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The global burden of skin disease may be reduced through research efforts focused on skin diseases with the highest reported disability-adjusted life years.
This study evaluates the representation of dermatologic conditions comprising the highest disability-adjusted life years in dermatology literature to identify areas that could benefit from greater research focus.
The top 10 skin disorders according to their respective disability-adjusted life years as per the 2013 Global Burden of Disease were identified using previous studies. The top 5 dermatology journals ranked by the 2019 h-index were also identified. A PubMed search of each journal was performed using individual skin disease terms. From 2015 to 2020, all indexed publications pertaining to each disease were recorded and compared to the total number of publications for each journal surveyed.
A total of 19,727 papers were published in the 5 journals over the span of 2015-2020. Although melanoma ranked as the eighth highest in disability-adjusted life years, it had the highest representation in the literature (1995/19,727, 10.11%). Melanoma was followed in representation by psoriasis (1936/19,727, 9.81%) and dermatitis (1927/19,727, 9.77%). These 3 conditions comprised a total of 29.69% (5858/19,727) of the total publications, while the remaining 7 skin conditions were represented by a combined 6.79% (1341/19,727) of the total publications.
This research identifies gaps in the literature related to the top skin diseases contributing to the global burden of disease. Our study provides insight into future opportunities of focused research on less-studied skin diseases to potentially aid in reducing the global burden of skin disease.
The 2013 Global Burden of Disease (GBD) Morbidity and Mortality report identified skin diseases as the fourth leading cause of global disability-adjusted life years (DALYs) [
A comprehensive search was performed using PubMed to identify peer-reviewed papers. A previous GBD study has identified and ranked individual skin disorders according to their respective DALYs [
Over the span of 2015-2020, 19,727 publications were recorded from the previously mentioned journals. Melanoma (eighth in DALYs) had the highest representation in the literature at 10.11% (1995/19,727) of the total publications, followed by psoriasis (1936/19,727, 9.81%) and dermatitis (1927/19,727, 9.77%) (
Top 10 skin conditions contributing to the global burden of disease [
Skin disease search term | Global burden of skin disease rank | Rank by percentage of total publications | Percentage of global burden of disease (measured in disability-adjusted life years)b | Proportion of global burden of skin disease measured in disability-adjusted life years, fraction (%)c | Publications in 2015-2020 (N=19,727), n (%) | Percentage of total publications/Percentage of global burden of skin disease |
Dermatitis | 1 | 3 | 0.38 | 0.38/1.70 (22.35) | 1927 (9.77) | 0.44 |
Acne | 2 | 4 | 0.29 | 0.29/1.70 (17.06) | 477 (2.42) | 0.14 |
Psoriasis | 3 | 2 | 0.19 | 0.19/1.70 (11.18) | 1936 (9.81) | 0.88 |
Urticariad | 3 | 7 | 0.19 | 0.19/1.70 (11.18) | 139 (0.70) | 0.06 |
Viral skin disease | 5 | 5 | 0.16 | 0.16/1.70 (9.41) | 283 (1.38) | 0.15 |
Fungal skin |
6 | 6 | 0.15 | 0.15/1.70 (8.82) | 193 (0.98) | 0.11 |
Scabies | 7 | 10 | 0.07 | 0.07/1.70 (4.12) | 54 (0.27) | 0.07 |
Melanoma | 8 | 1 | 0.06 | 0.06/1.70 (3.53) | 1995 (10.11) | 2.86 |
Pyoderma | 9 | 8 | 0.05 | 0.05/1.70 (2.94) | 124 (0.63) | 0.21 |
Cellulitis | 10 | 9 | 0.04 | 0.04/1.70 (2.35) | 81 (0.41) | 0.17 |
All other skin and subcutaneous |
N/Ae | N/A | 0.12 | 0.12/1.70 (7.00) | N/A | N/A |
aThe following journals ranked by the 2019 h-index were searched: rank 1, Journal of the American Academy of Dermatology; rank 2, Journal of Investigative Dermatology; rank 3, British Journal of Dermatology; rank 4, Journal of the American Medical Association Dermatology; and rank 5, Dermatologic Surgery.
bThe percentage values in this column have been directly taken from the global burden of disease paper [
cThis column shows the fractions of the total skin-related global burden of disease over the total percentage of global burden of disease (1.70%) calculated for the 10 skin diseases.
dUrticaria has the same ranking as psoriasis in the calculation of the global burden of skin disease rankings [
eN/A: not applicable.
Proportion of publications by year for each global burden of skin disease condition.
The disproportionate representation of melanoma in the literature compared to overall GBD is likely explained by the increased mortality risk of melanoma relative to other skin diseases [
Although this study utilizes 2013 GBD data to guide our literature search, it does not implicate the literature gaps identified in this study. Our study was limited by the use of 1 specific search term pertaining to the individual skin diseases. We recognize that performing our search across 5 journals with a single term per skin disease could have led to possible omissions. Although a variety of terms could be searched for some skin diseases within our study, such as fungal skin diseases, we elected to use a single term for consistency across all the skin diseases studied and recognize that certain publications discussing multiple skin diseases may have been listed under more than one search term. Lastly, we acknowledge that many of the mentioned skin diseases may be represented outside of dermatology-specific journals, which our study did not examine. Nonetheless, we offer a valuable initial survey of these skin diseases in highly read and influential dermatology literature and hope that our study will prompt future necessary work to identify potential avenues for refinement of current research efforts.
Indeed, a primary purpose of the GBD collaboration is to aid clinical researchers in determining priority of research at local, national, and global levels [
Dermatologic disease is a significant source of global DALYs. Although there has been significant research focus on dermatologic malignancies, dermatitis, and psoriasis in the last 5 years, this study highlights significant gaps and opportunities that remain in skin disease literature.
disability-adjusted life year
Global Burden of Disease
KJP contributed to the project conceptualization, methodology, data collection, writing of manuscript, review, and editing. MDS contributed to the methodology, statistical analysis, review, and editing. CWR contributed to the writing of manuscript, review, and editing. CLP contributed to project conceptualization, writing of manuscript, review, and editing. MRL contributed to the methodology, statistical analysis, review, and editing. RPD contributed to the review and editing, project supervision, and project administration.
RPD is the Editor-in-Chief of JMIR Dermatology, a Joint Coordinating Editor for Cochrane Skin, a Dermatology Section Editor for UpToDate, a Social Media Editor for the Journal of the American Academy of Dermatology, and a Podcast Editor for the Journal of Investigative Dermatology. He is a coordinating editor representative on Cochrane Council.