Assessing skin disease and associated health-related quality of life in a rural Lao community.

BACKGROUND: Skin diseases are common and often have an impact on an individual's health-related quality of life. In rural communities where access to healthcare may be limited and individuals rely on farming for food and income, the impact of skin diseases may be greater. The objectives for this study were to perform an assessment of skin disease prevalence in a rural village in Laos and assess the associated impact of any skin disease found using the Dermatology Life Quality Index (DLQI). METHODS: A rural village was purposively selected and 340 participants examined by dermatologists over a four day period. Brief questionnaires were performed, followed by full body skin examinations and DLQI questionnaires completed were relevant. The data were analysed using chi square and Wilcoxon signed rank tests. RESULTS: One hundred and eighty-one participants were found to have a skin disease (53%). The six most common skin diseases were: eczema (22%), dermatophyte infections (19%), acne (10%), scabies infestation (9%), melasma (8%) and pityriasis versicolor (4%). Just over half of those with skin disease (51%) completed the DLQI, with scores ranging from 0 to 24. Those with skin problems on examination were significantly more likely to be farmers, have had a previous skin problem, be older or live in a smaller family. Conclusions This study represents the first formal documentation of skin disease prevalence in Laos and establishes the high rate of skin disease in the rural community and the associated impact these diseases have on health-related quality of life.

Knowledge, perception, and practice of patients about pityriasis versicolor in Kaduna, North Central Nigeria.

BACKGROUND: Although pityriasis versicolor (PV) is a common fungal infection of the skin affecting up to 50% of the population in the tropics, little is known about what patients know, believe, or feel about the condition. METHODS: In a cross-sectional questionnaire study of 608 consecutive patients attending the General Outpatient Department and Skin Clinic of a public hospital in Kaduna, Nigeria, self-report of PV, knowledge about its causes, treatments used by patients, and perception and feelings about the condition were assessed. RESULTS: Overall 608 patients were studied (239/594 [40.2%] males, 355/594 [59.8%] females, age 11-49 years, mean ± SD age of 29.3 ± 10.1). Lifetime self-report prevalence of PV was 271/606 (44.7%) (males: 117/239 [50.0%] females: 148/355 [41.7%] P = 0.09). Three hundred and twenty-seven of 608 (53.8%) patients believed PV was transmitted from another person while 204/608 (33.6%) believed the condition was caused by poor personal hygiene. One hundred and thirty of 608 (21.4%) thought PV was caused by fungi living on the skin. Virtually all respondents who had PV had used at least one preparation with more than half visiting a healthcare facility. A total of 305/608 (50.2%), 189/608 (31.1%), and 142/608 (23.4%) respondents reported feeling or likely feeling uncomfortable, embarrassed, or ashamed, respectively, about PV. Being considered a dirty person (45.6%) and being avoided by other people (28%) were common concerns of respondents. CONCLUSION: Most patients did not know what caused PV, and many were uncomfortable, embarrassed, and ashamed, and feared being considered dirty and avoided by others.

A case control study of psychiatric morbidities among subjects with leprosy in Lagos, Nigeria.

OBJECTIVES: To determine the pattern of psychiatric morbidity prevalent among leprosy patients and to compare it with two control groups; those suffering from Tinea vesicolor and Normal subjects. DESIGN: Eighty-eight leprosy patients were matched for age and sex with those suffering from Tinea vesicolor as well as normal subjects. The subjects were assessed for psychiatric morbidity through a clinical interview with PSE-9. RESULTS: The prevalence of psychiatric morbidity among leprosy patients (580/1000) was significantly more than those with tinea vesicolor patients (182/1000) and normal subjects (148/1000) (p < 0.05). Depressive illness was the most common diagnosis in the three groups. CONCLUSIONS: Leprosy patients are more likely to manifest with psychiatric illness than those suffering from Tinea vesicolor and normal subjects.

The Explanatory Model Interview Catalogue (EMIC). Contribution to cross-cultural research methods from a study of leprosy and mental health.

The Explanatory Model Interview Catalogue (EMIC) has been developed to elicit illness-related perceptions, beliefs, and practices in a cultural study of leprosy and mental health in Bombay. Leprosy is an especially appropriate disorder for studying the inter-relationship of culture, mental health and medical illness because of deeply rooted cultural meanings, the emotional burden, and underuse of effective therapy. Fifty per cent of 56 recently diagnosed leprosy out-patients, 37% of 19 controls with another stigmatised dermatological condition (vitiligo), but only 8% of 12 controls with a comparable non-stigmatised condition (tinea versicolor) met DSM-III-R criteria for an axis I depressive, anxiety or somatoform disorder. Belief in a humoral (traditional) cause of illness predicted better attendance at clinic.

Anxiety and skin diseases.

The purpose of this investigation was to determine if a relationship exists between anxiety and skin diseases. It was hypothesized that subjects wtih different dermatoses would have different anxiety levels. Subjects with the following skin diseases were compared: atopic dermatitis, cystic acne, noncystic acne, tinea versicolor, and pityriasis rosea. Anxiety levels were measured by use of the State-Trait Anxiety Inventory (STAI). The STAI consists of two twenty-item self-report rating scales for two types of anxiety: A-State anxiety, which is transitory or situational, and A-Trait anxiety, which is chronic or an enduring personality trait. A one-way analysis of variance revealed significant differences between the aforementioned groups in both A-State and A-Trait anxiety, with the mean elevations highest in the subjects with disfiguring acne (cystic) and intolerably prurific eczema (atopic dermatitis).