LAUSR

To the Editor: Skin disease often impairs quality of life and results in an increase in years lived with disability (YLDs). In 2010, skin diseasewas the fourth cause of nonfatal disease burden worldwide. Skin conditions ranked between the second and eleventh leading causes of YLDs globally. We investigated changes in the global burden of skin disease experienced in developed and developing countries between 1990 and 2013. We used the Institute for Health Metrics and Evaluation (IHME) reports of Leading Causes of YLDs, 1990 and 2013. The percent change in skin diseases between 1990 and 2013 was collected for each country listed. Of the 187 reported countries, we identified 47 developed countries according to the 2015 Human Development Index. The greatest improvements were seen in Portugal, with a 9% decrease in disability between 1990 and 2013. Israel, Spain, the Czech Republic, and Hungary followed the lead with a 7% decrease in YLDs. In addition, 6 of the 47 developed countries did not see any changes in YLDs from skin conditions, and 11 experienced an increase in their YLDs (Fig 1). The mean percent change seen in developed countries was a 1.85% improvement in disability (standard deviation