Aboriginal and Torres Strait Islander peoples are afflicted by the same skin diseases and systemic diseases which manifest in the skin as the wider Australian population. However some diseases are more common, for example infectious diseases and vascular disease as the result of diabetes. Other conditions occur more rarely, for example melanoma, porphyria cutaneous tarda and haemochromatosis, and in remote communities atopic dermatitis.
Systemic diseases that may manifest in the skin such as lupus erythematosus, diabetes, renal failure, vascular disease and strongyloidiasis can reduce the life expectancy of Aboriginal and Torres Strait Islander peoples.
Life expectancy decrease because of systemic skin diseases
More Aboriginal people live in urban areas than remote communities and prevalence of skin diseases will vary depending on a person’s social circumstances. As a general rule the more urban peoples are afflicted with the complications of diabetes and the remote peoples with infectious skin disease. Knowledge of the fundamentals of Aboriginal and Torres Strait Islander people’s culture, views concerning health, ethics and racism, cultural biases and social disadvantage are essential. Social factors such as housing, education, employment and mobility will alter the prevalence of diseases and their management. In some communities language and communication are barriers to adequate medical care.
Difficulties in management
Some skin diseases are more difficult to treat due to significant medical co-morbidities including renal disease, liver disease diabetes, hyperlipidaema and lupus erythematosus. A selection of case reports will be presented from different areas of Australia demonstrating the clinical features and some of the difficulties in management. Disorders discussed will include lupus erythematosus, neonatal lupus, acanthosis nigricans, diabetes, vascular disease, streptococcal pyoderma, scabies, tinea, syphilis, community acquired MRSA, leprosy and strongyloidiasis.
Ian McCrossin, FACD, FAChSHM
Australasian College of Dermatologists
PO Box 1148
Nowra NSW 2541