Dermatologic Care and Skin Health of Migrant Populations in the US: A Scoping Review.

Abstract

Importance: Despite literature on migrant skin health globally, there remains a critical gap in understanding the dermatologic care and skin health of migrants in the US, where immigrants represent 13.9% of the population.

Objective: To understand the spectrum of dermatologic conditions reported among US migrant populations, identify considerations for dermatologic care delivery, and synthesize the current literature on skin health.

Evidence review: PubMed, Embase, and ClasePeriodica were searched for articles published from January 2000 to December 2022 using search terms related to dermatologic conditions and migrants. Original research articles, review articles, case reports, and case series that reported on dermatologic conditions affecting migrant populations within the US and US territories were included.

Findings: Of 87 articles included, cross-sectional studies accounted for 37 (42.5%), followed by case reports and case series (36 [41.4%]), qualitative studies (3 [3.4%]), and a mixed-methods study (1 [1.1%]). Articles discussed a range of dermatologic conditions: infections (45 [51.7%]), inflammatory conditions (33 [37.9%]), traumatic wounds (16 [18.4%]), neoplasms (10 [11.5%]), pigmentary disorders (10 [11.5%]), signs of torture/violence (4 [4.6%]), cosmetic (3 [3.4%]), hair/nail disorders (1 [1.1%]), and genodermatoses (1 [1.1%]). Of 65 articles (74.6%) reporting migrants' country of origin, Mexico was most frequently reported (28 [43.0%]), followed by Guatemala (14 [21.5%]), Vietnam (8 [12.3%]), and 38 other countries. Four themes were developed: (1) exposures before and during migration were risk factors for dermatologic conditions that presented at destination; (2) occupational and environmental exposures were risk factors for dermatologic conditions that developed at destination; (3) structural factors limited migrants' access to quality health care; and (4) educational interventions targeting different learner groups were opportunities to improve skin health of migrants.

Conclusions and relevance: This scoping review found that exposures before, during, and after migration and health care access are associated with the skin health of US migrant populations. Research opportunities include focusing on a broad spectrum of dermatologic diseases, countries of birth, occupations, and vulnerable populations, such as women and children, as well as implementing and evaluating policy that addresses structural barriers migrants face in accessing quality health care.