265 The global burden of skin disease: An update from the Global Burden of Disease Study 2017

Disability secondary to skin conditions is significant worldwide. The Global Burden of Disease (GBD) Study 2017 includes estimates of global morbidity and mortality due to skin diseases. The disability-adjusted life year (DALY), combines morbidity and mortality into a high-quality and comparative metric. We sought to measure the burden of 13 skin disease categories in 195 countries. Data points were derived from an extensive literature search as well as vital registration and verbal autopsy data kin disease data were extracted. These data points were modeled with Bayesian meta-regression to generate estimates of morbidity and mortality metrics for skin diseases. Skin conditions contributed 1.76% to the global burden of disease measured in DALYs from 354 diseases and injuries in 2017. Individual skin diseases varied in size from 0.44% of total burden for dermatitis (atopic, contact and seborrheic dermatitis), psoriasis 0.22%, urticaria 0.20%, scabies 0.18%, fungal skin diseases 0.17%, viral skin diseases 0.16%, acne vulgaris 0.10%, pyoderma 0.067%, melanoma 0.066%, keratinocyte carcinoma 0.053%, cellulitis 0.024%, alopecia areata 0.021%, and decubitus ulcer 0.020%. Skin diseases were the ninth largest cause of disability worldwide. With the international collaboration of experts; attention to diverse causes, risk factors, ages, and world regions; and sophisticated analytical modeling tools, GBD 2017 has established a standardized method for global health metrics. This advancement has important implications for the field of public health and clinical medicine, including dermatology, as it will aid research priority-setting decisions and public policy efforts at local and national levels.