Mortality from nonneoplastic skin disease in the United States.
BACKGROUND
The mortality burden from nonneoplastic skin disease in the United States is unknown.


OBJECTIVE
We sought to estimate mortality from nonneoplastic skin disease as underlying and contributing causes of death.


METHODS
Population-based death certificate data detailing mortality from nonneoplastic skin disease for years 1999 to 2009 were used to calculate absolute numbers of death and age-adjusted mortality by year, patient demographics, and 10 most commonly reported diagnoses.


RESULTS
Nonneoplastic skin diseases were reported as underlying and contributing causes of mortality for approximately 3948 and 19,542 patients per year, respectively. Age-adjusted underlying cause mortality (per 100,000 persons) were significantly greater (P < .0001) for patients who were black/African American (3.4), women (1.4), and residing in the South (1.6). Most deaths occurred in patients ages 65 years and older (34,248 total deaths). Common underlying causes of death included chronic ulcers (1789 deaths/y) and cellulitis (1348 deaths/y).


CONCLUSIONS
Errors in death certificate data and inability to adjust for patient-level confounders may limit the accuracy and generalizability of our results.


CONCLUSIONS
Mortality from nonneoplastic skin disease is uncommon yet potentially preventable. The elderly bear the greatest burden of mortality from nonneoplastic skin disease. Chronic ulcers and cellulitis constitute frequent causes of death.
Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut; Veterans Administration (VA) Connecticut Healthcare System, New Haven, Connecticut. Electronic address: jason.lott@yale.edu.
Jason P
JP
Lott
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut.
Cary P
CP
Gross
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002481:Cellulitis / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012871:Skin Diseases / Q000401:mortality*; D012883:Skin Ulcer / Q000401:mortality; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
CDC; Centers for Disease Control and Prevention; NCHS; National Center for Health Statistics; WONDER; Wide-ranging Online Data for Epidemiologic Research; death certificate; dermatology; epidemiology; health disparities; mortality; outcomes; public health; skin disease; vital statistics