Mohammad KA Basra; Muhammad Shahrukh


Expert Rev Pharmacoeconomics Outcomes Res. 2009;9(3):271-283. 

In This Article

Burden of Skin Diseases

As mentioned earlier, skin diseases are very common health problems worldwide. A community-based study in the USA found that a third of the population had a skin condition needing a single visit to a physician.[2] At the same time it should be remembered that almost 73% of people affected with skin disorder do not seek medical advice.[3] This may be influenced by the availability of different health systems in different countries, such as the free health care offered by the National Health Service in the UK versus a health insurance system in a number of other countries such as the USA.

There are no geographical limitations and boundaries of skin diseases. However, there are some variations in the distribution of types and frequencies of their occurrence. For example, infections and infestations are more common in the developing countries whereas, owing to a particular skin type, skin cancers are more prevalent in the developed coutries.

The burden of a disease is defined as the effects of the disease on the overall welfare of the population, which can be assessed from the viewpoints of the individual, the family and the society.[4] Components can be either economical (related to costs incurred or income lost) or noneconomical (related to survival and wellbeing). The metrics of impairment, disability and handicap are difficult to generate, direct and interpret.[4] The effects of a disease on an individual's well-being can be conceived as related to the impairment, disability or handicap caused by the disease.[4] A comprehensive assessment of handicap requires input from patients themselves, since clinicians are not able to predict accurately the QoL effects of their patient's conditions.[5] The measurement of the burden of skin diseases not only requires the traditional methods for calculating incidence and mortality but an accurate evaluation of other aspects of health, such as psychological, social and economical burdens.

In the General Household survey of 1978, chronic skin diseases were found to have prevented the activity of 0.34% of the population.[6] A further survey in 1989 concluded that 32% of the population was troubled by a long-standing skin disorder that might have limited their routine activities.[7] In this survey, 16 out of every 1000 people (~0.5% of the population) registered a complaint of skin disease, which, in children, was second to only respiratory disorders.[7] However, since both of these surveys were carried out in the UK-based health system, their findings may not be generalizable to other health systems such as in the Scandinavian countries, Germany, France or Italy.

The Lambeth study, the only study in the UK that estimated the prevalence of skin diseases in the general population, found that 55% of the population had some form of skin disease and only 22.5% actually had received medical attention.[8] According to a US study, the skin diseases were among the top 15 groups of medical conditions, with a financial toll estimated at US$39.3 billion per year in medical services and lost productivity.[1] Also in general practice, dermatology patients constitute a significant burden; out of 11191 patients seen during a 5 year period, 21% had some form of skin disease with the percentage increasing from 16% in 1989 to 37% in 1994.[9] Among school-aged children (primary and secondary school), out of 1006 students, 31.3% were shown to have one or more skin disorders.[10]


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