{"title":"Approach to Skin Problems in Travellers: Clinical and Epidemiological Clues.","authors":"Annika B Wilder-Smith, Eric Caumes","doi":"10.1093/jtm/taae142","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale for review: </strong>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.</p><p><strong>Key findings: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":null,"pages":null},"PeriodicalIF":9.1000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of travel medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jtm/taae142","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
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.
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.