Trend Analysis and Cross Nations Inequality Analysis of Infectious Skin Diseases from 1990 to 2021

doi:10.21203/rs.3.rs-5286808/v1

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Trend Analysis and Cross Nations Inequality Analysis of Infectious Skin Diseases from 1990 to 2021

https://doi.org/10.21203/rs.3.rs-5286808/v1

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Background

The skin serves as a crucial barrier against microbial invasion, but breaches in this barrier can lead to infectious skin diseases (ISD). ISD, including bacterial (BSD), fungal (FSD) and viral Skin Disease (VSD), pose significant global health challenges.

Methods

Age-standardized and age specific incidence, prevalence, and lived with disability (YLDs) data for ISD were sourced from the Global Burden of Disease Study 2021 (GBD 2021) and demographic data from the United Nations. We utilized linear regression to analyze prevalence trends and Average Annual Percentage Change (AAPC) for BSD, FSD and VSD. Log transformation of prevalence rates addressed heteroscedasticity. Cross-national inequality was assessed using concentration and slope indices based on SDI.

Result

From the prevalence perspective, FSD continues to rank first, with a prevalence rate of 7,789.55 (95% CI: 7,059.28 to 8,583.54) in 2021. Interestingly, VSD overtakes BSD, with a prevalence rate of 1,781.31 (95% CI: 1,733.08 to 1,835.16), while BSD has a prevalence rate of 473.98 (95% CI: 463.37 to 484.64). Next, looking at YLDs, VSD rises to the first position in 2021, with YLDs rate of 54.77 (95% CI: 34.83 to 81.77). FSD comes next, with YLDs rate of 43.39 (95% CI: 17.79 to 89.10). Lastly, BSD has YLDs rate of 4.21 (95% CI: 2.36 to 7.20). The rate of YLDs for FSD is primarily concentrated among the elderly, while VSD are concentrated among children. There is no significant difference for BSD. The burden is greater for males than females. The prevalence of BSD and FSD is negatively correlated with the Socio-demographic Index (SDI), with the burden primarily concentrated in low SDI countries. VSD shows a positive correlation, mainly concentrated in high SDI countries.

Conclusion

We discovered that the global impact of ISD remains significant. Both BSD and FSD are increasing, while VSD are decreasing. FSD is more common among the elderly, whereas VSD predominantly affects children. BSD and FSD are primarily found in less developed areas such as Africa, whereas VSD is more prevalent in developed regions like Europe and North America. ISD cases are also increasing in the Middle East and South America. To reduce the burden of ISD, it is crucial to improve global hygiene standards, boost vaccination rates against viruses, and strictly regulate the use of antimicrobial drugs.

Infectious Skin Disease (ISD)

Bacterial Skin Disease (BSD)

Fungal Skin Disease(FSD)

Viral Skin Disease (VSD)

Average annual percent change

Socio-demographic Index

Trend analysis

Cross nations inequality analysis

The healthy surface of the skin is an acidic, hypertonic environment rich in proteins and lipids, whose immune barrier function varies from person to person^[1]. When this barrier is breached by microbial invasion, it can lead to infectious skin diseases (ISD)^[2]. ISD are a category of skin disorders caused by various pathogenic microorganisms, including bacteria, viruses, and fungi^[3]. These diseases are widespread globally, especially in tropical and subtropical regions where climate and hygiene conditions facilitate their transmission and outbreaks^[4]. ISD not only cause local symptoms such as redness, swelling, itching, pain, and ulcers but can also be accompanied by systemic symptoms, and in severe cases, can be life-threatening^[5]. Common bacterial skin diseases (BSD) include impetigo, folliculitis, erysipelas, and cellulitis, often caused by bacteria like Streptococcus and Staphylococcus entering the skin through minor wounds or breaks, with higher incidence rates in regions with poor hygiene and humid climates^[6]. Viral skin diseases (VSD) include herpes zoster (shingles), herpes simplex, and contagious molluscum contagiosum. Herpes zoster is caused by the varicella-zoster virus, prevalent among elderly individuals and immunocompromised patients, while herpes simplex virus causes painful blisters around the mouth and genitals^[7]. Fungal skin diseases (FSD) encompass conditions such as athlete's foot, jock itch, ringworm, and candidiasis, transmitted through direct or indirect contact (such as sharing towels and clothing), thriving in warm and moist environments^[8]. Some FSD, like athlete's feet and nail fungus, often require prolonged treatment for complete recovery^[8].

Currently, BSD can be effectively treated with antibiotics like penicillin and cephalosporins^[9], while FSD can be managed with antifungal medications such as terbinafine and itraconazole. However, the global challenge of antimicrobial resistance is severe, exacerbated by the misuse of antibiotics and pesticides^[10]. VSD generally lack specific treatments but can be managed with antiviral medications like acyclovir^[11].

With increasing global climate change, international travel, immigration trends, widespread use of immunosuppressants^[12], and the impact of events like the COVID-19 pandemic^[13], vulnerable populations are becoming more susceptible to ISD, intensifying their global burden. Therefore, utilizing the latest GBD 2021 data to analyze the global burden of ISD is crucial for informing effective public health policies and interventions.

Data source

Data can be accessed through the Global Health Data Exchange platform (https://www.healthdata.org/). Demographic data is sourced from the United Nations (https://population.un.org/wpp/). GBD 2021 provides the latest epidemiological data estimates, covering the burden of 371 diseases and injuries across 21 GBD regions and 204 countries and territories from 1990 to 2021. In this study, we extracted the global incidence cases and age-standardized rates for Bacterial Skin Disease, Fungal Skin Disease, and Viral Skin Disease from GBD 2021. Additionally, we utilized the Sociodemographic Index (SDI), which quantifies the sociodemographic development level of a country or territory based on income, education, and fertility conditions.

Trend analysis

We used linear regression to calculate the prevalence rate of each ISD and its Average Annual Percentage Change (AAPC). Specifically, we transformed the yearly prevalence rate data into a logarithmic scale and used these log-transformed prevalence rates as the dependent variable, with each year as the independent variable in the regression analysis. By calculating the weighted average of the Annual Percentage Change (APC), we obtained the AAPC for each ISD. This method leverages the robustness of the linear regression model to assess the temporal changes in prevalence rates. Log transformation helps to address heteroscedasticity in the prevalence rate data, making the regression results more reliable. Through this approach, we can identify and quantify the prevalence rate trends of each ISD over the study period, providing a comprehensive perspective on the dynamic patterns of ISD prevalence.

Cross-nation inequality analysis

We used concentration index and slope index to quantify the concentrated distribution of ISD burdens across countries. Firstly, a weighted regression model is employed to account for heteroscedasticity, regressing national years lived with disability (YLDs) rates for each age group on a relative position scale associated with SDI to calculate the inequality slope index. Secondly, the concentration index is computed by numerically integrating the area under the Lorenz concentration curve, which is fitted based on the cumulative distribution of population ranked by SDI and YLDs, providing an effective assessment of the unequal distribution of ISD burdens across countries and offering a quantitative analytical tool for research purposes.

Statistics

Rates were expressed as estimates per 100,000 population with their 95% UI. All analyses and visualizations were conducted using Joinpoint software and R software (V.4.3.1).

Global ISD incidence, prevalence, and YLDs cases and age-standardized rates

Firstly, looking at the incidence, the highest number of cases and incidence rates each year are for FSD, with 1,729,224,009 cases (95% CI: 1,562,709,709 to 1,894,666,053) and an incidence rate of 21,668.40 (95% CI: 19,601.19 to 23,729.17) in 2021. Next is BSD, with 880,831,364 cases (95% CI: 855,895,431 to 905,652,994) and an incidence rate of 11,295.90 (95% CI: 10,982.62 to 11,619.01). Lastly, VSD has 84,730,445 cases (95% CI: 82,132,966 to 87,586,946) and an incidence rate of 1126.25 (95% CI: 1090.92 to 1165.91) (Fig. 1, Supplementary Table 1, 2).

From the prevalence perspective, FSD continues to rank first, with 616,532,287 cases (95% CI: 558,724,637 to 679,274,726) and a prevalence rate of 7,789.55 (95% CI: 7,059.28 to 8,583.54) in 2021. Interestingly, VSD overtakes BSD, with 136,807,659 cases (95% CI: 133,155,771 to 140,724,829) and a prevalence rate of 1,781.31 (95% CI: 1,733.08 to 1,835.16), while BSD has 36,958,263 cases (95% CI: 36,139,205 to 37,765,496) and a prevalence rate of 473.98 (95% CI: 463.37 to 484.64).

Next, looking at YLDs, VSD rises to the first position in 2021, with 4,199,075 cases (95% CI: 2,671,027 to 6,261,658) and YLDs rate of 54.77 (95% CI: 34.83 to 81.77). FSD comes next, with 3,429,497 cases (95% CI: 1,407,894 to 7,044,259) and YLDs rate of 43.39 (95% CI: 17.79 to 89.10). Lastly, BSD has 334,915 cases (95% CI: 189,302 to 569,706) and YLDs rate of 4.21 (95% CI: 2.36 to 7.20).

Based on different age groups and sex, the incidence, prevalence, and YLDs age-standardized rates of ISD

We investigated the burden of ISD across different age groups. We found that the highest incidence and prevalence rates of BSD were in the age groups under 5 years [15,477.29 (95% CI: 14,648.09 to 16,383.16) and 659.44 (95% CI: 628.24 to 687.88)] and 85 + years [14,574.98 (95% CI: 13,639.95 to 15,556.13) and 617.29 (95% CI: 587.00 to 647.59)]. FSD had the highest incidence rate in the 85 + years group [106293.26 (95% CI: 86020.70 to 127854.16)] and the highest prevalence rate in the 80–84 years group [74971.40 (95% CI: 60950.50 to 92547.59)]. VSD had the highest incidence rate in the 5–9 years group [2836.71 (95% CI: 2654.08 to 3027.29)] and the < 5 years group [2469.72 (95% CI: 2332.09 to 2618.08)]. The highest prevalence rate for VSD was in the 5–9 years group [3671.01 (95% CI: 3431.43 to 3929.41)] and the 10–14 years group [2997.93 (95% CI: 2791.91 to 3214.98)] (Fig. 2, Supplementary Table 3)

From the perspective of YLDs, the highest YLDs for BSD were in the 70–74 years group [7.36 (95% CI: 4.68 to 11.30)] and the 65–69 years group [7.07 (95% CI: 4.49 to 10.73)]. For FSD, the highest YLDs were in the 85 + years group [178.96 (95% CI: 70.52 to 372.25)] and the 80–84 years group [121.40 (95% CI: 49.71 to 252.06)]. VSD had the highest YLDs in the 5–9 years group [114.98 (95% CI: 70.54 to 174.82)] and the 10–14 years group [93.52 (95% CI: 59.81 to 141.17)]. This indicates that children and the elderly bear the greatest burden of ISD.

From a gender perspective, we found significant gender differences in the burden of ISD. The incidence rates of BSD and FSD were higher in males than females, while VSD showed no difference. In terms of prevalence rates and YLDs, males had higher rates for FSD and VSD compared to females, while BSD showed no difference. This suggests that males may be more prone to BSD, but the burden of FSD and VSD is greater (Fig. 3, Supplementary Table 4).

The global trends in ISD age-standardized prevalence rate based on Joinpoint regression from 1990 to 2021

To explore the global trends in ISD, we utilized Joinpoint regression (Fig. 4, Table 1). The results indicate significant increases in the prevalence rates of BSD and FSD compared to 1990, while VSD shows a significant decrease. BSD increased from 390.90 (95% CI: 382.23 to 398.80) in 1990 to 474.00 (95% CI: 463.37 to 484.64) in 2021, with no apparent turning points in the growth trend. FSD increased from 7350.13 (95% CI: 6652.51 to 8063.66) in 1990 to 7810.79 (95% CI: 7059.28 to 8583.54) in 2021. The growth rate slowed down from 1990 to 2005 [APC1990-2005: 0.264 (95% CI: 0.2599 to 0.2681), p = 0.000], then further slowed from 2005 to 2016 [APC2005-2016: 0.1404 (95% CI: 0.1328 to 0.1479), p = 0.000]. The trend stabilized from 2016 to 2019 (p = 0.795), but showed an upward trend in 2019 [APC2019-2021: 0.2481 (95% CI: 0.1513 to 0.345), p = 0.000]. VSD decreased from 1829.18 (95% CI: 1763.21 to 1867.37) in 1990 to 1783.85 (95% CI: 1733.08 to 1835.16) in 2021. The rate of decrease slowed from 2006 to 2015 [APC2006-2015: -0.0132 (95% CI: -0.0148 to -0.0116), p = 0.000], then slightly increased from 2015 to 2019 [APC2015-2019: 0.0333 (95% CI: 0.0259 to 0.0407), p = 0.000], followed by a rapid decrease after 2019 [APC2019-2021: -0.0287 (95% CI: -0.0435 to -0.0139), p = 0.001].

Table 1

The prevalence of ISD and their AAPC from 1990 to 2021 in the global.
Cause	1990 number	2021 number	1990 rate	2021 rate	AAPC
BSD	20733396	36958263	390.68	473.98	0.6235 (0.6143 to 0.6326)
FSD	367581342	616532287	7334.21	7789.55	0.1924 (0.1813 to 0.2034)
VSD	100377653	136807659	1812.95	1781.31	-0.0566 (-0.0589 to -0.0542)

ISD age-standardized prevalence rate and trends across nations from 1990 to 2021

Firstly, focusing on BSD, the highest prevalence rates were observed in Equatorial Guinea [1116.85 (95% CI: 1074.47 to 1157.89)], Gabon [1115.54 (95% CI: 1077.11 to 1157.18)], and Congo [1109.07 (95% CI: 1069.75 to 1148.85)]. The fastest growth rates were seen in Taiwan ,China [AAPC: 0.3961 (95% CI: 0.3868 to 0.4054), p = 0.000] and American Samoa [AAPC: 0.3943 (95% CI: 0.3733 to 0.4153), p = 0.000], while the most significant declines occurred in China [AAPC: -0.1057 (95% CI: -0.1152 to -0.0963), p = 0.000] and Italy [AAPC: -0.1163 (95% CI: -0.1397 to -0.0928), p = 0.000] (Fig. 5, Supplementary Table 5, 6).

Next is FSD, with the highest prevalence rates in Mali [23696.61 (95% CI: 20972.72 to 26338.73)], Ethiopia [23086.22 (95% CI: 20202.85 to 25968.55)], and Nigeria [20826.82 (95% CI: 18579.08 to 23380.75)]. The fastest growth rates were observed in Mexico [AAPC: 0.369 (95% CI: 0.3613 to 0.3766), p = 0.000] and Kenya [AAPC: 0.1747 (95% CI: 0.1075 to 0.2419), p = 0.000], while the most significant declines were seen in Equatorial Guinea [AAPC: -0.6248 (95% CI: -0.6382 to -0.6114), p = 0.000] and Rwanda [AAPC: -0.6315 (95% CI: -0.6652 to -0.5977), p = 0.000].

Lastly, for VSD, the highest prevalence rates were observed in Germany [4469.80 (95% CI: 4305.02 to 4639.21)], United States of America [4218.77 (95% CI: 4153.97 to 4281.10)], and Canada [4104.45 (95% CI: 3961.14 to 4253.45)]. The fastest growth rates were seen in Equatorial Guinea [AAPC: 0.4848 (95% CI: 0.4774 to 0.4923), p = 0.000] and Mexico [AAPC: 0.4347 (95% CI: 0.4309 to 0.4384), p = 0.000], while the most significant declines were observed in Ethiopia [AAPC: -0.0334 (95% CI: -0.0354 to -0.0315), p = 0.000] and United States of America [AAPC: -0.0655 (95% CI: -0.0691 to -0.0618), p = 0.000].

The correlation analysis between age-standardized prevalence rates and SDI, as well as the cross-national inequality analysis

Initially, we conducted a correlation analysis between prevalence rates and SDI and found that BSD and FSD exhibited a negative correlation with SDI, while VSD showed a positive correlation (Fig. 6). This was further validated in the subsequent cross-national inequality analysis. Concentration indices and slope indices indicated that the populations affected by BSD and FSD were predominantly concentrated in low SDI regions (with concentration indices greater than 0 and coefficients of the slope index less than 0), whereas VSD was mainly concentrated in high SDI regions (with concentration indices less than 0 and coefficients of the slope index greater than 0).

Compared to 1990, the cross-national disparities in prevalence rates narrowed for BSD [-3.38 (95% CI: -4.12 to -2.65) and − 2.76 (95% CI: -3.52 to -1.99)] and FSD [-43.21 (95% CI: -50.74 to -35.68) and − 37.12 (95% CI: -44.62 to -29.62)], while the disparity increased for VSD [18.56 (95% CI: 9.63 to 27.49) and 21.17 (95% CI: 12.65 to 29.70)] by 2021 (Fig. 7, Supplementary Table 7).

ISD are skin diseases caused by infections, which can be categorized into BSD, FSD, and VSD based on the causative agent^[11]. The global prevalence of ISD has been increasing year by year, resulting in significant economic and social burdens. Additionally, the COVID-19 pandemic that began in 2019 has caused changes in the incidence and prevalence of ISD worldwide^[13]. Therefore, using GBD 2021 data, we explored the age, gender, and regional differences in ISD globally, as well as their long-term trends, to provide recommendations for targeted health care policies.

Our study found that among global ISD, FSD has the highest incidence and prevalence rates. Although BSD has a high incidence rate, its YLDs is not high, likely due to the widespread use of antibiotics. Notably, while VSD has lower incidence and prevalence rates, it has the highest YLDs, possibly due to the chronic nature and high recurrence rate of viral infections. From an age perspective, BSD shows no significant differences across age groups. FSD is primarily concentrated among the elderly, while VSD is concentrated among children, with males having higher YLDs than females. This may be due to the enhancing effect of estrogen on skin immunity^{[14, 15]}.

ISD mainly occur in individuals with weakened immune systems, those using immunosuppressants, organ transplant recipients, cancer patients, and those with immune deficiencies^[16]. Children and the elderly, due to their weaker immune systems, are more susceptible^{[6, 9]}. Common bacterial skin diseases include infections caused by Staphylococcus aureus and Streptococcus^[17]. The YLDs of BSD have significantly decreased since the advent of antibiotics. However, in recent years, antibiotic resistance has become a major issue, especially with methicillin-resistant Staphylococcus aureus (MRSA)^[18]. Since the 1990s, the incidence of MRSA has steadily increased. Although countries like the United States, Canada, and those in the Mediterranean have effectively controlled its spread^[19], developing countries, including those in Africa, have not, contributing to the increase in BSD^[20]. FSD is a significant global health issue, with high prevalence and mortality rates, mainly concentrated in tropical regions^[16]. Their spread and development are closely related to climate^[4]. However, international travel, migration, and climate change have led to an increase in FSD in other regions^[21]. Most pathogenic fungi to humans are saprophytes in nature, such as dermatophytes, Candida, and Aspergillus^[22]. Infections confined to the epidermis are superficial, while those that penetrate the epidermis and dermis are deep infections^[5]. Immunodeficiency is a risk factor, and specific gene mutations can also increase susceptibility to FSD^[16]. FSD also face issues of antimicrobial resistance^[8]. The primary pathogens of VSD include enteroviruses, HSV-1 and 2, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, and HHV-6, HHV-7, and HHV-8^[11]. These viruses mainly affect children, making the disease burden higher in this group^[23]. Despite the widespread use of vaccines significantly reducing the incidence and prevalence of these viruses, the YLDs remain high due to chronic infections, immune evasion^[24], recurrences, and lack of effective treatments^[25].

Furthermore, we conducted a long-term trend analysis, as well as SDI correlation and cross-national inequality analysis. BSD shows a significant upward trend, possibly related to increased antibiotic resistance^{[26, 27]} and changes in hygiene conditions^[28]. The growth rate of FSD slowed and stabilized from 2016 to 2019, likely due to standardized drug use and the release of antifungal treatment guidelines, which controlled resistance issues^[29]. However, from 2019 to 2021, FSD showed an upward trend, probably due to long-term antifungal drug use leading to resistance issues^[30], and climate change and global warming^{[4, 31]}. VSD, on the other hand, shows an overall downward trend. The gradual increase in vaccination rates against viruses such as varicella and shingles significantly reduced the incidence of these diseases^{[32, 33]}. Post-2019, VSD incidence rapidly decreased, possibly due to the global implementation of COVID-19 preventive measures such as frequent handwashing, mask-wearing, and social distancing^[34], which also reduced the spread of VSD.

Regionally, BSD and FSD are mainly concentrated in developing countries with poor economic and health conditions with low SDI, such as African countries, while VSD is primarily found in developed countries in Europe and America. The prevalence of BSD and FSD in African countries is likely due to the climate and geographical conditions conducive to the proliferation of pathogenic bacteria and fungi^[35]. Poor management of antimicrobial drugs in developing countries has exacerbated resistance issues, and the unregulated use of fungicides in agriculture has led to the emergence of new resistant strains^[26]. Developed countries are more likely to use antifungal drugs in clinical practice to treat FSD^[36]. Conversely, the prevalence of VSD in developed countries with high SDI may be attributed to the higher proportion of elderly populations, increased use of immunosuppressants, higher numbers of cancer patients and organ transplant recipients^[37], and more frequent social interactions^[38]. These factors facilitate the interpersonal spread of viruses. However, COVID-19 social control measures have reduced the incidence of VSD^[34]. It is also worth noting that ISD in the Middle East and South America show an upward trend.

This study is the first to use GBD 2021 data to analyze the global burden of ISD, providing recommendations for effective prevention and reduction of their burden. However, our study has some limitations. Firstly, we relied on self-reported GBD data, which may underestimate the burden of ISD in some countries. Secondly, we did not distinguish between specific pathogens of ISD, making it difficult to provide targeted public health guidance. Thirdly, the COVID-19 pandemic has led to overburdened healthcare systems, and some ISD cases may not have been recorded in time.

In conclusion, we found that the global burden of ISD remains severe. BSD and FSD show an upward trend, while VSD shows a downward trend. FSD is more prevalent among the elderly, and VSD among children. BSD and FSD are concentrated in less developed regions such as Africa, while VSD is concentrated in developed regions such as Europe and North America. ISD in the Middle East and South America are on the rise. We should improve global hygiene standards, increase vaccination rates against viruses, and strictly manage the use of antimicrobial drugs to reduce the burden of ISD.

ISD

Infectious Skin Disease

BSD

Bacterial Skin Disease

FSD

Fungal Skin Disease

VSD

Viral Skin Disease

APC

Annual Percent Change

AAPC

Average Annual Percentage Change

YLDs

Years Lived with Disability

SDI

Socio-demographic Index

Availability of data and materials

The data is available in the 2021 Global Burden of Disease study (healthdata.org). Joinpoint software could be downloaded at cancer.gov. Demographic data sourced from the United Nations (https://population.un.org/wpp/).

Funding

This work was supported by the [The Science and Technology Science and Technology Programme of Guangzhou ] under Grant [No.202002030213].

Ethical approval

Not applicable.

Conflict interests statement

The authors declare they have no conflict of interest.

Author contributions
BY, XFL, GXW, HHN,HFL,RQF and TX designed and conducted the whole research. LFX, XSC, and DDM applied for the dataset analysis. XFL, JNT, LYH and BY drafted the manuscript. All authors contributed to the article and approved the submitted version.TX revised and finalized the manuscript.

Acknowledgements

We are very grateful for the data support from the 2021 Global Burden of Disease study and the Joinpoint software from the National Cancer Institute.

Costa FG, Horswill AR (2022) Overcoming pH defenses on the skin to establish infections. PLoS Pathog 18(5):e1010512
Dryden MS (2010) Complicated skin and soft tissue infection. J Antimicrob Chemother 65(Suppl 3):iii35–44
Dawson AL, Dellavalle RP, Elston DM (2012) Infectious skin diseases: a review and needs assessment. Dermatol Clin 30(1):141–151 ix-x
Dayrit JF, Sugiharto A, Coates SJ, Lucero-Prisno DE 3rd, Davis MDD, Andersen LK (2022) Climate change, human migration, and skin disease: is there a link? Int J Dermatol 61(2):127–138
Watkins RR, David MZ (2021) Approach to the Patient with a Skin and Soft Tissue Infection. Infect Dis Clin North Am 35(1):1–48
Maher E, Anokhin A (2024) Bacterial Skin and Soft Tissue Infections in Older Adults. Clin Geriatr Med 40(1):117–130
Karagounis TK, Pomeranz MK (2021) Viral Venereal Diseases of the Skin. Am J Clin Dermatol 22(4):523–540
Peghin M, Ruiz-Camps I (2022) Recent concepts in fungal involvement in skin and soft tissue infections. Curr Opin Infect Dis 35(2):103–111
Gillet Y, Lorrot M, Minodier P, Ouziel A, Haas H, Cohen R (2023) Antimicrobial treatment of skin and soft tissue infections. Infect Dis Now 53(8s):104787
Saunte DML, Hare RK, Jørgensen KM, Jørgensen R, Deleuran M, Zachariae CO et al (2019) Emerging Terbinafine Resistance in Trichophyton: Clinical Characteristics, Squalene Epoxidase Gene Mutations, and a Reliable EUCAST Method for Detection. Antimicrob Agents Chemother ; 63(10)
Moffarah AS, Al Mohajer M, Hurwitz BL, Armstrong DG (2016) Skin and Soft Tissue Infections. Microbiol Spectr ; 4(4)
Nawas ZY, Tong Y, Kollipara R, Peranteau AJ, Woc-Colburn L, Yan AC et al (2016) Emerging infectious diseases with cutaneous manifestations: Viral and bacterial infections. J Am Acad Dermatol 75(1):1–16
Merino P, Kupferwasser D, Flores EA, Phan Tran D, Ortega A, Miller LG (2023) Skin and soft tissue infection incidence before and during the COVID-19 pandemic. Epidemiol Infect 151:e190
Agarwal P, Jagati A, Rathod SP, Kalra K, Patel S, Chaudhari M (2021) Clinical Features of Mycetoma and the Appropriate Treatment Options. Res Rep Trop Med 12:173–179
Young KZ, Dimitrion P, Zhou L, Adrianto I, Mi QS (2023) Sex-biased immunological processes drive hidradenitis suppurativa. Front Immunol 14:1167021
Zhang Y, Li R, Wang X (2020) Monogenetic causes of fungal disease: recent developments. Curr Opin Microbiol 58:75–86
Chambers ES, Vukmanovic-Stejic M (2020) Skin barrier immunity and ageing. Immunology 160(2):116–125
Lorrot M, Bourrat E, Doit C, Prot-Labarthe S, Dauger S, Faye A et al (2014) [Superficial skin infections and bacterial dermohypodermitis]. Arch Pediatr 21(8):906–912
Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al (2014) Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 59(2):e10–52
Makwela AB, Grootboom WM, Abraham V, Witika B, Godman B, Skosana PP (2023) Antimicrobial Management of Skin and Soft Tissue Infections among Surgical Wards in South Africa: Findings and Implications. Antibiot (Basel) ; 12(2)
Seas C, Legua P (2022) Mycetoma, chromoblastomycosis and other deep fungal infections: diagnostic and treatment approach. Curr Opin Infect Dis 35(5):379–383
Guégan S, Lanternier F, Rouzaud C, Dupin N, Lortholary O (2016) Fungal skin and soft tissue infections. Curr Opin Infect Dis 29(2):124–130
Ramdass P, Mullick S, Farber HF (2015) Viral Skin Diseases. Prim Care 42(4):517–567
Lei V, Petty AJ, Atwater AR, Wolfe SA, MacLeod AS (2020) Skin Viral Infections: Host Antiviral Innate Immunity and Viral Immune Evasion. Front Immunol 11:593901
Waheed S, Nuttall L, Fidler K, Dudley J, Bamford A, Lyall H (2022) Neonatal Herpes Simplex Virus: Cutaneous Recurrence Is Common on Stopping Prophylactic Suppression Therapy. J Pediatr Infect Dis Soc 11(11):518–521
Al Meslamani AZ (2023) Antibiotic resistance in low- and middle-income countries: current practices and its global implications. Expert Rev Anti Infect Ther 21(12):1281–1286
Semret M, Haraoui LP (2019) Antimicrobial Resistance in the Tropics. Infect Dis Clin North Am 33(1):231–245
Pathak R, Shrestha S, Poudel P, Marahatta S, Khadka DK (2023) Association of socio-demographic factors and personal hygiene with infectious childhood dermatoses. Skin Health Dis 3(3):e219
Hill RC, Caplan AS, Elewski B, Gold JAW, Lockhart SR, Smith DJ et al (2024) Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance. Am J Clin Dermatol 25(3):359–389
Koh XQ, Pan JY (2023) Recalcitrant cutaneous fungal infections-A growing problem. Australas J Dermatol 64(3):315–321
Balato N, Ayala F, Megna M, Balato A, Patruno C (2013) Climate change and skin. G Ital Dermatol Venereol 148(1):135–146
Wijesinghe VN, Farouk IA, Zabidi NZ, Puniyamurti A, Choo WS, Lal SK (2021) Current vaccine approaches and emerging strategies against herpes simplex virus (HSV). Expert Rev Vaccines 20(9):1077–1096
Lee GH, Kim J, Kim HW, Cho JW (2021) Herpes simplex viruses (1 and 2) and varicella-zoster virus infections in an adult population with aseptic meningitis or encephalitis: A nine-year retrospective clinical study. Med (Baltim) 100(46):e27856
Yamamoto-Kataoka S, Kataoka Y, Tochitani K, Miyakoshi C, Yamamoto Y (2022) Influence of anti-coronavirus disease 2019 policies on 10 pediatric infectious diseases. Pediatr Int 64(1):e14958
de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D et al (2012) Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 13(6):607–615
Pathadka S, Yan VKC, Neoh CF, Al-Badriyeh D, Kong DCM, Slavin MA et al (2022) Global Consumption Trend of Antifungal Agents in Humans From 2008 to 2018: Data From 65 Middle- and High-Income Countries. Drugs 82(11):1193–1205
Burke VE, Lopez FA (2017) Approach to skin and soft tissue infections in non-HIV immunocompromised hosts. Curr Opin Infect Dis 30(4):354–363
Jefferson T, Del Mar C, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA et al (2010) Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev ; (1):Cd006207

No competing interests reported.

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Trend Analysis and Cross Nations Inequality Analysis of Infectious Skin Diseases from 1990 to 2021

Status:

Version 1

Abstract

Background

Methods

Result

Conclusion

Figures

Introduction

Method

Data source

Trend analysis

Cross-nation inequality analysis

Statistics

Result

Global ISD incidence, prevalence, and YLDs cases and age-standardized rates

ISD age-standardized prevalence rate and trends across nations from 1990 to 2021

Discussion

Abbreviations

Declarations

References

Additional Declarations

Supplementary Files

Status:

Version 1