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INTRODUCTION

KEY POINTS

  • Multiple hospital-based surveys showed that the spectrum of skin disorders in Southeast Asia is similar to that seen in other regions except for an increase in pigmentary disorders such as nevus of Ota and Ito.

  • Endemic subcutaneous mycoses such as chromoblastomycosis and sporotrichosis, which are prevalent in Southeast Asia, are not usually reported because of limited access to confirmatory laboratory tests.

  • The diagnosis of chronic granulomatous skin infections such as chromoblastomycosis, sporotrichosis, lupus vulgaris, tuberculosis verrucosa cutis, and Mycobacterium marinum infection, which have similar clinical manifestations, is often only made retrospectively after successful therapeutic trial due to poor laboratory support.

  • The incidence of systemic mycoses (mucormycosis, histoplasmosis, and penicilliosis) is increasing in tandem with the increasing number of immunocompromised patients, such as diabetic patients, organ transplant recipients, and patients with human immunodeficiency virus infection.

  • Common dermatologic conditions seen in one part of this region may be different from those seen in another part because of the wide variation in ethnicity, skin types, hygienic practices, access to medical care, health-seeking behavior, and socioeconomic status.

  • Preferences for alternative treatment and/or poor access to medical care often result in disease presentation in an advanced stage.

  • Because most Southeast Asians have Fitzpatrick skin phototypes III to IV, skin cancers are not common but are increasingly seen in organ transplant recipients who are on long-term immunosuppressive therapy.

Mainland Southeast Asia, comprising West Malaysia, Thailand, Vietnam, Cambodia, Laos, and Myanmar, has a population of about 0.6 billion.1 Although there is no large-scale population-based study to determine the prevalence of skin diseases in this region, multiple hospital-based surveys showed that the spectrum of skin disorders is similar to that seen in other regions except for an increase in pigmentary disorders such as nevus of Ota and Ito.2,3 However, endemic subcutaneous mycoses such as chromoblastomycosis and sporotrichosis, which are prevalent in Southeast Asia, are not usually reported because of limited access to confirmatory laboratory tests. Without good laboratory support, it is impossible to distinguish subcutaneous mycosis from cutaneous tuberculosis (especially lupus vulgaris and tuberculosis verrucosa cutis) and from Mycobacterium marinum infection, which have similar clinical manifestations. The incidence of systemic mycoses (mucormycosis, histoplasmosis, and penicilliosis) is increasing in tandem with the increasing number of immunocompromised patients, such as diabetic patients, organ transplant recipients, and patients with human immunodeficiency virus (HIV) infection.4,5,6 Because most Southeast Asians have Fitzpatrick skin phototypes III to IV, skin cancers are not common but are increasingly seen in organ transplant recipients who are on long-term cyclosporine. Arsenic-induced nonmelanoma skin cancers are seen among patients with chronic exposure to arsenic found in well water and traditional Chinese medication.

Common dermatologic conditions seen in one part of this region may be different from those seen in another part because of the wide variation in ethnicity, skin types, hygienic practices, access to medical care, health-seeking behavior, and socioeconomic status. Preferences for alternative ...

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