الفهرس 
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Abstract
Skin disorders have remained over the years as one of the commonest causes of hospital visits to dermatology clinics. The pattern of skin diseases varies from one country to another and in various regions within the same country.
Epidemiological studies of skin diseases are important in the study of disease pattern, changes in disease pattern and planning for dermatology services and research for a country.
The present study was a retrospective hospital-based study that designed:
• To describe the pattern of skin diseases seen at the dermatology clinic at Assiut University Hospital during the period 2008-2012.
• To study the trend in disease pattern by comparison of the present study with a previous study that was done at AssiutUniversityHospitalduring the period 1969-1973.
The records of outpatients who attended the dermatology clinic at Assiut University Hospital during a five years period (starting from January 2008 till the end of December 2012) were reviewed. All patients with any dermatoses were included in this study. Each patient’s age, sex and diagnosis were recorded. Patients were divided into six groups according to age, these included infant (up to 2 years), preschool age (>2-5 years), school age (>5-18 years), young adult (>18-39 years), old adult (>39-60 years), old (>60 years).
The diagnosis of skin diseases was classified according to International Classification of Diseases ICD (10th version 2010).
A total sample of 57884 patients were enrolled in the study, males represented 54.0% of all patients and females 46.0%. Young adult (>18-39 years) constituted the largest group of the total studied patients (47.7%) followed by school age >5-18 years (23.7%).
The results showed that the infectious skin diseases were the most prevalent group of all skin diseases(38%), followed by hypersensitivity diseases (33.3%), adnexal disorders (14.3%), pigmentary diseases (6.1%), papulosquamous diseases (3.7%), neoplasm (2.4%), other disorders (1.6%) and radiation related disorders (0.1%)
The distribution of the infectious skin diseases was:
• Viral skin diseases represented (18.70%) of the skin diseases. Warts were the commonest of them, followed by Chicken pox.
• Fungal skin diseases constituted (8.18%) of the skin diseases. Pityriasis versicolor was the commonest of them, followed by tinea corporis,tinea capitis and tinea pedis.
• Bacterial skin infectionscame the third in the group (7.90%). The commonest bacterial skin diseases were impetigo, followed by frunculosis.
• Parasitic skin infestations represented (3.05%) of the group. Scabies formed the major bulk, followed by pediculosis capitis.
The distribution of the non-infectious skin diseases was:
• Hypersensitivity skin diseases represented (33.3%) of the total skin diseases. The dermatitis subgroup constituted (24.5%) of the total skin diseases and contact dermatitis represented the highest percen, followed by atopic dermatitis, pityriasis alba and seborrheic dermatitis. While urticaria and related diseases had a rate of (8.79%) of the total skin diseases.
• Adnexal skin disorders had a percentage of (14.3%) of the skin diseases. Acne representsd the highest percent (6.97%), followed by diffuse hair loss (4.15%), alopecia areata (1.53%) and milliria (0.93%).
• Pigmentary skin disorders represented (6.2%). Vitiligo formed the major portion (2.79%) then post inflammatory hyperpigmentation (1.96%), melasma (0.94%) and freckles (0.39%).
• Papulsquamous disorders percentage was (3.7%) of the skin diseases. Psoriasis had the highest percent (2.07%) then lichen planus (0.85%), pityriasis rosea (0.48%) and pityriasis rubra pilaris (0.22%).
• Neoplasm represented (2.4%) of the total diseases. Benign neoplasm mainly seborrheic keratosis (1.49%) was the commonest of group. Malignant neoplasm were rare which had a lower rate basal cell carcinoma (0.04%).
• Other groups were: bullous disorders (e.g: pemphigus vulgaris 0.25%), connective tissue diseases (systemic lupus erythematosus 0.1%), genodermatoses (icthyosis vulgaris0.16%), metabolicdisorders (porphyria 0.07%) and non-infectious granulomas (sarcoidosis 0.05%).
The distribution of skin diseases found to be differed according to age, sex of the patient and seasons:
In children, the common skin diseases were: impetigo, frunculosis, chicken pox, tinea capitis, pityriasis alba, seborrheic dermatitis, papular urticaria and milliaria. In young adult, the common skin diseases were: warts, pityriasis versicolor, contact dermatitis, acne, diffuse hair loss, post inflammatory hyper-pigmentation and melasma. In middle age, the common skin diseases were: warts, pityriasis versicolor, contact dermatitis and alopecia areata. In old age, the common skin diseases were: parasitic skin diseases (scabies), xerosis and vitiligo.
Also, the results show that the percentages of following skin diseases were higher in male than female: warts, pityriasis versicolor, tinea capitis, impetigo, scabies, atopic dermatitis, papular urticaria, alopecia areata, xerosis and vitiligo.
On other hand, the percentages of following skin diseases were higher in female than male: frunculosis, pediculosis capitis, contact dermatitis, seborrheic dermatitis, acne, diffuse hair loss, milliaria and melasma.
The following skin diseases were common during summer: impetigo, pediculosis capitis, milliaria and vitiligo.
Also the skin diseases that common in winter were: pityriasis alba, seborrheic dermatitis, acne, xerosis and melasma.
The study shows that rate of the infectious skin diseases in the present study showed a decline from the previous study that was done in 1976 in Assiut University Hospital (37.9% vs. 50.8% respectively), bacterial, fungal, parasitic and mycobacterial were decreased in the present study than the previous study (20.37%, 11.71%, 8.88%, 5.35% vs. 7.90%, 8.18%, 3.05%, 0.11% respectively), except the viral skin diseases which increased in present study (18.71% vs. 4.47%). The percentages of non-infectious skin diseases were increased in the present study than the previous study (62% vs. 49.2% respectively). Skin diseases which increased in the present study than the previous study were: contact dermatitis (17.54% vs. 1.50%), atopic dermatitis (3.02% vs. 1.95%), pityriasis alba (1.04% vs. 0.416%), papular urticaria (2.96% vs. 1.64%), acne vulgaris (6.97% vs. 3.99%), psoriasis (2.07% vs. 1.76%). However, skin diseases that decreased in the present study than the previous study were napkin dermatitis (0.33% vs. 0.87%), neurodermatitis (0.221% vs. 1.25%), seborrhoeic dermatitis (0.44% vs. 3.5%), urticaria (5.19% vs. 8.22%), vitiligo (2.79% vs. 3.81%) and prurigo (0.22% vs. 2.63%).
Out of the study it was concluded that infectious skin diseases still occupied a major portion particularly viral infections. On other hand, there was a trend of increasing the non-infectious skin diseases particularly contact dermatitis, acne, vitiligo, psoriasis, lichen planus, pityriasis rosea.
It is recommended to perform further studies on the trend of skin diseases in the community. Also efficient medical recording system is needed for continuous assessment of skin disorders.