{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:15:18Z","timestamp":1787008518695,"version":"build-2736575974"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Eastern Cape is an under-resourced province and the poorest in South Africa, where little is known about the epidemiology of skin diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the nature and prevalence of skin diseases in two neighbouring rural villages in the Eastern Cape, South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional point prevalence study of skin diseases of residents (adults and children) in Mtyholo Dlova and Mdolomba villages in December 2023. Through house-to-house visits, we collected data on the households, participant demographics and skin diagnoses following clinical skin examination by dermatologists. Point prevalence rates and 95% confidence intervals (CIs) were calculated for each skin condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 309 households were visited with 698 participants included of whom 99% were Xhosa people, 56% were female [mean (SD) age 37.4 (24.2) years], 39% were unemployed, 18% were retired, 60% did not smoke and 69% did not drink alcohol. Seventy-five per cent of households had an average monthly income &amp;lt; ZAR3000 South African Rand (128 GBP). In total, 439 people had at least one skin disease with a point prevalence of any skin disease of 62.9% (95% CI 59.3\u201366.5). The most prevalent diseases in children (aged &amp;lt; 18\u2005years) were tinea capitis (16.4%), acne vulgaris (13.0%), pityriasis alba (10.6%), prurigo (4.8%), postinflammatory hyperpigmentation (3.9%), xerosis (3.9%), atopic dermatitis (3.4%) and scabies (3.4%). In adults, the most prevalent diseases were xerosis (7.8%), acne vulgaris (7.4%), melasma (6.2%), dermatosis papulosa nigra (5.6%), scarring alopecia (3.5%), nonscarring alopecia (3.1%) and tinea pedis (3.1%). Psoriasis was rare, with a prevalence of 0.3% in the study population. Generally, skin disease was more common in female than male participants (65.8% vs. 59.2%) with sex-specific differences in the prevalence of certain dermatoses; melasma, alopecia (scarring and nonscarring), seborrhoeic dermatitis, dermatosis papulosa nigra and irritant contact dermatitis were more prevalent in female participants, whereas there was a predominance of pseudofolliculitis barbae, atopic dermatitis, postinflammatory hyperpigmentation, acne vulgaris, pityriasis versicolor, scabies, tinea pedis and tinea capitis in male participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Skin disease is common in the Eastern Cape, South Africa. These findings may help strengthen the provision of dermatology services and the distribution of resources in the region, and highlight training opportunities for healthcare workers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljaf386","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:13:37Z","timestamp":1759320817000},"page":"125-134","source":"Crossref","is-referenced-by-count":3,"title":["Skin disease in the Eastern Cape (SKINSCAPE): a Global Psoriasis Atlas point prevalence study in rural South Africa"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8418-8332","authenticated-orcid":false,"given":"Alison K","family":"Wright","sequence":"first","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester , Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Swan","sequence":"additional","affiliation":[{"name":"Division of Musculoskeletal & Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine & Health, University of Manchester , Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Musculoskeletal & Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine & Health, University of Manchester , Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3325-3675","authenticated-orcid":false,"given":"Su M","family":"Lwin","sequence":"additional","affiliation":[{"name":"St John\u2019s Institute of Dermatology, King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1094-7113","authenticated-orcid":false,"given":"Shir","family":"Azrielant","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Tel Aviv Sourasky Medical Centre , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-6191","authenticated-orcid":false,"given":"Antoinette","family":"Chateau","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chioma","family":"Ede","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Helen Joseph Hospital, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6559-8491","authenticated-orcid":false,"given":"Jacob","family":"Sons","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zikhona","family":"Gxolo","sequence":"additional","affiliation":[{"name":"Cecilia Makiwane Hospital , Mdantsane ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andiswa","family":"Skenjana","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avumile","family":"Mankahla","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Nelson Mandela Academic Hospital, Walter Sisulu University , Mthatha ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarina","family":"Drusinsky","sequence":"additional","affiliation":[{"name":"Dermacare Dermatology & Aesthetic Centre , East London ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9881-1631","authenticated-orcid":false,"given":"Susanna M","family":"Kannenberg","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, University of Stellenbosch, Tygerberg Academic Hospital , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sthembiso","family":"Mhlanga","sequence":"additional","affiliation":[{"name":"Ngwelezana Tertiary Hospital, KwaZulu-Natal Department of Health , Empangeni ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpume","family":"Luthuli","sequence":"additional","affiliation":[{"name":"MultiMedics , Umhlanga ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Topping","sequence":"additional","affiliation":[{"name":"Dermatology Medical Affairs, The Janssen Pharmaceutical Companies of Johnson & Johnson ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Taicher","sequence":"additional","affiliation":[{"name":"L\u2019Or\u00e9al Dermatological Beauty Global , Levallois Perret ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-6286","authenticated-orcid":false,"given":"Carsten","family":"Flohr","sequence":"additional","affiliation":[{"name":"St John\u2019s Institute of Dermatology, King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ncoza C","family":"Dlova","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2958-915X","authenticated-orcid":false,"given":"Darren M","family":"Ashcroft","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester , Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-4427","authenticated-orcid":false,"given":"Christopher E M","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, University of Manchester , Manchester ,","place":["UK"]},{"name":"Department of Dermatology, King\u2019s College Hospital, King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"2026010607280434900_ljaf386-B1","author":"World Health Organization"},{"key":"2026010607280434900_ljaf386-B2","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the\u00a0Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","year":"2024","journal-title":"Lancet"},{"issue":"S7","key":"2026010607280434900_ljaf386-B3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/jdv.19390","article-title":"The burden of skin disease in Europe","volume":"37","author":"Trakatelli","year":"2023","journal-title":"J Eur Acad Dermatology Venereol"},{"key":"2026010607280434900_ljaf386-B4","doi-asserted-by":"crossref","first-page":"1309549","DOI":"10.3389\/fimmu.2023.1309549","article-title":"Large-scale epidemiological analysis of common skin diseases to identify shared and unique comorbidities and demographic factors","volume":"14","author":"Li","year":"2024","journal-title":"Front Immunol"},{"key":"2026010607280434900_ljaf386-B5"},{"issue":"S1","key":"2026010607280434900_ljaf386-B6","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/bjd.20016","article-title":"Socioeconomic factors influence severity rather than incidence of dermatoses","volume":"185","author":"Hiranput","year":"2021","journal-title":"Br J Dermatol"},{"key":"2026010607280434900_ljaf386-B7","doi-asserted-by":"crossref","first-page":"1145513","DOI":"10.3389\/fpubh.2023.1145513","article-title":"The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019","volume":"11","author":"Yakupu","year":"2023","journal-title":"Front Public Health"},{"key":"2026010607280434900_ljaf386-B8","doi-asserted-by":"crossref","first-page":"m1590","DOI":"10.1136\/bmj.m1590","article-title":"National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study","volume":"369","author":"Parisi","year":"2020","journal-title":"BMJ"},{"key":"2026010607280434900_ljaf386-B9","first-page":"1076","article-title":"Access to public health services in South Africa\u2019s rural Eastern Cape province","volume":"4","author":"Willie","year":"2023","journal-title":"J Med Public Health"},{"key":"2026010607280434900_ljaf386-B10","author":"Statistics South Africa"},{"key":"2026010607280434900_ljaf386-B11","author":"Statistics South Africa"},{"key":"2026010607280434900_ljaf386-B12","author":"Statistics South Africa"},{"key":"2026010607280434900_ljaf386-B13","author":"Statistics South Africa"},{"key":"2026010607280434900_ljaf386-B14","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap) \u2013 a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"2026010607280434900_ljaf386-B15","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"2026010607280434900_ljaf386-B16","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2230.1994.tb01167.x","article-title":"Dermatology Life Quality Index (DLQI) \u2013 a simple practical measure for routine clinical use","volume":"19","author":"Finlay","year":"1994","journal-title":"Clin Exp Dermatol"},{"key":"2026010607280434900_ljaf386-B17","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/j.1087-0024.2004.09113.x","article-title":"10\u2005years experience of the Dermatology Life Quality Index (DLQI)","volume":"9","author":"Lewis","year":"2004","journal-title":"J Investig Dermatol Symp Proc"},{"key":"2026010607280434900_ljaf386-B18","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.det.2011.08.012","article-title":"A review of health outcomes in patients with psoriasis","volume":"30","author":"Li","year":"2012","journal-title":"Dermatol Clin"},{"key":"2026010607280434900_ljaf386-B19","first-page":"77","article-title":"Psoriasis: epidemiology, clinical and histological features, triggering factors, assessment of severity and psychosocial aspects","author":"Coimbra","year":"2012","journal-title":"Psoriasis \u2013 A Systemic Disease."},{"key":"2026010607280434900_ljaf386-B20","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/DER.0000000000000895","article-title":"The Eczema Area and Severity Index \u2013 a practical guide","volume":"33","author":"Hanifin","year":"2022","journal-title":"Dermatitis"},{"key":"2026010607280434900_ljaf386-B21","volume-title":"Biostatistics: A Foundation for Analysis in the Health Sciences","author":"Daniel","year":"1999","edition":"7th edn"},{"key":"2026010607280434900_ljaf386-B22","first-page":"327","volume-title":"Dermatology in black skin","author":"de Avelar Alchorne","year":"2024"},{"key":"2026010607280434900_ljaf386-B23","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1111\/ijd.12589","article-title":"The spectrum of skin diseases in a black population in Durban, KwaZulu-Natal, South Africa","volume":"54","author":"Dlova","year":"2015","journal-title":"Int J Dermatol"},{"key":"2026010607280434900_ljaf386-B24","first-page":"1","article-title":"Skin disease prevalence amongst rural communities in KwaZulu-Natal Province, South Africa","volume":"5","author":"Naidoo","year":"2023","journal-title":"African Journal of Inter-multidisciplinary Studies"},{"key":"2026010607280434900_ljaf386-B25","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1046\/j.1365-2230.2003.01417.x","article-title":"Dermatological disorders in Johannesburg, South Africa","volume":"28","author":"Hartshorne","year":"2003","journal-title":"Clin Exp Dermatol"},{"key":"2026010607280434900_ljaf386-B26","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/bjd.15534","article-title":"Prevalence of skin diseases treated at public referral hospitals in KwaZulu-Natal, South Africa","volume":"178","author":"Dlova","year":"2018","journal-title":"Br J Dermatol"},{"key":"2026010607280434900_ljaf386-B27","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1471-5945-12-7","article-title":"The spectrum of skin diseases in a rural setting in Cameroon (sub-Saharan Africa)","volume":"12","author":"Bissek","year":"2012","journal-title":"BMC Dermatol"},{"key":"2026010607280434900_ljaf386-B28","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1001\/archderm.134.11.1363","article-title":"Prevalence of skin disease in rural Tanzania and factors influencing the choice of health care, modern or traditional","volume":"134","author":"Satimia","year":"1998","journal-title":"Arch Dermatol"},{"key":"2026010607280434900_ljaf386-B29","doi-asserted-by":"crossref","first-page":"357","DOI":"10.33192\/Smj.2021.47","article-title":"Prevalence and pattern of diseases of the skin and subcutaneous tissue in a primary care area in Thailand","volume":"73","author":"Chaiyamahapurk","year":"2021","journal-title":"Siriraj Med J"},{"key":"2026010607280434900_ljaf386-B30","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12895-018-0079-8","article-title":"Assessing skin disease and associated health-related quality of life in a rural Lao community","volume":"18","author":"Wootton","year":"2018","journal-title":"BMC Dermatol"},{"key":"2026010607280434900_ljaf386-B31","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.dsi.2017.11.001","article-title":"Skin care services and disease prevalence in Taiwan: a nationwide study","volume":"36","author":"Dai","year":"2018","journal-title":"Dermatol Sin"},{"key":"2026010607280434900_ljaf386-B32","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/jdv.18050","article-title":"Prevalence of most common skin diseases in Europe: a population-based study","volume":"36","author":"Richard","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026010607280434900_ljaf386-B33","author":"World Health Organization"},{"key":"2026010607280434900_ljaf386-B34","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1093\/inthealth\/ihaf068","article-title":"Harnessing artificial intelligence for skin-related neglected tropical diseases (skin NTDs): opportunities, challenges and future directions","volume":"17","author":"Yotsu","year":"2025","journal-title":"Int Health"},{"key":"2026010607280434900_ljaf386-B35","author":"ESPEN"},{"key":"2026010607280434900_ljaf386-B36","author":"World Health Organization"},{"key":"2026010607280434900_ljaf386-B37","doi-asserted-by":"crossref","first-page":"e22018","DOI":"10.1016\/j.heliyon.2023.e22018","article-title":"Buruli ulcer in Africa: geographical distribution, ecology, risk factors, diagnosis, and indigenous plant treatment options \u2013 a comprehensive review","volume":"9","author":"Osei-Owusu","year":"2023","journal-title":"Heliyon"},{"key":"2026010607280434900_ljaf386-B38","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S0140-6736(18)31204-2","article-title":"Leishmaniasis","volume":"392","author":"Burza","year":"2018","journal-title":"Lancet"},{"key":"2026010607280434900_ljaf386-B39","author":"World Health Organization"},{"key":"2026010607280434900_ljaf386-B40","doi-asserted-by":"crossref","first-page":"e0008397","DOI":"10.1371\/journal.pntd.0008397","article-title":"The global distribution of actinomycetoma and eumycetoma","volume":"14","author":"Emery","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"2026010607280434900_ljaf386-B41","doi-asserted-by":"crossref","first-page":"885","DOI":"10.7196\/SAMJ.2019.v109i11.13718","article-title":"The estimated burden of fungal disease in South Africa","volume":"109","author":"Schwartz","year":"2019","journal-title":"South African Med J"},{"key":"2026010607280434900_ljaf386-B42","author":"World Health Organization"},{"key":"2026010607280434900_ljaf386-B43","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/bjd.21036","article-title":"Counting dermatologists in South Africa: number, distribution and requirement","volume":"187","author":"Tiwari","year":"2022","journal-title":"Br J Dermatol"},{"key":"2026010607280434900_ljaf386-B44","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jep.2014.02.023","article-title":"Ethnobotanical survey of medicinal plants used in the management of skin disorders among the Xhosa communities of the Amathole District, Eastern Cape, South Africa","volume":"153","author":"Afolayan","year":"2014","journal-title":"J Ethnopharmacol"},{"key":"2026010607280434900_ljaf386-B45","first-page":"973","article-title":"Geographic differences in atopic dermatitis risk between urban and rural area: a systematic review and meta-analysis","volume":"21","author":"Shin","year":"2023","journal-title":"J Dtsch Dermatol Ges"},{"key":"2026010607280434900_ljaf386-B46","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.jaci.2018.07.023","article-title":"Rural and urban food allergy prevalence from the South African Food Allergy (SAFFA) study","volume":"143","author":"Botha","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"2026010607280434900_ljaf386-B47","doi-asserted-by":"crossref","first-page":"269","DOI":"10.4103\/ijd.IJD_792_19","article-title":"Epidemiological pattern of contact dermatitis among urban and rural patients attending a tertiary care center in a semi-urban area in Eastern India","volume":"65","author":"Ghosh","year":"2020","journal-title":"Indian J Dermatol"},{"key":"2026010607280434900_ljaf386-B48","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.1111\/jdv.20194","article-title":"Large-scale international study on scalp seborrheic dermatitis: prevalence, demographics, healthcare trends and quality of life","volume":"39","author":"Grimalt","year":"2025","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026010607280434900_ljaf386-B49","doi-asserted-by":"crossref","first-page":"492","DOI":"10.3390\/jcm13020492","article-title":"Multimorbidity of psoriasis: a large-scale population study of its associated comorbidities","volume":"13","author":"Almenara-Blasco","year":"2024","journal-title":"J Clin Med"},{"key":"2026010607280434900_ljaf386-B50","doi-asserted-by":"crossref","first-page":"117062","DOI":"10.1016\/j.envres.2023.117062","article-title":"A prospective study of the association between living in a rural environment during childhood and risk of psoriasis","volume":"237","author":"Conte","year":"2023","journal-title":"Environ Res"},{"key":"2026010607280434900_ljaf386-B51","author":"South African Government Official Information and Services"},{"key":"2026010607280434900_ljaf386-B52","first-page":"307","article-title":"Ulwaluko rite of passage among the Xhosa in South Africa: the challenges relating to poor standards in unlicenced circumcision schools","volume":"11","author":"Mpateni","year":"2021","journal-title":"African J Soc Work"},{"key":"2026010607280434900_ljaf386-B53","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.clindermatol.2010.09.023","article-title":"Diagnostic procedures in dermatology","volume":"29","author":"Ruocco","year":"2011","journal-title":"Clin Dermatol"},{"key":"2026010607280434900_ljaf386-B54","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/jdv.13301","article-title":"The effect of environmental humidity and temperature on skin barrier function and dermatitis","volume":"30","author":"Engebretsen","year":"2016","journal-title":"J Eur Acad Dermatology Venereol"},{"key":"2026010607280434900_ljaf386-B55","first-page":"1","article-title":"Change management in the implementation of electronic health records (EHR) systems at Inkosi Albert Luthuli Central Hospital, South Africa","volume":"87","author":"Msomi","year":"2021","journal-title":"South African J Libr Inf Sci"},{"key":"2026010607280434900_ljaf386-B56","doi-asserted-by":"crossref","DOI":"10.3389\/fdgth.2023.1207602","article-title":"Exploring the barriers and facilitators to implementing electronic health records in a middle-income country: a qualitative study from South Africa","volume":"5","author":"Zharima","year":"2023","journal-title":"Front Digit Health"},{"key":"2026010607280434900_ljaf386-B57","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.det.2020.08.006","article-title":"Dermatology training in Africa","volume":"39","author":"Mosam","year":"2021","journal-title":"Dermatol Clin"},{"key":"2026010607280434900_ljaf386-B58","first-page":"a5200","article-title":"The impact of basic dermatology education and training on primary healthcare providers in KwaZulu-Natal, South Africa","volume":"63","author":"Makaula","year":"2021","journal-title":"South African Fam Pract"},{"key":"2026010607280434900_ljaf386-B59","doi-asserted-by":"crossref","first-page":"a578","DOI":"10.4102\/apsdpr.v10i1.578","article-title":"Assessment of medicine stock-outs challenges in public health services","volume":"10","author":"Zuma","year":"2022","journal-title":"Africa\u2019s Public Service Delivery & Performance Review"},{"key":"2026010607280434900_ljaf386-B60","author":"Department of Health Republic of South Africa"},{"key":"2026010607280434900_ljaf386-B61","author":"Wishnia"}],"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljaf386\/64488727\/ljaf386.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/194\/1\/125\/64488727\/ljaf386.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/194\/1\/125\/64488727\/ljaf386.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:28:21Z","timestamp":1767702501000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/article\/194\/1\/125\/8272876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,10,3]]},"published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljaf386","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,10,3]]}}}