Approach to Skin Problems in Travellers: Clinical and Epidemiological Clues.

IF 9.1 2区 医学 Q1 INFECTIOUS DISEASES
Annika B Wilder-Smith, Eric Caumes
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引用次数: 0

Abstract

Rationale for review: Travel-related skin problems are a common reason for healthcare consultations. We present a clinical approach to diagnosing skin diseases in travellers, emphasizing clinical examination and epidemiological clues such as travel history, incubation time and at-risk behaviors.

Key findings: Skin problems or manifestations of systemic infections are the third most common health issue encountered by travellers, though their causes and frequency may vary based on the season and destination. The four most frequent skin conditions affecting travellers include arthropod bites, sunburns, hookworm-related cutaneous larva migrans, and bacterial skin and soft tissue infections. Dengue fever is the leading cause of febrile exanthema in travellers returning from Asia, Latin America, and the Caribbean, while hookworm-related cutaneous larva migrans is the most common cause of creeping dermatitis. Notable travel-related infections associated with pruritus include cercarial dermatitis, scabies, creeping dermatitis, and urticaria. Acute schistosomiasis is the most common parasitic cause of acute urticaria in travellers. African tick-bite fever is the most frequently encountered rickettsiosis, typically presenting with single or multiple eschars.

Conclusions: Diagnostic approaches emphasize the importance of travel history, at-risk activities during travel, and lesion distribution. At-risk activities include sun exposure, walking barefoot, exposure to sea and fresh water, hiking in forested or jungle areas, exposure frequency to mosquitoes and sandflies, poor hygiene and food intake, drug history, and sexual behaviour. Morphological characteristics (vesicula, bullae, pustule, papule, nodule, plaque, oedema, and ulcer), distinguishing between single and multiple skin lesions, localized or generalized, and whether mucosa, scalp, palmar or plantar surfaces are affected, provide further clinical clues. Systemic signs and symptoms such as fever and pruritus will aid in the differential diagnosis algorithms. With a thorough clinical assessment and knowledge of geographic and exposure-related risk factors, the differential diagnosis of travel-associated skin conditions can be narrowed down allowing for timely clinical management.

处理旅行者皮肤问题的方法:临床和流行病学线索。
审查理由:与旅行有关的皮肤问题是医疗咨询的常见原因。我们介绍了一种诊断旅行者皮肤病的临床方法,强调临床检查和流行病学线索,如旅行史、潜伏时间和高危行为:主要发现:皮肤问题或全身感染的表现是旅行者遇到的第三大常见健康问题,但其原因和频率可能因季节和目的地而异。影响旅行者最常见的四种皮肤病包括节肢动物叮咬、晒伤、与钩虫相关的皮肤幼虫移行症以及细菌性皮肤和软组织感染。登革热是导致从亚洲、拉丁美洲和加勒比海地区回国的旅行者出现发热性红斑的主要原因,而与钩虫相关的皮肤幼虫移行症是导致蠕行性皮炎的最常见原因。与瘙痒症相关的旅行相关感染包括carcarial皮炎、疥疮、匍匐性皮炎和荨麻疹。急性血吸虫病是导致旅行者急性荨麻疹的最常见寄生虫病因。非洲蜱咬热是最常见的立克次体病,通常表现为单个或多个疱疹:诊断方法强调旅行史、旅行期间的高危活动和皮损分布的重要性。高危活动包括暴晒、赤脚行走、接触海水和淡水、在森林或丛林地区徒步旅行、接触蚊子和沙蝇的频率、不良卫生习惯和食物摄入、吸毒史和性行为。形态学特征(水泡、水疱、脓疱、丘疹、结节、斑块、水肿和溃疡),区分单个或多个皮损,局部或全身,以及粘膜、头皮、掌跖是否受累,可提供进一步的临床线索。发热和瘙痒等全身症状和体征有助于鉴别诊断算法。通过全面的临床评估以及对地理和接触相关风险因素的了解,可以缩小旅行相关皮肤病的鉴别诊断范围,以便及时进行临床治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of travel medicine
Journal of travel medicine 医学-医学:内科
CiteScore
20.90
自引率
5.10%
发文量
143
审稿时长
6-12 weeks
期刊介绍: The Journal of Travel Medicine is a publication that focuses on travel medicine and its intersection with other disciplines. It publishes cutting-edge research, consensus papers, policy papers, and expert reviews. The journal is affiliated with the Asia Pacific Travel Health Society. The journal's main areas of interest include the prevention and management of travel-associated infections, non-communicable diseases, vaccines, malaria prevention and treatment, multi-drug resistant pathogens, and surveillance on all individuals crossing international borders. The Journal of Travel Medicine is indexed in multiple major indexing services, including Adis International Ltd., CABI, EBSCOhost, Elsevier BV, Gale, Journal Watch Infectious Diseases (Online), MetaPress, National Library of Medicine, OCLC, Ovid, ProQuest, Thomson Reuters, and the U.S. National Library of Medicine.
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