Epidemiology of viral skin disease: An increased burden in childhood and a correlation with atopic dermatitis and gross domestic product

Abstract

Background: Viral cutaneous infections have impact globally due to several factors, including changing rates of atopic dermatitis (AD), vaccination rates, and access to trained dermatologists. Furthermore, advancements in treatments and access to vaccinations suggest an association between the wealth of countries and the burden of their disease. Purpose: The overall purpose of this study is to better understand the global impact of viral skin disease across differing demographics and time periods, as well as the burden in relation to national wealth. Methods: In this article, the prevalence, incidence, and years lived with disability (YLDs) were analyzed for viral cutaneous infections in 195 countries from 1990 to 2019, using the global burden of disease dataset. Furthermore, the disease burden was assessed as a function of gross-domestic product (GDP) and AD. Results: The prevalence of individuals affected by viral skin diseases is approximately 154 million globally. Young children (1–9 years old) were more likely to be affected. The age-standardized prevalence rates per 100,000 in the Americas and Asia decreased between 1990 and 2019 from 2819 to 2650 and from 2074 to 1906, respectively. This decrease was outside the 95% uncertainty interval. Increased GDP predicted increased prevalence and YLD (P < 0.0001). There was a relationship between 1 year lived with disability per capita of AD and an increase of 0.14 (0.07, 0.21) cases of viral skin diseases (P = 0.002). Conclusion: The increase in disease burden with increased GDP may be correlated to decreased access to dermatologists in developing countries. An increased burden with AD is likely due to skin barrier and immune regulatory dysfunction. The morbidity of skin diseases demonstrates the need for increased access to vaccination campaigns and dermatologic care across developing nations.