{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:32:32Z","timestamp":1781753552677,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dermatologic disease is a neglected public health challenge that disproportionately affects resource\u2010poor settings. Globally, dermatologic disease contributes the fourth highest burden of nonfatal disability with the most acute impact in the Oceanic region, including the Republic of Palau. Efforts to address the dermatologic health inequality are hindered without the necessary epidemiologic evidence to guide health policy in the resource\u2010poor setting of Palau.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a 4\u2010year cross\u2010sectional study of all Dermatology Service patients in the Belau National Hospital and outreach community health centers from 2015 to 2018. No other specialized dermatology service was available. Skin disease was classified by both diagnosis and Global Burden of Disease criteria and analyzed by age, gender, region, and surrounding Oceanic nations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study enrolled 494 patients comprising 179 males and 315 females between 2015 and 2018. The most prevalent diseases were eczema (48.8%), superficial fungal infection (24.5%), and pruritus (22.7%). The neglected tropical disease of scabies was detected in four patients. Males were significantly more likely to present with cellulitis, keratinocyte carcinoma, stasis dermatitis, wounds, marine\u2010related dermatitis, viral skin disease, tinea faciei, verruca, and xerosis and females with melasma and hyperpigmentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study presents the first primary epidemiologic data describing the prevalence of dermatologic disease in the Palauan adult population. The significant burden of disease in Palau compared with other Oceanic nations validates ongoing dermatology services and informs public health implications for resource allocation and disease management to achieve health equality in the resource\u2010poor nation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.16049","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T18:06:17Z","timestamp":1643393177000},"page":"833-840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology of dermatologic disease in Palau: a cross\u2010sectional study in the national public and community health service"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7120-712X","authenticated-orcid":false,"given":"Wan\u2010Ting J.","family":"Lee","sequence":"first","affiliation":[{"name":"Faculty of Medicine The University of Queensland  St. Lucia Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Center of Intelligent Healthcare National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Kuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Hwa","family":"Lin","sequence":"additional","affiliation":[{"name":"International Health Care Center Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Te\u2010Yu","family":"Lo","sequence":"additional","affiliation":[{"name":"International Health Care Center Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh\u2010Chen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9680-3120","authenticated-orcid":false,"given":"Sam L.","family":"Kahler","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  St. Lucia Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haw\u2010Yueh","family":"Thong","sequence":"additional","affiliation":[{"name":"Department of Dermatology Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13671-017-0192-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2001.tb00042.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5538"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd11.130344"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5538"},{"key":"e_1_2_6_7_1","unstructured":"ROP Statistical Yearbooks \u2013 PalauGov.pw[Internet]. 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