populations had the greatest DALY rates from melanoma and keratinocyte carcinoma. Skin conditions also exhibit distinct geographical patterns of disease burden. What should readers take away from your report?

Response: Skin diseases are a major cause of disability worldwide. Just as skin disease represent a diverse set pathologies, the impact of these diseases have important effects on particular world populations and age groups. A high-quality and objective measure of burden, such as the DALY, allows for comparison of diverse diseases across geography and time. What recommendations do you have for future research as a result of this study?

Response: Estimates from the Global Burden of Disease study are based on diverse data sources from around the world including systematic reviews, surveys, population-based disease registries, hospital inpatient data, outpatient data, cohort studies, and autopsy data. Continual efforts are underway to collect high-quality data from areas where literature and current data are sparse. In an increasingly globalized world, epidemiological understanding of the burden of skin disease is truly an international collaboration. Global Burden of Disease metrics have far-reaching potential to impact public policy, research prioritization process, and clinical practice. Is there anything else you would like to add?

Response: The Global Burden of Disease Study is supported, in part, by the Bill and Melinda Gates Foundation, which had no role in the design or conduct of the study. Thank you for your contribution to the community.


Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, Nsoesie EO, Ferrari AJ, Erskine HE, Silverberg JI, Vos T, Naghavi M. Global Skin Disease Morbidity and MortalityAn Update From the Global Burden of Disease Study 2013. JAMA Dermatol. Published online March 01, 2017. doi:10.1001/jamadermatol.2016.5538

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 7, 2017 by Marie Benz MD FAAD