The worldwide burden of skin diseases: Lessons from the Global Burden of Disease data

Skin diseases represent a major public health concern, affecting all demographics and imposing significant personal, economic and social burdens.

To assess the epidemiology and impact of skin diseases using the Global Burden of Disease (GBD) data, highlighting regional variations, knowledge gaps and areas for improvement.

GBD data on prevalence, incidence, disability-adjusted life years (DALYs) and years lived with disability (YLDs) for skin conditions from 2000 to 2021 were analysed.

According to GBD 2021, the global prevalence of skin and subcutaneous diseases, excluding sexually transmitted infections (STIs) and skin cancers, was 25.7%, ranking sixth among the most prevalent disease categories worldwide. These conditions accounted for a global YLDs rate of 495.1 per 100,000 person-years, placing them eighth in terms of disease burden. Overall, the most prevalent conditions were STIs excluding HIV (16.8%), fungal infections (7.8%), and acne (3.0%). Squamous cell carcinoma, basal cell carcinoma and decubitus ulcers showed increasing prevalence, while atopic dermatitis, scabies and viral infections declined slightly. Acne, scabies and atopic dermatitis predominated in youth, whereas fungal infections, contact dermatitis and skin cancers predominated in older adults. Females showed higher prevalence of STIs, acne and atopic dermatitis. Infectious skin diseases were more common in Sub-Saharan Africa and tropical regions, while chronic inflammatory and neoplastic diseases predominated in high-income regions.

Several limitations were identified. The GBD initiative only includes some dermatological diseases reflecting the difficulties in obtaining data because of the multitude of skin diseases with underreporting and misdiagnosis. There are significant gaps in data from low- and middle-income countries, a lack of reliable trends and inadequate quality-adjusted life year estimates considering cultural and social variations. The GBD initiative provides valuable insights but underestimates the true burden of skin diseases. Improved reporting and inclusion of neglected conditions are urgently needed through global collaboration among stakeholders.