Non-infectious skin disease in Indigenous Australians.

The burden of non-infectious skin disease in the Indigenous Australian population has not been previously examined. This study considers the published data on the epidemiology and clinical features of a number of non-infectious skin diseases in Indigenous Australians. It also outlines hypotheses for the possible differences in the prevalence of such diseases in this group compared with the general Australian population. There is a paucity of literature on the topic but, from the material available, Indigenous Australians appear to have a reduced prevalence of psoriasis, type 1 hypersensitivity reactions and skin cancer but increased rates of lupus erythematosus, kava dermopathy and vitamin D deficiency when compared to the non-Indigenous Australian population. This article profiles the prevalence and presentation of non-infectious skin diseases in the Indigenous Australian population to synthesise our limited knowledge and highlight deficiencies in our understanding.

Treatment-resistant elephantiasic thyroid dermopathy responding to rituximab and plasmapheresis.

A 44-year-old woman was diagnosed with Graves' disease in 1995 and over the following 12 months developed thyroid dermopathy (pretibial myxoedema). Despite being trialled on multiple recognized therapies over the course of 11 years, the patient's dermopathy progressively worsened. She developed ocular proptosis, elephantiasic thyroid dermopathy and acropachy in both hands. In mid 2006, the patient was started on rituximab and plasmapheresis, with rapid response. The patient's condition stabilized and in October 2009 at the age of 58 years she was able to cease therapy.

Dermatology outpatient population profiling: indigenous and non-indigenous dermatoepidemiology.

BACKGROUND: Little is known about the population using Australian dermatology outpatient services, in particular, Indigenous patients. This information is important to direct the strategic planning of dermatology services. METHODS: This study is a multicentre, retrospective audit of all patients attending public, outpatient dermatology clinics over 7 months across four Perth tertiary hospitals. The patient population (4873 patients) was profiled by age, gender, Indigenous status and rural/urban status. Medical records of the Indigenous patient population (104 patients) were reviewed to reveal the most common skin conditions. RESULTS: The population using public, outpatient services had a median age of 48 years, 51.4% were male and 13.6% were from rural areas. Male patient median age was 50 years compared to 45 years for female patients (P = 0.002). Indigenous patients had a median age of 22 years, a female to male ratio of 3:2 and 26.9% were from rural areas. Over 50% of Indigenous patient appointments were missed. Skin infections, eczematous conditions and naevi were the most common skin conditions in Indigenous patients. CONCLUSIONS: This data can guide strategies towards improving the provision of dermatology services for the Australian population. Particular attention is required towards improving Indigenous Australians' capacity to access dermatology services.