title: Global Skin Disease Morbidity and Mortality: An Update From the Global Burden of Disease Study 2013.
abstract: Disability secondary to skin conditions is substantial worldwide. The Global Burden of Disease Study 2013 includes estimates of global morbidity and mortality due to skin diseases.
  
  
  
  To measure the burden of skin diseases worldwide.
  
  
  
  For nonfatal estimates, data were found by literature search using PubMed and Google Scholar in English and Spanish for years 1980 through 2013 and by accessing administrative data on hospital inpatient and outpatient episodes. Data for fatal estimates were based on vital registration and verbal autopsy data.
  
  
  
  Skin disease data were extracted from more than 4000 sources including systematic reviews, surveys, population-based disease registries, hospital inpatient data, outpatient data, cohort studies, and autopsy data. Data metrics included incidence, prevalence, remission, duration, severity, deaths, and mortality risk.
  
  
  
  Data were extracted by age, time period, case definitions, and other study characteristics. Data points were modeled with Bayesian meta-regression to generate estimates of morbidity and mortality metrics for skin diseases. All estimates were made with 95% uncertainty intervals.
  
  
  
  Disability-adjusted life years (DALYs), years lived with disability, and years of life lost from 15 skin conditions in 188 countries.
  
  
  
  Skin conditions contributed 1.79% to the global burden of disease measured in DALYs from 306 diseases and injuries in 2013. Individual skin diseases varied in size from 0.38% of total burden for dermatitis (atopic, contact, and seborrheic dermatitis), 0.29% for acne vulgaris, 0.19% for psoriasis, 0.19% for urticaria, 0.16% for viral skin diseases, 0.15% for fungal skin diseases, 0.07% for scabies, 0.06% for malignant skin melanoma, 0.05% for pyoderma, 0.04% for cellulitis, 0.03% for keratinocyte carcinoma, 0.03% for decubitus ulcer, and 0.01% for alopecia areata. All other skin and subcutaneous diseases composed 0.12% of total DALYs.
  
  
  
  Skin and subcutaneous diseases were the 18th leading cause of global DALYs in Global Burden of Disease 2013. Excluding mortality, skin diseases were the fourth leading cause of disability worldwide.
authors.affiliation: University Hospitals Case Western Medical Center, Cleveland, Ohio2now with Department of Dermatology, University of Colorado, Denver.
authors.forename: Chante
authors.initials: C
authors.lastname: Karimkhani
authors.affiliation: Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Denver4University of Colorado School of Medicine, Aurora5Colorado School of Public Health, Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Dellavalle
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle7Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Luc E
authors.initials: LE
authors.lastname: Coffeng
authors.affiliation: Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, United Kingdom.
authors.forename: Carsten
authors.initials: C
authors.lastname: Flohr
authors.affiliation: Department of Dermatology, Kings College NHS Trust, London, United Kingdom.
authors.forename: Roderick J
authors.initials: RJ
authors.lastname: Hay
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Sinéad M
authors.initials: SM
authors.lastname: Langan
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Elaine O
authors.initials: EO
authors.lastname: Nsoesie
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle11School of Public Health, University of Queensland, Herston, Queensland, Australia12Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
authors.forename: Alize J
authors.initials: AJ
authors.lastname: Ferrari
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle11School of Public Health, University of Queensland, Herston, Queensland, Australia12Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Erskine
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois14Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois15Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Silverberg
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Naghavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D000071219:Global Burden of Disease; D014943:Global Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D012871:Skin Diseases / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D055815:Young Adult