Melissa R Laughter1, Mayra B C Maymone1, Chante Karimkhani1, Chandler Rundle1, Sophia Hu1, Sophia Wolfe1, Katrina Abuabara2, Parker Hollingsworth3, Gil S Weintraub1, Cory A Dunnick1, Adnan Kisa4,5, Giovanni Damiani6,7, Aziz Sheikh8, Jasvinder A Singh9,10,11, Takeshi Fukumoto12,13, Rupak Desai14, Ayman Grada15, Irina Filip16, Amir Radfar17, Mohsen Naghavi18, Robert P Dellavalle1. 1. Department of Dermatology, University of Colorado School of Medicine, Denver. 2. Department of Dermatology, University of California San Francisco, San Francisco. 3. Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts. 4. School of Health Sciences, Kristiania University College, Oslo, Norway. 5. Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana. 6. Department of Dermatology, Case Western Reserve University, Cleveland, Ohio. 7. Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 8. Usher Institute, The University of Edinburgh, Edinburgh, Scotland. 9. Medicine Service, Veterans Affairs Medical Center, Birmingham, Alabama. 10. Department of Medicine at the School of Medicine, University of Alabama at Birmingham, Birmingham. 11. Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham. 12. Kobe University Graduate School of Medicine, Division of Dermatology, Department of Internal Related, Kobe, Japan. 13. Gene Expression and Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania. 14. Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia. 15. Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts. 16. Kaiser Permanente, Ontario, California. 17. College of Medicine, University of Central Florida, Orlando. 18. Institute of Health Metrics and Evaluation, University of Washington, Seattle.
Abstract
Importance: Skin and subcutaneous diseases affect the health of millions of individuals in the US. Data are needed that highlight the geographic trends and variations of skin disease burden across the country to guide health care decision-making. Objective: To characterize trends and variations in the burden of skin and subcutaneous tissue diseases across the US from 1990 to 2017. Design, Setting, and Participants: For this cohort study, data were obtained from the Global Burden of Disease (GBD), a study with an online database that incorporates current and previous epidemiological studies of disease burden, and from GBD 2017, which includes more than 90 000 data sources such as systematic reviews, surveys, population-based disease registries, hospital inpatient and outpatient data, cohort studies, and autopsy data. The GBD separated skin conditions into 15 subcategories according to incidence, prevalence, adequacy of data, and standardized disease definitions. GBD 2017 also estimated the burden from melanoma of the skin and keratinocyte carcinoma. Data analysis for the present study was conducted from September 9, 2019, to March 31, 2020. Main Outcomes and Measures: Primary study outcomes included age-standardized disability-adjusted life-years (DALYs), incidence, and prevalence. The data were stratified by US states with the highest and lowest age-standardized DALY rate per 100 000 people, incidence, and prevalence of each skin condition. The percentage change in DALY rates in each state was calculated from 1990 to 2017. Results: Overall, age-standardized DALY rates for skin and subcutaneous diseases increased from 1990 (821.6; 95% uncertainty interval [UI], 570.3-1124.9) to 2017 (884.2; 95% UI, 614.0-1207.9) in all 50 states and the District of Columbia. The degree of increase varied according to geographic location, with the largest percentage change of 0.12% (95% UI, 0.09%-0.15%) in New York and the smallest percentage change of 0.04% (95% UI, 0.02%-0.07%) in Colorado, 0.04% (95% UI, 0.01%-0.06%) in Nevada, 0.04% (95% UI, 0.02%-0.07%) in New Mexico, and 0.04% (95% UI, 0.02%-0.07%) in Utah. The age-standardized DALY rate, incidence, and prevalence of specific skin conditions differed among the states. New York had the highest age-standardized DALY rate for skin and subcutaneous disease in 2017 (1097.0 [95% UI, 764.9-1496.1]), whereas Wyoming had the lowest age-standardized DALY rate (672.9 [95% UI, 465.6-922.3]). In all 50 states and the District of Columbia, women had higher age-standardized DALY rates for overall skin and subcutaneous diseases than men (women: 971.20 [95% UI, 676.76-1334.59] vs men: 799.23 [95% UI, 559.62-1091.50]). However, men had higher DALY rates than women for malignant melanoma (men: 80.82 [95% UI, 51.68-123.18] vs women: 42.74 [95% UI, 34.05-70.66]) and keratinocyte carcinomas (men: 37.56 [95% UI, 29.35-49.52] vs women: 14.42 [95% UI, 10.01-20.66]). Conclusions and Relevance: Data from the GBD suggest that the burden of skin and subcutaneous disease was large and that DALY rate trends varied across the US; the age-standardized DALY rate for keratinocyte carcinoma appeared greater in men. These findings can be used by states to target interventions and meet the needs of their population.
Importance: Skin and subcutaneous diseases affect the health of millions of individuals in the US. Data are needed that highlight the geographic trends and variations of skin disease burden across the country to guide health care decision-making. Objective: To characterize trends and variations in the burden of skin and subcutaneous tissue diseases across the US from 1990 to 2017. Design, Setting, and Participants: For this cohort study, data were obtained from the Global Burden of Disease (GBD), a study with an online database that incorporates current and previous epidemiological studies of disease burden, and from GBD 2017, which includes more than 90 000 data sources such as systematic reviews, surveys, population-based disease registries, hospital inpatient and outpatient data, cohort studies, and autopsy data. The GBD separated skin conditions into 15 subcategories according to incidence, prevalence, adequacy of data, and standardized disease definitions. GBD 2017 also estimated the burden from melanoma of the skin and keratinocyte carcinoma. Data analysis for the present study was conducted from September 9, 2019, to March 31, 2020. Main Outcomes and Measures: Primary study outcomes included age-standardized disability-adjusted life-years (DALYs), incidence, and prevalence. The data were stratified by US states with the highest and lowest age-standardized DALY rate per 100 000 people, incidence, and prevalence of each skin condition. The percentage change in DALY rates in each state was calculated from 1990 to 2017. Results: Overall, age-standardized DALY rates for skin and subcutaneous diseases increased from 1990 (821.6; 95% uncertainty interval [UI], 570.3-1124.9) to 2017 (884.2; 95% UI, 614.0-1207.9) in all 50 states and the District of Columbia. The degree of increase varied according to geographic location, with the largest percentage change of 0.12% (95% UI, 0.09%-0.15%) in New York and the smallest percentage change of 0.04% (95% UI, 0.02%-0.07%) in Colorado, 0.04% (95% UI, 0.01%-0.06%) in Nevada, 0.04% (95% UI, 0.02%-0.07%) in New Mexico, and 0.04% (95% UI, 0.02%-0.07%) in Utah. The age-standardized DALY rate, incidence, and prevalence of specific skin conditions differed among the states. New York had the highest age-standardized DALY rate for skin and subcutaneous disease in 2017 (1097.0 [95% UI, 764.9-1496.1]), whereas Wyoming had the lowest age-standardized DALY rate (672.9 [95% UI, 465.6-922.3]). In all 50 states and the District of Columbia, women had higher age-standardized DALY rates for overall skin and subcutaneous diseases than men (women: 971.20 [95% UI, 676.76-1334.59] vs men: 799.23 [95% UI, 559.62-1091.50]). However, men had higher DALY rates than women for malignant melanoma (men: 80.82 [95% UI, 51.68-123.18] vs women: 42.74 [95% UI, 34.05-70.66]) and keratinocyte carcinomas (men: 37.56 [95% UI, 29.35-49.52] vs women: 14.42 [95% UI, 10.01-20.66]). Conclusions and Relevance: Data from the GBD suggest that the burden of skin and subcutaneous disease was large and that DALY rate trends varied across the US; the age-standardized DALY rate for keratinocyte carcinoma appeared greater in men. These findings can be used by states to target interventions and meet the needs of their population.
Authors: Christopher J L Murray; Majid Ezzati; Abraham D Flaxman; Stephen Lim; Rafael Lozano; Catherine Michaud; Mohsen Naghavi; Joshua A Salomon; Kenji Shibuya; Theo Vos; Daniel Wikler; Alan D Lopez Journal: Lancet Date: 2012-12-15 Impact factor: 79.321
Authors: Roderick J Hay; Nicole E Johns; Hywel C Williams; Ian W Bolliger; Robert P Dellavalle; David J Margolis; Robin Marks; Luigi Naldi; Martin A Weinstock; Sarah K Wulf; Catherine Michaud; Christopher J L Murray; Mohsen Naghavi Journal: J Invest Dermatol Date: 2013-10-28 Impact factor: 8.551
Authors: Gretchen A Stevens; Leontine Alkema; Robert E Black; J Ties Boerma; Gary S Collins; Majid Ezzati; John T Grove; Daniel R Hogan; Margaret C Hogan; Richard Horton; Joy E Lawn; Ana Marušić; Colin D Mathers; Christopher J L Murray; Igor Rudan; Joshua A Salomon; Paul J Simpson; Theo Vos; Vivian Welch Journal: Lancet Date: 2016-06-28 Impact factor: 79.321
Authors: Chante Karimkhani; Robert P Dellavalle; Luc E Coffeng; Carsten Flohr; Roderick J Hay; Sinéad M Langan; Elaine O Nsoesie; Alize J Ferrari; Holly E Erskine; Jonathan I Silverberg; Theo Vos; Mohsen Naghavi Journal: JAMA Dermatol Date: 2017-05-01 Impact factor: 10.282
Authors: Ines B Moura; Ayman Grada; William Spittal; Emma Clark; Duncan Ewin; James Altringham; Emilio Fumero; Mark H Wilcox; Anthony M Buckley Journal: Front Microbiol Date: 2022-05-31 Impact factor: 6.064
Authors: Wouter H van der Valk; Sara A Serdy; CiCi Deakin; Jiyoon Lee; Jin Kim; Anh Phuong Le; Karl R Koehler Journal: Nat Protoc Date: 2022-03-23 Impact factor: 17.021
Authors: Bart Sturm; David Creytens; Jan Smits; Ariadne H A G Ooms; Erik Eijken; Eline Kurpershoek; Heidi V N Küsters-Vandevelde; Carla Wauters; Willeke A M Blokx; Jeroen A W M van der Laak Journal: Diagnostics (Basel) Date: 2022-02-08
Authors: Salvador González; José Aguilera; Brian Berman; Piergiacomo Calzavara-Pinton; Yolanda Gilaberte; Chee-Leok Goh; Henry W Lim; Sergio Schalka; Fernando Stengel; Peter Wolf; Flora Xiang Journal: Front Med (Lausanne) Date: 2022-03-31
Authors: Filipa A L S Silva; Raquel Costa-Almeida; Licínia Timochenco; Sara I Amaral; Soraia Pinto; Inês C Gonçalves; José R Fernandes; Fernão D Magalhães; Bruno Sarmento; Artur M Pinto Journal: Materials (Basel) Date: 2021-05-25 Impact factor: 3.623