Dermatological Diseases in Indigenous Children and Adolescents in Polycrisis: A Scoping Review.

Abstract

Background: Polycrisis refers to interacting social, economic, environmental, institutional, cultural, political, and health-system crises that amplify one another. In Indigenous children and adolescents, dermatological diseases may indicate not only a clinical skin condition but also overlapping vulnerabilities involving housing, water and sanitation, nutrition, environmental exposure, territorial disruption, discrimination, and barriers to culturally safe care.

Aims: To map evidence on how polycrisis is related to dermatological diseases among Indigenous children and adolescents, and to describe the dermatological conditions most frequently reported in these populations.

Methods: This scoping review considered records published between 2010 and 2025, without language restrictions. Eligible records included quantitative, qualitative, review, perspective, editorial, secondary-analysis, and gray-literature sources when they addressed dermatological disease in Indigenous children or adolescents and overlapping crisis-related determinants. The review followed Joanna Briggs Institute guidance and PRISMA-ScR reporting standards.

Results: Eight studies were included. The evidence does not establish causality, but it maps recurrent pathways through which environmental exposure, poverty, overcrowding, limited water and sanitation, geographic isolation, fragmented services, cultural safety barriers, stigma, and under-documentation converge with pediatric skin disease. Atopic dermatitis/eczema and infectious dermatoses, including bacterial skin infections, scabies, fungal infections, and pediculosis, were the most frequent categories.

Conclusions: Pediatric skin health in Indigenous communities should be understood as a clinical and public health indicator of intersecting environmental, socioeconomic, institutional, cultural, and political crises. Dermatological care in these settings requires accurate diagnosis and treatment, but also intercultural, rights-based, and social-determinants-informed responses.