Autoimmune skin disease among dermatology outpatients in Botswana: a retrospective review. Int J Dermatol 2019 Jan;58(1):50-53
Date
09/01/2018Pubmed ID
30168847DOI
10.1111/ijd.14201Scopus ID
2-s2.0-85052881231 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
BACKGROUND: There is a paucity of data describing autoimmune skin diseases in sub-Saharan Africa and in HIV positive cohorts. We describe the incidence of autoimmune skin diseases in public dermatology clinics in Botswana.
METHODS: New patient records from public dermatology clinics were reviewed retrospectively for the period of September 2008 to December 2015. New diagnoses of cutaneous lupus erythematosus, systemic lupus erythematosus (SLE) with cutaneous involvement, dermatomyositis, systemic sclerosis, lichen sclerosus, bullous pemphigoid, pemphigus foliaceus, pemphigus vulgaris, and pemphigus vegetans were identified. Demographic data were recorded, and incidence was determined.
RESULTS: A total of 262 patients were diagnosed with autoimmune skin disease (4% of all new patients) with an incidence rate of 28.8 (per 1,000,000). Cutaneous lupus was the most common diagnosis with discoid lupus occurring most frequently (12.6). The incidence of systemic sclerosis (2.2), morphea (1.6), lichen sclerosus (1.5), SLE with cutaneous involvement (1.3) and dermatomyositis (1.2) was relatively lower. Bullous pemphigoid was the most common bullous disease (3.8). Pemphigus foliaceus (0.9), pemphigus vulgaris (0.6), and pemphigus vegetans (0.2) were observed at a lower rate. At least 19.8% of these patients were also HIV positive.
CONCLUSIONS: The incidence of autoimmune skin diseases in Botswana is lower compared to other published studies in other geographic areas, which may be reflective of a younger population, barriers to access, genetic differences, and a lack of comparative studies in sub-Saharan Africa. The hygiene hypothesis and helminth infections may also contribute to these differences. Further studies are needed to understand these disorders in this region.
Author List
Madu PN, Williams VL, Noe MH, Omech BG, Kovarik CL, Wanat KAAuthor
Karolyn A. Wanat MD Vice Chair, Professor in the Dermatology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Ambulatory Care Facilities
Autoimmune Diseases
Botswana
Dermatology
Female
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Skin Diseases
Young Adult
