What is the impact of skin diseases in the UK?

A common problem

Over half the UK population experience a skin condition each year, resulting in nearly 13 million GP consultations (in England and Wales) and 0.8 million referrals for specialistadvice. Skin conditions are the most common reasonfor people to consult their GP with

a new problem.1

A major impact on patients’ lives

Skin disease caused nearly 4,000 deaths in 2005, including 1,817 deaths due to malignant melanoma, (nearly twice as many as cervical cancer).1 

Quality of life can be significantly impaired by skin diseases such as psoriasis, atopic eczema, vitiligo 5 and acne, at times, even to a greater extent than life-threateningconditions such as cancer.1 

   • Psoriasis patients can be affected psychologically, with an increased rate of depression and suicidal ideation in hospital

     psoriasis inpatients and outpatients (5.5%), rising to 7.2% for inpatients only.2

     Patients with severe psoriasis have an increased mortality compared to the general population,with men dying on average 3.5

     years earlier and women 4.4 years earlier.3 

  • “My Vitiligo started when I was 14 years old. At 18 I started to suffer from Ankylosing Spondylitis, followed by Crohn’s disease at

      twenty four. At thirty, after many years of oral steroids, osteoporosis was confirmed.  

      Last year I was diagnosed with rheumatoid arthritis. I have also had many bouts of Iritis over the years and to top it all off I also

      have Alpha-1 Antitrypsin Deficiency, a rare genetic disorder which causes rapid destruction of lung tissue and at thirty three

      contracted emphysema.  None of these diseases can be cured; only controlled.

      I have come to terms with the pain and discomfort all these diseases bring – but I have never been able to come to terms with

      having Vitiligo, and I still dread every summer”.

   • Specific issues relating to the psychological impact of childhood eczema on children and their families are well documented, with

      sleeplessness and its consequences leading to impaired psycho-social functioning of the child and the family. Children with

      very troublesome atopic eczema may need disability allowance to help with the cost of extra care required from family or paid

      carers.1 

    • There is a significant psychological morbidity for acne patients including anxiety, depression, suicidal ideation and suicide.1 

A major impact on the workplace

Skin disease is the second most common occupational disease in the EU after musculoskeletal disorders.  Contact dermatitis accounts for 70-90%, urticaria less than 10%, others include folliculitis/acne, infections,neoplasia, hyperpigmentation and vitiligo.

Those at highest risk include hairdressers, health care workers, cleaners, construction workers, cooks and caterers mechanics, metalworkers and vehicle assemblers, chemical/petroleum plant operatives, agricultural workers.4 

A major need for improved services

There is no compulsory requirement for dermatology training for primary care health professionals.

The ratio of consultant dermatologists to the population remains low in the UK at 1:130,000 with many only available part-time.

The average for France, Germany and Italy is 1:16,000.1 

References:

1. Skin Conditions in the UK: Health Care Needs Assessment, Julia Schofield, Douglas Grindlay and Hywel Williams. Centre of Evidence

Based Dermatology, University of Nottingham.

2. Gelfand JM, Troxel AB, Lewis JD, et al. The risk of mortality in patients with psoriasis: results from a population-based study.

Arch Dermatol 2007; 143: 1493-1499

3. Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis.

Br J Dermatol 1998; 139: 846-850.

4. European Agency for Safety and Health. European Risk Observatory Report EN8. Expert forecast on emerging chemical risks related to occupational safety and health. Office for Official Publications of the European Community.

5. Bewley A, Talsania N, Lamb B, Vitiligo is more than skin deep: a survey of members of the Vitiligo Society.  Clinical and Experimental Dermatology Volume 35, Issue 7, pages 736–739, October 2010.