Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia.
Perth Children's Hospital, Perth, Western Australia, Australia.
Trop Med Int Health. 2024 Nov;29(11):923-950. doi: 10.1111/tmi.14047. Epub 2024 Oct 13.
The skin is the largest and most visible organ of the human body. As such, skin infections can have a significant impact on overall health, social wellbeing and self-image. In 2019, we published a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource-limited settings where skin infections are endemic. This current review serves as an update to assess the evidence for treatment of these conditions as well as atopic dermatitis, molluscum contagiosum and head lice in endemic settings. The data from this systematic review have supported an update to the Australian National Healthy Skin guidelines.
A systematic review was conducted using two separate searches in MEDLINE, PubMed, Embase, CINAHL, Cochrane and Web of Science. The first search was an update of the 2018 systematic review using the same search strategy for the same skin conditions to identify emerging literature from 2018 to 2022. The second search strategy used the same key terms but with the addition of atopic dermatitis, head lice and molluscum contagiosum from 1960 to 2022. Eligible studies included Indigenous peoples and populations in resource-limited settings with a diagnosis of impetigo, scabies, crusted scabies, tinea capitis, atopic dermatitis, molluscum contagiosum or who presented with head lice. Studies conducted in high-income countries were excluded. Articles were screened for inclusion independently by one author with a second group of reviewers independently double screening. Data extraction and an in-depth quality assessment conducted by one author and checked by two others.
Of 1466 original articles identified, 68 studies were included and key findings outlined for impetigo, scabies, crusted scabies, atopic dermatitis, head lice and molluscum contagiosum. Recommendations for each condition based on the available evidence are provided.
The importance of assessing literature relevant to the populations with heavy burden of skin infections is outlined in this systematic review. We have summarised updates to this literature, which may benefit in developing guidelines for skin infection management similar to the National Healthy Skin Guidelines for Australia.
皮肤是人体最大、最显眼的器官。因此，皮肤感染会对整体健康、社会福利和自我形象产生重大影响。2019 年，我们发表了一篇关于皮肤感染（包括脓疱疮、疥疮、结痂性疥疮和癣）治疗、预防和公共卫生控制的系统评价，这些感染在资源有限的地方流行。本综述是对这些疾病以及流行地区特应性皮炎、传染性软疣和头虱治疗证据的更新评估。这项系统评价的数据支持了对澳大利亚国家健康皮肤指南的更新。
使用 MEDLINE、PubMed、Embase、CINAHL、Cochrane 和 Web of Science 中的两个单独搜索进行了系统评价。第一次搜索是对 2018 年系统评价的更新，使用相同的搜索策略搜索相同的皮肤状况，以确定 2018 年至 2022 年期间的新文献。第二次搜索策略使用相同的关键词，但从 1960 年到 2022 年增加了特应性皮炎、头虱和传染性软疣。合格的研究包括资源有限环境中的土著人民和人群，他们被诊断患有脓疱疮、疥疮、结痂性疥疮、头癣、特应性皮炎、传染性软疣或有头虱。排除在高收入国家进行的研究。由一位作者独立筛选纳入的文章，另一位作者进行双独立筛选。由一位作者进行数据提取和深入质量评估，由另外两位作者进行检查。
从 1466 篇原始文章中确定了 68 项研究，概述了脓疱疮、疥疮、结痂性疥疮、特应性皮炎、头虱和传染性软疣的关键发现。根据现有证据为每种情况提供了建议。
本系统评价概述了评估与皮肤感染负担沉重的人群相关文献的重要性。我们总结了这些文献的更新，这可能有助于制定类似澳大利亚国家健康皮肤指南的皮肤感染管理指南。
