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Dermatologic conditions of the ill returned traveler: an analysis from the GeoSentinel Surveillance Network


Lederman, E R; Weld, L H; Elyazar, I R F; von Sonnenburg, F; Loutan, L; Schwartz, E; Keystone, J S (2008). Dermatologic conditions of the ill returned traveler: an analysis from the GeoSentinel Surveillance Network. International Journal of Infectious Diseases, 12(6):593-602.

Abstract

BACKGROUND: Skin disorders are common in travelers. Knowledge of the relative frequency of post-travel-related skin disorders, including their geographic and demographic risk factors, will allow for effective pre-travel counseling, as well as improved post-travel diagnosis and therapeutic intervention. METHODS: We performed a retrospective study using anonymous patient demographic, clinical, and travel-related data from the GeoSentinel Surveillance Network clinics from January 1997 through February 2006. The characteristics of these travelers and their itineraries were analyzed using SAS 9.0 statistical software. RESULTS: A skin-related diagnosis was reported for 4594 patients (18% of all patients seen in a GeoSentinel clinic after travel). The most common skin-related diagnoses were cutaneous larva migrans (CLM), insect bites including superinfected bites, skin abscess, and allergic reaction (38% of all diagnoses). Arthropod-related skin diseases accounted for 31% of all skin diagnoses. Ill travelers who visited countries in the Caribbean experienced the highest proportionate morbidity due to dermatologic conditions. Pediatric travelers had significantly more dog bites and CLM and fewer insect bites compared with their adult counterparts; geriatric travelers had proportionately more spotted fever and cellulitis. CONCLUSIONS: Clinicians seeing patients post-travel should be alert to classic travel-related skin diseases such as CLM as well as more mundane entities such as pyodermas and allergic reactions. To prevent and manage skin-related morbidity during travel, international travelers should avoid direct contact with sand, soil, and animals and carry a travel kit including insect repellent, topical antifungals, and corticosteroids and, in the case of extended and/or remote travel, an oral antibiotic with ample coverage for pyogenic organisms.

BACKGROUND: Skin disorders are common in travelers. Knowledge of the relative frequency of post-travel-related skin disorders, including their geographic and demographic risk factors, will allow for effective pre-travel counseling, as well as improved post-travel diagnosis and therapeutic intervention. METHODS: We performed a retrospective study using anonymous patient demographic, clinical, and travel-related data from the GeoSentinel Surveillance Network clinics from January 1997 through February 2006. The characteristics of these travelers and their itineraries were analyzed using SAS 9.0 statistical software. RESULTS: A skin-related diagnosis was reported for 4594 patients (18% of all patients seen in a GeoSentinel clinic after travel). The most common skin-related diagnoses were cutaneous larva migrans (CLM), insect bites including superinfected bites, skin abscess, and allergic reaction (38% of all diagnoses). Arthropod-related skin diseases accounted for 31% of all skin diagnoses. Ill travelers who visited countries in the Caribbean experienced the highest proportionate morbidity due to dermatologic conditions. Pediatric travelers had significantly more dog bites and CLM and fewer insect bites compared with their adult counterparts; geriatric travelers had proportionately more spotted fever and cellulitis. CONCLUSIONS: Clinicians seeing patients post-travel should be alert to classic travel-related skin diseases such as CLM as well as more mundane entities such as pyodermas and allergic reactions. To prevent and manage skin-related morbidity during travel, international travelers should avoid direct contact with sand, soil, and animals and carry a travel kit including insect repellent, topical antifungals, and corticosteroids and, in the case of extended and/or remote travel, an oral antibiotic with ample coverage for pyogenic organisms.

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Additional indexing

Contributors:GeoSentinel Surveillance Network
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:16 Mar 2009 12:25
Last Modified:05 Apr 2016 13:05
Publisher:Elsevier
ISSN:1201-9712
Additional Information:Elsevier full text article at http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B7CPT-4S26S01-1-1&_cdi=17975&_user=5294990&_orig=search&_coverDate=11%2F30%2F2008&_sk=999879993&view=c&wchp=dGLbVlb-zSkzV&md5=1e1f39aeac893815183a13e00f637a2f&ie=/sdarticle.pdf
Publisher DOI:https://doi.org/10.1016/j.ijid.2007.12.008
PubMed ID:18343180
Permanent URL: https://doi.org/10.5167/uzh-16221

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