PEDIATRIC skin disease burden rose globally, with acne and atopic dermatitis driving disability in young people.
Pediatric Skin Disease Burden Shows Regional Variation
A global analysis of individuals younger than 20 years found that the burden of skin and subcutaneous diseases increased substantially from 1990 to 2021, highlighting the need to prioritize pediatric dermatology within public health planning.
Using Global Burden of Disease 2021 data, researchers assessed incidence, prevalence, deaths, disability-adjusted life years, years lived with disability, and years of life lost across skin disease categories. The study included acne vulgaris, atopic dermatitis, bacterial skin diseases, fungal skin diseases, viral skin diseases, cellulitis, contact dermatitis, pruritus, psoriasis, scabies, urticaria, and other skin and subcutaneous diseases.
Globally, DALYs from skin and subcutaneous diseases among individuals younger than 20 years rose from 653,365.48 in 1990 to 860,806.73 in 2021, with an estimated annual percentage change of 0.45. Dermatitis also increased, from 547,494.02 to 656,740.86 DALYs, although at a slower annual rate.
Acne and Atopic Dermatitis Drive Disability
Acne vulgaris and atopic dermatitis were the main contributors to disability. Atopic dermatitis carried a substantial burden in early childhood, while acne became a dominant driver among adolescents. Children aged 5–9 years had the lowest burden overall, whereas children younger than 5 years and adolescents aged 15–19 years had higher DALYs.
Regional patterns differed by socioeconomic development. High Socio-demographic Index countries tended to sit closer to the efficiency frontier, suggesting lower incidence relative to development level. Low-SDI countries showed a disproportionate burden, particularly for infectious skin diseases such as cellulitis, bacterial skin diseases, fungal skin diseases, and parasitic infections.
U.S. Burden Expected to Increase
Forecasting suggested divergent future trends. Dermatitis and other skin and subcutaneous diseases are projected to decline in China and Europe, while the U.S. is expected to see increases across dermatitis, other skin and subcutaneous diseases, and viral skin diseases. Viral skin diseases are also projected to rise in Europe, particularly among females.
Although most dermatologic diseases are not fatal, bacterial skin diseases had the highest mortality burden among the conditions analyzed, especially in low and lower middle SDI regions. The findings support age-specific and region-specific strategies, with early intervention for atopic dermatitis in young children, targeted acne management in adolescents, and improved infection control where infectious skin diseases remain prominent.
Reference
He X et al. A Global Study of Skin and Subcutaneous Diseases Among Individuals Under 20 Years of Age. Clin Cosmet Investig Dermatol. 2026;19:601691.
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