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Journal of the American Academy of Dermatology
Volume 71, n° 6
page 1137 (décembre 2014)
Doi : 10.1016/j.jaad.2014.08.022
accepted : 13 August 2014
Original Articles

Global mortality from conditions with skin manifestations

Lindsay N. Boyers, BA a, Chante Karimkhani, BA b, Mohsen Naghavi, MD, PhD, MPH c, David Sherwood, PhD d, David J. Margolis, MD, PhD e, Roderick J. Hay, DM, FRCP f, Hywel C. Williams, DSc, FRCP g, Luigi Naldi, MD h, Luc E. Coffeng, MD, PhD c, Martin A. Weinstock, MD, PhD i, j, k, Cory A. Dunnick, MD l, m, Hannah Pederson, BS n, Theo Vos, PhD c, Robert P. Dellavalle, MD, PhD, MSPH l, m, o,
a Georgetown University School of Medicine, Washington, District of Columbia 
b Columbia University College of Physicians and Surgeons, New York, New York 
c Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 
d Department of Integrative Physiology, University of Colorado, Boulder, Colorado 
e Department of Biostatistics and Epidemiology and Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania 
f Department of Dermatology, Kings College Hospital National Health Service Trust, London, United Kingdom 
g Center of Evidence-based Dermatology, University of Nottingham, Nottingham, United Kingdom 
h Department of Dermatology, Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy 
i Dermatoepidemiology Unit, US Department of Veterans Affairs Medical Center Providence, Providence, Rhode Island 
j Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island 
k Departments of Dermatology and Epidemiology, Brown University, Providence, Rhode Island 
l Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado 
m Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado 
n University of Colorado School of Medicine, Aurora, Colorado 
o Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado 

Reprint requests: Robert P. Dellavalle, MD, PhD, MSPH, Dermatology Service, US Department of Veteran Affairs Medical Center, 1055 Clermont St, Box 165, Denver, CO 80220.

Global Burden of Disease Study is a research database containing systematically compiled information from vital statistics and epidemiologic literature to inform research, public policy, and resource allocation.


We sought to compare mortality among conditions with skin manifestations in 50 developed and 137 developing countries from 1990 to 2010.


This was a cross-sectional study to calculate mean age-standardized mortality (per 100,000 persons) across countries for 10 disease categories with skin manifestations. We compared differences in mortality from these disorders by time period (year 1990 vs year 2010) and by developing versus developed country status.


Melanoma death rates were 5.6 and 4.7 times greater in developed compared with developing countries in 1990 and 2010, respectively. Measles death rates in 1990 and 2010 were 345 and 197 times greater in developing countries, and corresponding syphilis death rates were 33 and 45 times greater.


Inability to adjust for patient-, provider-, and geographic-level confounders may limit the accuracy and generalizability of these results.


The mortality burden from skin-related conditions differs between developing and developed countries, with the greatest differences observed for melanoma, measles, and syphilis. These results may help prioritize and optimize efforts to prevent and treat these disorders.

The full text of this article is available in PDF format.

Key words : basal cell carcinoma, burden of disease, dermatology, developed countries, developing countries, epidemiology, Global Burden of Disease Study 2010, measles, melanoma, mortality, nonmelanoma skin cancer, rate of death, squamous cell carcinoma, syphilis

Abbreviations used : BCC, CSM, GBD, ICD-10 , SCC, WHO

 The Global Burden of Disease Study 2010 was supported in part by the Bill and Melinda Gates Foundation (grant number: OPP43650_01).
 Ms Boyers and Ms Karimkhani are co-first authors.
 Supplementary tables are available at
 Disclosure: Ms Boyers, Dr Weinstock, and Dr Dellavalle are employees of the US Department of Veterans Affairs. The US Department of Veterans Affairs had no role in the design and execution of the study. Any opinions expressed herein do not necessarily reflect the opinions of the US Department of Veterans Affairs. Ms Karimkhani; Drs Naghavi, Sherwood, Margolis, Hay, Williams, Naldi, Coffeng, Dunnick, and Vos; and Ms Pederson have no conflicts of interest to declare.

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