Dermatology: a public health perspective

Dermatology is a branch of medicine which is related to the diagnosis, treatment and prevention of the diseases and disorders that affect the skin and its appendages including hair, nail, sweat glands and mucosal surfaces of mouth and external genitalia. There are about 3000 clinical entities in the field of dermatology, which are very diverse in terms of their etiologies. Although some of these diseases are really prevalent and some others of them have high incidence rates and acknowledging that because of their visibility in many cases they are associated with stress, anxiety and impairment of patients' quality of lives, their resultant burden of disease at individual, familial and social levels are usually ignored. Herein, we provide some examples of the adverse public health and health economics effects of different dermatological diseases and disorders in different countries and populations. We also provide some reasons for this negligence and suggest some strategies to tackle this problem

Safety and efficacy of tacrolimus 0.03% ointment in the treatment of atopic dermatitis: a randomized, double-blind, placebo controlled clinical trial

Atopic dermatitis [AD] is a chronic, relapsing, pruritic skin disease more common in infancy and childhood. Emollients, topical corticosteroids, and avoidance of irritating factors are the mainstay of its treatment, but fear of side effects has limited the use of topical corticosteroids. The objective of this study was to evaluate the safety and efficacy of topical tacrolimus 0.03% ointment in the treatment of AD. In this randomized, double-blind, clinical trial, 76 patients with AD older than 2 years were randomly allocated in two groups and treated with either tacrolimus 0.03% ointment [Abu-Rayhan Co., Iran] or placebo, twice a day for 6 weeks. Responses to treatment were compared every 2 weeks using SCORAD. Twenty-nine patients in tacrolimus group and 26 in placebo group completed the trial. The reduction in SCORAD after 2 and 4 weeks in tacrolimus group was significantly higher than placebo group [P<0.05]. The frequency of treatment-induced pruritus and burning sensation was similar in both groups but erythema was more observed in the placebo group [P<0.05]. Tacrolimus 0.03% ointment is more effective than placebo in the treatment of AD