Skin diseases in indigenous population: retrospective epidemiological study at Xingu Indigenous Park (XIP) and review of the literature.

BACKGROUND: Skin diseases among indigenous populations have been poorly described in the literature. Risk factors linked to habits, cultural practices, genetics, and environmental characteristics can influence the frequency and clinical presentation of these diseases. METHODS: This was a cross-sectional study conducted through a review of dermatological medical records. Data were obtained over three visits to Xingu Indigenous Park (XIP). Main dermatoses were compared by gender, age, ethnicity, and village. Diseases were classified into four groups: infectious, inflammatory, neoplastic, and other. RESULTS: Of the 398 patients included in the study, 54.2% were female. The participants ranged in age from 1 to 75 years (median, 10 years). The predominant ethnic group was Caiabi (49.7%), followed by Ikpeng (14.3%) and Kamaiurá (10.0%). The primary village studied was Diauarum, followed by Moigú and Morena. Infectious dermatoses were the most frequent (43.8%), followed by inflammatory (33.7%), neoplastic (15.5%), and other skin diseases (7.0%). Infectious diseases were predominant in Caiabi and Kamaiurá Indians, whereas inflammatory skin diseases were more frequent in Ikpeng and Juruna populations. We also observed a high frequency of malignancy in the Ikpeng and Trumai ethnic groups. Infectious skin diseases, except for fungal infections, were frequent in younger age groups. This trend was not replicated for neoplastic skin diseases. Uncommon dermatoses such as Heck's disease, lichen striatus, and aquagenic urticaria were also observed. Jorge Lobo's disease was not included in this analysis. CONCLUSION: Improved knowledge of the distribution of common dermatoses among different ethnic groups and villages in XIP will aid in the prevention of skin infections and skin cancer. This improved knowledge will also allow the development of skin disease guidelines that can help local indigenous health professionals.

Refining the ideas of "ethnic" skin.

Skin disease occur worldwide, affecting people of all nationalities and all skin types. These diseases may have a genetic component and may manifest differently in specific population groups; however, there has been little study on this aspect. If population-based differences exist, it is reasonable to assume that understanding these differences may optimize treatment. While there is a relative paucity of information about similarities and differences in skin diseases around the world, the knowledge-base is expanding. One challenge in understanding population-based variations is posed by terminology used in the literature: including ethnic skin, Hispanic skin, Asian skin, and skin of color. As will be discussed in this article, we recommend that the first three descriptors are no longer used in dermatology because they refer to nonspecific groups of people. In contrast, "skin of color" may be used - perhaps with further refinements in the future - as a term that relates to skin biology and provides relevant information to dermatologists.

Refining the ideas of "ethnic" skin

Abstract: Skin disease occur worldwide, affecting people of all nationalities and all skin types. These diseases may have a genetic component and may manifest differently in specific population groups; however, there has been little study on this aspect. If population-based differences exist, it is reasonable to assume that understanding these differences may optimize treatment. While there is a relative paucity of information about similarities and differences in skin diseases around the world, the knowledge-base is expanding. One challenge in understanding population-based variations is posed by terminology used in the literature: including ethnic skin, Hispanic skin, Asian skin, and skin of color. As will be discussed in this article, we recommend that the first three descriptors are no longer used in dermatology because they refer to nonspecific groups of people. In contrast, "skin of color" may be used - perhaps with further refinements in the future - as a term that relates to skin biology and provides relevant information to dermatologists.

Skin diseases in internationally adopted children.

Internationally adopted children often present diseases contracted in the country of origin. Skin diseases are common in new arrivals, and diagnosis may prove challenging for GPs or even dermatologists if they are inexperienced in the extensive geographic and ethnic diversity of international adoptees. To analyse the frequency and characteristics of skin diseases in international adoptees. In total, 142 adoptees were evaluated for a cross-sectional cohort study. The most frequent diseases observed at arrival were dermatological conditions. Of the adoptees, 70% presented at least one skin disease, of which 57.5% were infectious; Tinea capitis being the most frequent (n = 42). The recovery rate of Tinea capitis was 89% (n = 32/36). Ten cases of scabies were diagnosed. Other diseases included viral skin infection (n = 22), with 16 cases of Molluscum contagiosum and bacterial infection. Skin diseases are very common in internationally adopted children. There is a need for close collaboration between dermatologists and paediatricians to diagnose such infections, as well as clear guidelines to treat them.

Epidemiology of sarcoidosis in Afro-Caribbean people: a 7-year retrospective study in Guadeloupe.

BACKGROUND: There are no reliable epidemiological data on sarcoidosis in the French West Indies, although this disease is known to be more frequent and more severe in Black African-Americans and West Indians. OBJECTIVES: This retrospective study aimed to assess the incidence and prevalence of sarcoidosis in Guadeloupe over a 7-year period and to determine its epidemiological, clinical, and evolutionary characteristics. METHODS: Patients were identified through the computerized databases of the three pathology laboratories and two hospitals on the islands of Guadeloupe. Histologically proven cases of sarcoidosis were selected. All patients were recalled at a single study time-point. RESULTS: A total of 75 patients were identified. These included 44 women and 31 men (sex ratio: 1.4), with a mean ± standard deviation (SD) age of 47 ± 14 years and Fitzpatrick skin types IV-VI. The average incidence was 2.28 per 100,000 inhabitants per year (95% confidence interval [CI] 1.69-3.02). The prevalence of sarcoidosis in 2009 was 21.09 per 100,000 inhabitants (95% CI 16.00-26.18). Most patients (61/71, 85.9%) exhibited multiple organ involvement; the mean ± SD number of organs involved was 2.6 ± 1.1. The initiation of systemic therapy was required in 75.7% of cases. Several lines of treatment were necessary in 41.5% of affected patients. At the study time-point, seven patients were found to have died. Four of these deaths were directly attributable to sarcoidosis (mortality rate: 5.3%). CONCLUSIONS: This epidemiological study on sarcoidosis in Guadeloupe reveals a low incidence of the disease and a high degree of severity as evidenced by the average number of affected organs, the high frequency of extrathoracic organ involvement, the frequent use of corticosteroids, and a mortality rate of 5.3%.

A prospective study of cutaneous findings in newborns in the United States: correlation with race, ethnicity, and gestational status using updated classification and nomenclature.

OBJECTIVE: To provide incidence data based on ethnicity, prematurity, and body site for vascular, pigmented, and other common congenital cutaneous findings; to compare these results with previously published prospective studies; and to define updated nomenclature, classification, clinical course, and prognostic factors for the pediatric practitioner to promote a better understanding of benign versus more worrisome birthmarks. STUDY DESIGN: This prospective study enrolled 594 infants in San Diego, California. Cutaneous examination was performed by pediatric dermatologists in the first 48 hours of life, with subsequent longitudinal contact via telephone, and repeat evaluations if any new lesions were reported by parents. Incidence rates were calculated by ethnicity and prematurity status. RESULTS: The most common vascular lesion was nevus simplex (83%), followed by infantile hemangioma (4.5% by age 3 months), capillary malformation (0.3%), and rapidly involuting congenital hemangioma (0.3%). Pigmented lesions seen at birth included dermal melanocytosis (20%), congenital melanocytic nevi (2.4%), and café au lait macules (2%). Other common skin findings were erythema toxicum neonatorum (7%), milia (8%), and sebaceous gland hyperplasia (42.6%). CONCLUSION: This study of congenital cutaneous lesions, using current nomenclature and data acquired by pediatric cutaneous lesion experts, provides data regarding the role of race and ethnicity in the incidence of birthmarks, and provides valid data on the prevalence of infantile hemangioma.

Patología cutánea en piel polinésica: Isla de Pascua, Chile / Skin diseases in Polynesian: Easter Island, Chile

La Isla Rapa Nui se encuentra ubicada en el Océano Pacífico, presentando un clima subtropical oceánico. No existen registros sobre la patología cutánea de la isla. El objetivo del trabajo es establecer la prevalencia y distribución de las patologías cutáneas presentes en la población Rapa Nui. Se realizó un estudio descriptivo transversal con un muestreo por conveniencia, en el hospital Hanga Roa en agosto 2009. La muestra consistió en 131 isleños, 66 por ciento mujeres y 34 por ciento hombres. Los tumores pigmentarios y la patología infecciosa (micosis) fueron las patologías más prevalentes. Cuatro pacientes presentaron queratosis actínicas y otros cuatro carcinomas basocelulares (CBC).

The Easter Island is located in the south pacific, and has a subtropical weather. There are no records about skin diseases in the island. The purpose of this study is to describe the distribution and prevalence of skin diseases in the islanders. A cross sectional study was designed with a convenience sampling at Hanga Roa's Hospital in August 2009. The sampling was 131 islanders, 66 percent women and 34 percent men. Pigmentary tumors and infectious diseases (mycosis) where the most prevalent diseases. Four patients presented actinic keratosis and four basal cell carcinoma (BCC).

Skin damage occurs early in systemic lupus erythematosus and independently of disease duration in Brazilian patients.

To determine if skin damage is related to disease duration in Brazilian patients with SLE followed in a tertiary reference center through the application of standardized damage index (SLICC/ACR-DI). Sixty SLE patients were enrolled in this study. Relevant data were obtained through patients' interview, physical and laboratory examinations and review of the hospital records. The frequency and the different types of organ damage were determined using de SLICC/ACR-DI. Statistics were performed through chi-square and Student's t tests. Multivariate regression was used to correlate damage with disease duration. Forty-one (68.3%) patients presented any type of cumulative organ damage. The skin (35%), renal (23.3%) and neuropsychiatric (18.3%) systems were the most frequently involved, followed by peripheric vascular, ocular and cardiovascular systems. Non-Caucasoid patients and patients with longer disease duration had a slight tendency for greater organ damage (P = 0.05). Skin damage occurred independently of disease duration, whereas cardiovascular (P = 0.051), peripheral vascular (P = 0.057) and pulmonary damage (P = 0.06) had a tendency to occur more frequently in patients with longer disease duration. In this study, 68.3% of permanent damage was observed. An elevated frequency of skin damage was observed in this population which occurred independently of disease duration. Non-Caucasian patients had a tendency to present higher scores, but more studies are necessary to determine if ethnic or economic factors are involved.

Onchodermatitis--correlation between skin disease and parasitic load in an endemic focus in Ecuador.

Onchocerciasis is a chronic parasitic infection in which infiltration of the skin by microfilariae has been associated with a number of different pathological changes. This survey compared the prevalence of different forms of skin disease in two villages, one of which was located within the endemic zone for onchocerciasis (Zapallo Grande), in a lowland rain forest area of western Ecuador. The commonest skin diseases in both villages were scabies, pyoderma and pityriasis versicolor. In addition changes closely correlated with the presence of microfilariae in skin snips were found in Zapallo Grande--such as atrophic gluteal changes, and acute and chronic papular dermatitis. The only other skin disease associated with onchocerciasis was widespread tinea corporis due to T. rubrum. The Amerindians in the endemic onchocerciasis area were more likely than Negroes to have generalized atrophic changes of the skin, whereas in the latter group significant numbers of individuals had no obvious skin lesions but large numbers of microfilariae were detected in skin snips. Acute papular dermatitis was common in both groups and in biopsied lesions microfilariae could usually be identified within the epidermis or close to the dermo-epidermal junction. One patient had developed severe reactive onchodermatitis (Sowda). Swabs taken from onchocercal skin lesions showed no evidence of skin surface carriage of Staphylococcus aureus. Changes classically associated with onchocerciasis such as pretibial hypopigmentation (leopard skin) and hanging groin were notably absent in this population.