The burden of atopic dermatitis and bacterial skin infections among urban-living Indigenous children and young people in high-income countries: A systematic review.

BACKGROUND: A high burden of bacterial skin infections (BSI) is well documented in remote-living Indigenous children and young people (CYP) in high-income countries (HIC). Atopic dermatitis (AD) is the most common chronic inflammatory skin condition seen in CYP and predisposes to BSI. Despite the rate of urbanization for Indigenous people increasing globally, research is lacking on the burden of AD and BSI for urban-living Indigenous CYP in HIC. Indigenous people in HIC share a history of colonization, displacement and subsequent ongoing negative impacts on health. OBJECTIVE: To provide a global background on the burden of AD and BSI in urban-living Indigenous CYP in HIC. METHODS: A systematic review of primary observational studies on AD and BSI in English containing epidemiologic data was performed. MEDLINE, EMBASE, EMCARE, Web of Science, and PubMed databases were searched for articles between January 1990 and December 2021. RESULTS: From 2278 original manuscripts, 16 were included: seven manuscripts documenting eight studies on AD; and nine manuscripts documenting nine studies on BSI. Current and severe symptoms of AD were more common in urban-living Indigenous CYP in HIC compared with their non-Indigenous peers, with children having a higher prevalence than adolescents. Urban-living Indigenous CYP in HIC had a higher incidence of all measures of BSI compared with their non-Indigenous peers, and were over-represented for all measures of BSI compared with their proportion of the background population. Limitations include incomplete representation of all Indigenous populations in HIC. CONCLUSION: A significant burden of AD and BSI exists in urban-living Indigenous CYP in HIC.

Global Burden of Bacterial Skin Diseases: A Systematic Analysis Combined With Sociodemographic Index, 1990-2019.

Background: The latest incidence and disability-adjusted life-years (DALYs) of major bacterial skin diseases (BSD) and their relationship with socioeconomic are not readily available. Objective: Describe the global age-standardized incidence and DALYs rates of BSD and analyze their relationship with socioeconomic. Methods: All data were obtained from Global Burden of Disease (GBD) 2019 database. The correlation between BSD and socioeconomic development status was analyzed. Results: The age-standardized incidence and age-standardized DALYs rate of BSD are: 169.72 million [165.28-175.44] and 0.41 million [0.33-0.48]. Of the two main BSD, pyoderma cause significantly much heavier burden than cellulitis. The change of age-standardized incidence (7.38% [7.06-7.67]) and DALYs (-10.27% [-25.65 to 25.45]) rate of BSD presented an upward or downward trend from 1990 to 2019. The highest burden was in the low-middle sociodemographic index (SDI) area while the area with the lowest burden was recorded in the high-middle SDI area in 2019. Limitations: GBD 2019 data of BSD are derived from estimation and mathematical modeling. Conclusion: The burden of BSD is related to socioeconomic development status. The results based on GBD2019 data may benefit policymakers in guiding priority-setting decisions for the global burden of BSD.

Tuberculides tuberculosas en población adulta de la Región Metropolitana, Chile: serie de casos 2006-2010 / Tuberculids in the adult population of the Region Metropolitan, Chile: case series 2006-2010

Introducción: Las tuberculides tuberculosas (TLTB) se subdividen en verdaderas de etiología atribuible al Mycobacterium tuberculosis y facultativas causadas por múltiples condiciones, entre ellas la tuberculosis. En Chile representan el 75% de las tuberculosis cutáneas en la región metropolitana (RM). Objetivo: caracterizar las TLTB de la RM de acuerdo a epidemiología, clínica, estudio y manejo terapéutico. Material y método: Estudio descriptivo retrospectivo del total de TLTB diagnosticadas por biopsia en los servicios de anatomía patológica de 4 hospitales públicos de la RM y un hospital privado de la RM en el quinquenio 2006-2010. Resultados: 83 casos de TLTB, 59% aportados por el sistema público, 84% de los pacientes fueron mujeres, 18% fueron tuberculides verdaderas y 82% tuberculides facultativas. A pesar de ser el tratamiento antituberculoso la elección en las tuberculides verdaderas, sólo se indicó en el 65% de los casos y de estos, 45% realmente lo realizó. Sólo el 4,5% de las tuberculides facultativas de esta serie tuvieron indicación de tratamiento antituberculoso, realizándose en el 100% de los casos. Conclusión: Existe seguimiento insuficiente a través del tiempo en estos pacientes, dificultando dimensionar el éxito real de los tratamientos indicados. Se evidencia una falla en la coordinación al momento de derivar los pacientes al programa de control de la tuberculosis.

Introduction: Tuberculids are subdivided in true tuberculids, which are associated to mycobacterium tuberculosis, and facultative tuberculids which can be caused by several conditions, including tuberculosis. In Chile tuberculids represent 75% of cutaneous tuberculosis in the metropolitan region (MR). Objective: to characterize tuberculids according to epidemiology, clinical, study and therapeutic management. Methods: Descriptive study of the total tuberculids diagnosed by biopsy in the pathology services of 4 public hospitals of the MRI and a private hospital of the MRI in the five-year period 2006- 2010. Results: 83 cases of tuberculids, 59% where provided by the public system, 84% of the patients were women, 18% were true tuberculids and 82% facultative tuberculids. Despite being antitubercular therapy the first line treatment for true tuberculids, this treatment was prescribed in 65% of cases and only 45% of these were actually treated. Only 4.5% of the facultative tuberculids in this series had indication of antitubercular therapy, performed in 100% of cases. Conclusions: There is insufficient follow up in these patients, making it difficult to assess the real success of the treatment. Is evident the lack of coordination when referring patients to the tuberculosis control program.

Mycobacterium peregrinum Skin Infection: Case Report.

BACKGROUND: Mycobacterium peregrinum is a rapidly growing mycobacterium (RGM) that rarely causes skin infections. The correct identification of the specific RGM infecting the skin will enhance therapeutic success. OBJECTIVE: To highlight the importance of rapid and precise identification of the Mycobacterium involved in skin infections in order to enhance therapeutic success. METHODS: We describe an RGM skin infection in an immunocompetent patient. RESULTS: Classic methods (biochemical tests and culture) of RGM identification are time-consuming, and the histopathological features are not specific. Some molecular methods are reliable but expensive. The PRAhsp-65 is a simple procedure that is helpful in identifying the specific agent of an RGM. CONCLUSION: Although skin infections caused by M peregrinum are rare, they represent a substantial clinical challenge. Specific and more effective treatment options depend on the development of precise and rapid methods for identifying mycobacterial species.

Mycobacterium peregrinum skin infection: case report

BACKGROUND: Mycobacterium peregrinum is a rapidly growing mycobacterium (RGM) that rarely causes skin infections. The correct identification of the specific RGM infecting the skin will enhance therapeutic success. OBJECTIVE: To highlight the importance of rapid and precise identification of the Mycobacterium involved in skin infections in order to enhance therapeutic success. METHODS: We describe an RGM skin infection in an immunocompetent patient. RESULTS: Classic methods (biochemical tests and culture) of RGM identification are time-consuming, and the histopathological features are not specific. Some molecular methods are reliable but expensive. The PRAhsp-65 is a simple procedure that is helpful in identifying the specific agent of an RGM. CONCLUSION: Although skin infections caused by M peregrinum are rare, they represent a substantial clinical challenge. Specific and more effective treatment options depend on the development of precise and rapid methods for identifying mycobacterial species.