skin conditionsand related needfor medicalcare … from the national health survey skin...

Data from theNATIONAL HEALTH SURVEY

Skin Conditions and Related

Need for Medical Care

Among Persons 1=74 YearsUnited States, 1971-1974

DHEW Publication No. (PHS) 79-1660

U.S, DEPARTMENT OF HEALTH, EDUCATION, AND WELFAREPublic Health Service

Office of the Assistant Secretary for HealthNational Center for Health StatisticsHyattsville, Md. November 1978

Series 11Number 212

NATIONAL CENTIER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director

JACOB J. FELDAMN, Ph.D., Associate Director for Amdy.sis

GAIL F. FISHER, Ph.D., Associate Director for the Cooperative Health Statistics System

ELIJAH L. WHITE, Associate Director for Data Systems

JAMES T. BAIRD, JR., Ph.D., Associate Director for International Statistics

ROBERT C. HUBER, Associate Director for Managewzent

MONROE G. SIRKEN, Ph.D., Associate Director for Mathematical Statistics

PETER L. HURLEY, Associate Director for Operations

JAMES M. ROBEY, Ph.D., Associate Director for Program Development

PAUL E. LEAVERTON, Ph.D., Associate Director for Research

ALICE HAYWOOD,, Information Officer

DIVISION OF HEALTH EXAMINATION STATISTICS

MICHAEL A. W. HATTWICK, M.D., Director

JEAN ROEERTS, Chiej, Medical Statistics Branch

ROBERT S. MURPHY, Chiej Survey Planning and Development Branch

DIVISION OF OPERATIONS

HENRY MILLER, ChieJ Health -Examination Field Operations Branch

COOPERATION OF THE U.S. BUREAU OF THE CENSUS

Under the legislation establishing the National Health Survey, the Public Health Service isauthorized to use, insofar as possible, the sesw?icesor facilities of other Federal, State, or privateagencies. In accordance with specifications established by the National Center for Health Statis-tics, the U.S. Bureau of the Census participated in the design and selection of the sample andcarried out the household interview stage of :the data collection and certain parts of the statis-tical processing.

Vital and Health Statistics-Series 11-No. 212

DHEW Publication No. (PHS) 79-1660Library of Congress Catalog Card Number 78-11486

Library of Congress Cataloging h Publication Data

Johnson, Mane-Louise T.Skin conditions and related need for medicaI care among persons 1-74 years, United

States, 1971-1974.

(Vital and health statistics: Series 11, Data from the National Health Survey; no. 212)(DHEW publication; no. (PHS) 79-1660)

1. Skin–Diseases–United States–Statistics. 2. Health surveys-United States. I. Roberts,Jean, joint author. II. Title. III. Series: United States. National Center for Health Statistics.Vital and health statistics: Series 11, Data from the National Health Survey, Data from thehealth examination survey; no. 212. IV. Series: United States. Dept. of Health, Education,and Welfare. DHEW publication; no. (PHS) 79-1660. [DNLM: 1. Skin diseases—Occurrence—United States. 2. Skin diseases–Pathology. W2 A N148vk no. 212]RA407.3.A347 no,, 212 [RL72] 312’.0973s[312’.35’00973] 78-11486

CONTENTS

Introduction ...........................................................................................................................................

Dermatology Examination .....................................................................................................................Mycological Studies ..........................................................................................................................Biopsies .............................................................................................................................................Photography ............... ...................................... .............. ..................................................................Classification of Disease Conditions ..................................................................................................Quality Control .................................................................................................................................

Findings ......................................................................... ........ ............ ....................................................Prevalence ................................................................................................................... ................... ...Extent of Concern for Skin Pathology ............................. .................................................................Recurrence and Duration of Skin Pathology of Concern ...................................................................Handicap From Skin Condition ........................................................................................................Discomfort From Skin Condition .....................................................................................................Adequacy of Treatment for Skin Condition ......................................... ................ ............................Comparison With Previous Studies ................................ ....................................................................

summary...............................................................................................................................................

References .............................................................................................................................................

fist of Detailed Tables ...........................................................................................................................

AppendixesL Statisticrd Notes ............................................................................................................. ..........IL The Dermatology Examination Form .......................................................................................III. Skin Pathology Classification and Glossary of Selected Terms ..................................................

LIST OF TEXT FIGURES

1. Prevalence rates for significant skin pathology and significant skin conditions among persons 1-74years, by age: United States, 1971-1974 ......................................................................................

2. Prevalence rates for significant skin pathology among persons 1-74 years, by age and sex: UnitedStates, 1971-1974 ................... .....................................................................................................

3. Prevalence rates for significant skin pathology and significant skin conditions among persons 1-74yea-s, by age and sex: United States, 1971-1974 .. .......................................................................

4. Prevrdence rates for the 7 most frequently occurring types of skin pathology among persons 1-74years, by sex: United States, 1971-1974 ............................... ...................................................... .

5. Prevalence rates for the 4 most frequently occurring types of skin pathology among persons 1-74years, by age: United States, 1971-1974 ................................ ..................... .................................

6. Prevalence rates for the principaf types of skin pathology within each age group among persons1-74 years: United States, 1971-1974 ........................................................................... ...............

7. Prevalence rates for the 4 most frequently occurring types of skin pathology among persons 1-74years, by age and sex: United States, 1971-1971 .........................................................................

1

333444

44

101415172022

24

26

27

486067

8. Prevalence rates for significant skin pathology with occupationrd exposure among persons 18-74years, by age and sex: United States, 1971-1974 ............................................................... ..........

...[11

9. Prevalence rates for skin conditions of concern (complaints), significant skin pathology not ofconcern, and nonsignificant skin pathoIogy of concern among persons 1-74 years, by age:United States, 1971-1974 .. .. .... .. .. .... ... .. .... .. .. .... .... . .... ... .. ... .... .. .... . ... ...... ... .... .. ... .... .. ... .... .. ... ...... . .

10. Prevalence rates for skin conditions of concern (complaints) among persons 1-74 years, by ageand sex: United States, 1971-1974 .. ..... .. . .. ... ... ..... .... .... .. .. .... .. ... ... ... . ..... .. .... .... . .. .. ... ... . .... .. . .. .... . ..

11. Prevrdence rates for the major types of skin conditions of concern (complaints) within each agegroup among persons 1-74 years: United States, 1971-1974 . . .. .... .. ... ..... . ... ... ... ... .... . .. ..... ... .. .... .. . .

12. Prevalence rates for the major types of skin conditions of concern (complaints) among persons1-74 years, by age: United States, 1971-1974 .. .... .. .... .... .. .. .. .. .. . ... .. ... . ... ... ... .. .... .. . .. .... .. . ..... .. .. ......

13. Percent of persons 1-74 years with selected significant skin pathology who are concerned aboutthe condition, by sex: United States, 1971-1974 .. ... .... .. .... .. . ..... . ... ..... .. . .... .. .. . ..... .. .. ..... .. .. ... ... ... ..

14. Percent of skin conditions of concern (complaints) considered sociaf or employment-houseworkhandicap by the individual or to be disfiguring to at least some extent by the examiner, by age:United States, 1971-1974 . ..... .. .. .... .. . .. ... ... .. .... . .... ... ... .. .... .. .. ... .. . .... .. .. . .. .... ... .. .... .. ... .... ... .. .... . .... ...

15. Percent of males and females 1-74 years with skin conditions of concern (complaints) rated asdisfiguring by examiner or causing some type of handicap to the affected person: UnitedStates, 1971-1974 . ..... . .. ..... .. . ..... .. ... .... . ... .... ... .. .... . .. .. .... .. .. .... .. .. .... .. .. . .... .. .... ... .. ... .... .. . ..... .. . .. ..... .

16. Percent distribution of persons with skin conditions of concern (complaints), by adequacy oftreatment for condition(s) and age: United States, 1971-1974 . .... .. .. . .... .. ... ... ... .. ..... . .... ... ... .. .... ...

LIST OF TEXT TABLES

A. Rank order and rates (greater than 10.0 per 1,000 population) of the most prevalent types ofskin pathology, within each age group: United IStates, 1971-1974 ... ... ... ... ... ... .. .... .. .... ... .. ... .... .. .. .

B. Prevalence rates for selected significant and nonsignificant types of skin conditions and propor-tion of each type rated as significant among persons 1-74 years: United States, 1971 -1974 .. . ... ..

c. Rank order and rates (greater than 3.0 per 1,000 population) of the most prevalent types of skinconditions of concern (complaints), within each age group: United States, 1971 -1974 . ... .... .. .. ...

D. Proportion of persons with selected specific types of significant skin pathology who complainedabout the condition, within each age group: United States, 1971-1974 .... .. .. ..... . ... ..... . ... .... .. .. .... .

E. Percent of persons 1-74 years with skin conditions of concern (complaints), by the recurrenceand duration of condition, the degree of resultant handicap or disfigurement, part of bodyaffected, and sex, showing selected standard errors: United States, 1971-1974 . . .... ... ... .... .. .. .... ...

F. Percent distribution of persons 1-74 years with skin conditions of concern (complaints) by extentof discomfort from condition, according to part of body affected and sex, showing selectedstandard errors: United States, 1971-1974 .. ... ... .. .. ..... .. ... .... .. . ..... . ..... ... . .. ..... .. .. ...... . .. ..... .. ... ... ... ..

G. Percent distribution of persons 1-74 years with skin conditions of concern (complaints) reportingsome degree of resultant handicap-employ merit-housework, social, or overall discomfort-byexaminer’s rating of extent of disfigurement, age, and sex: United States, 1971 -1974 . ... .. ... .... ...

H. Percent of persons 1-74 years with skin conditions of concern (complaints), by type of caresought, adequacy of present treatment, reasons for not seeking care, part of body affected, andsex, showing selected standard errors: United States, 1971-1974 .... .. .. .... .. ... ..... . ... ..... . ... ... .. .... ... .

J. Percent of persons with skin conditions of concern (complaints) by reason no care was soughtand adequacy of treatment sought, accordkg to age and sex: United States, 1971 -1974 ... . .. . .....

K. Prevalence of selected skin conditions from the Health Interview Survey (HIS) of 1969 and thedermatology component of the Health and Nutrition Examination Sumey (HAF’ES) of 1971-1974: United States .. ... ... ... .. ... .. . .. .... ... .. .... .. .. .... ... ... ... .. .. ..... .. ... ... ... . ...... .. . ..... . .. . ..... . ... ...... . .. ..... . .. .

11

11

13

13

14

16

19

21

7’

10

12

13

15

18

19

20

22

23

iv

SYMBOLS

Data not available---—-–--------———— ---

Category not applicable———————— . . .

Quantity zero-—-———— —————-

Quantity more than Obut less than 0.05— 0.0

Figure does not meet standards ofreliability or precision *

SKIN CONDITIONS AND

MEDICAL CARE AMONG

RELATED NEED FOR

PERSON 1-74 YEARS

Marie-Louise T. Johnson, M.D., Ph.D., New York University School of Medicine;and Jean Roberts, M.S., Division of Health Examination Statistics

INTRODUCTION

This report contains estimates of the preva-lence of the various types of skin pathologyincluding those derrnatological conditions aboutwhich the individual expresses concern, the ex-tent of handicap or discomfort from such condi-tions, and the extent of need for related medicalcare among the civilian noninstitutionalized pop-ulation of the United States 1-74 years of age.These national estimates are based on findingsfrom the first Health and Nutrition ExaminationSurvey of 1971-1974. The prevalence data areanalyzed by age and sex.

An Advance Data report “Prevalence of Der-matological Disease Among Persons 1-74 Yearsof Age: United States” summarizing some ofthese findings has been published. 1

The Health Examination Survey in whichthese data were obtained is one of the majorprograms of the National Center for Health Sta-tistics authorized under the National Heahh Sur-vey Act of 1956 by the 84th Congress as a con-tinuing Public Health Service activity to deter-mine the hezdth status of the population.

The intent of the National Health Survey2 iscarried out through the programs of the HealthExamination Survey; the Health Interview Sur-vey which collects health information from sam-ples of persons by household interviews focusedprimarily on the impact of illness and disabilitywithin various population groups; the HealthManpower and Facilities surveys which obtaindata on hospitals, nursing homes and other resi-dent institutions, and the entire range of person-

neI in the health occupations; and the HealthResources Utilization surveys.

Only in the Health Examination Survey pro-grams are health data collected by direct physi-cal examinations, tests, and measurements per-formed on samples of the population. Hence, itprovides the best of the survey methods forobtaining diagnostic data on the prevalence ofmedicaI1y defined illness. It is the only one ofthe survey programs of the National Center forHealth Statistics that secures information onpreviously unrecognized or undiagnosed condi-tions as well as on a variety of physical, physio-logical, and psychological measures within thepopulation. Medical history, demographic, andsocioeconomic data with which the examinationfindings may be interrelated are also collectedon the sample population under study in theseexamination surveys.

Since it was organized, the Health Examina-tion Survey has been conducted as a series ofseparate programs, called “cycles, ” each ofwhich is Iimited to some specific segment of theU.S. population and to specific aspects ofhealth. During the first cycle in 1960-1962, theprewdence of certain chronic diseases, includingheart disease and =thritis, and the distributionsof various physical and physiological measureswere determined among a defined adult popula-tion.3 ~4For that program, a national probabilitysample of 7,710 adults, of whom 6,672 (86.5percent) were examined, was selected to repre-sent the 111 million civilian noninstitutionalizedadults age 18-79 years in the U.S. population atthat time.

For the second and third cycles in1963-1965 and 1966-1970, the target popula-tions were the Nation’s noninstitutionalized chil-dren age 6-11 years and youths age 12-17 years,respectively.5 Y6 In both programs, the examina-tion focused primarily on health factors relatedto growth and development. For the second pro-gram, a national probability sample of 7,417, ofwhich 7,119 (96 percent) were examined, wasselected to represent the nearly 24 million U.S.children age 6-11 years in the noninstitutional-ized population. For the third program, a na-tional probability sample of 7,514, of whom6,768 (90 percent) were examined, was selectedto represent the 22.7 million of that age in thecivilian noninstitutionalized population.

The first Health and Nutrition ExaminationSurvey (HANES I), from which the findings inthis report were obtained, was designed to meas-ure the nutritional status of the U.S. populationage 1-74 years and to obtain some limited infor-mation on the general health status of the entireage group as well as more detailed informationon the health status and medical care needs ofadults age 25-74 years in the civiIian noninstitu-tionalized population. A comprehensive descrip-tion of the specific content and plan of opera-tion of the HANES I program, including sampledesign, has been published.7 Data collectionoperations were slowed during the survey be-cause of budgetary limitations, making it neces-sary to extend HANES I through mid-1974 sothat the entire probability sample selected in theoriginal design for this program could be ex-amined.

As in previous Health Examination Surveyprograms, the U.S. Bureau of the Census cooper-ated in the sample design and in the initial visitsand interviewing at selected eligible householdsin the 65 primary sampling units (PSU’S)throughout the United States. Additional house-hold visiting, interviewing, history taking, andexplaining of the examination portion of theprogram were done by members of the fieldteams of the mobile examination center. Theselected sample persons for whom an appoint-ment could be made were brought into thespecially constructed mobile examination cen-ters which were moved into a central location ineach of the PSU’S. The teams that traveled tothe various survey locations throughout the

country included medical and dental examinersas well as technicians, interviewers, and otherstaff.

The probability sample design used ifi thestudy provided for a sampling ratio of poor per-sons, preschool children, women of childbearingages, and the elderly that was higher than theratio among others in the civilian noninstitu-tionalized population.

Field data collection operations for HANESI were started in April 1971 and completed inJune 1974. Of the 28,043 persons 1-74 yearsselected in the national probability sample torepresent the 194 million of those ages at mid-survey time in the civilian noninstitutionalizedpopulation, 20,749 (74.0 percent) were ex-amined. The response rate decreases with agefrom 83.7 percent among those 1-5 years to64.3 percent among those 65-74 years. Whenadjustments are made for the differential, samp-ling ratios used in the age-sex-income-definedpopulation subgroups, this represents an effec-tive response rate of 75.2 percent.

The findings in this report are shown asnational estimates based on weighted observa-tion; that is, the data obtained for each ex-amined person are inflated to the size of thetotal population of which the sample was repre-sent ative.

The estimates have been calculated asthough the examined persons in each of the age(at interview), sex, and income classes are a ran-dom subsarnple of the sample persons in thesame class. Although there is evidence fromearlier examination surveys and medical historydata from HANES I that this is not an unr~~ason-able approximation, it is clear that some esti-mates are subject to considerable risk of biaswhen more than one-quarter of the sample per-sons in a particular age-sex-income class werenot examined. All age-specific data in this reportare shown as age at the time of examination.

The dermatology component of HANES Iwas planned at the request of and in cooperationwith the Committee on Planning for the Na-tional Program for Dermatology of the NationalAcademy of Dermatology. Dr. Marie-Louise T.Johnson, Chairman of the Data Collection Unitfor the National Program, was primarily respon-sible for planning the content of the den~atol-ogy examination, recruiting the dermatologists,

2

and training them in the examination methodol-ogy so as to minimize interobserver variation.

Statistical notes on the sampIe design, relia-bility of the data, and sampling and measure-ment error are included in appendix I. The der-matology examination form is reproduced inappendix II, and a glossary of the most prevalentdermatological diseases or conditions may befound in appendix 111.

DERMATOLOGY EXAMINATION

The dermatological part of the HANES Iexamination included a complete clinical examin-ation of the skin and subcutaneous tissue thatconsidered normal variations in texture andcolor, certain manifestations of aging, and allpathological changes. Whenever possible, signifi-cant diagnoses such as malignancy were docu-mented by tissue biopsy and suspected infec-tions by Tzanck smear or by culture to identifyfungi or bacteria. Estimates were made of actinicexposure experienced, as well as actinic damagesustained, and of occupational risk from irritantand allergic contractants. For an examinee witha significant hand, foot, or generalized problem,a judgment was made about the burden to theexaminee in terms of discomfort or disability,about care sought, and about the effect thatcould be expected from the current best careavailabIe in the present state of the art.

The Dermatology Examination form whichprovided for the recording of the examiner’sfindings was divided into five parts. The firstgave a summary of the major dermatologicalfindings and procedures as well as significanthistorical and environmental data. The secondprovided for information about the skin in gen-eral such as color, texture, the ectoderndappendages, vascular lesions, pigmented nevi,and those pathological changes that occur in ageneralized fashion such as purpura, seborrheickeratoses, or warts. The third part was for re-gional findings pecuIiar to amanatomical area asthe head or neck, such conditions as xanthe-lasma, cheilosis, or scrotal tongue. The fourthpart focused on disease-oriented informationgiving more detail on such common problems asacne, psoriasis, atopy, and others. The last partrepresented an effort to evaluate the impact of

the dermatoIogical condition observed-how ithad modified the individual’s life through physi-cal or psychic incapacitation, and how it mayhave precluded a preferred activity. An estima-tion was made by the examiner of the degree ofdisfigurement the condition had produced aswell as the symptoms the exzuninee had suf-fered. Information was obtained from theexaminee about care sought for the skin prob-lem or, if no care was sought, why not. Had itbeen a matter of not knowing about availabletherapy on the part of the examinee or hisphysician? Had it been a problem of finances orinconvenience in travel, or the unavadability ofcare at any price or distance? If the person wasreceiving treatment, a judgment was made bythe examiner concerning the adequacy oftherapy, and if inadequate, whether the currentbest care in the present state of the art in medi-cine would improve the condition.

Mycological Studies

AH lesions that the examiner considered tobe fungous or to include fungous in the differ-ential were scraped, as were all scaling lesions ofthe hands and feet and all circumscribed scalinglesions anywhere on the body that might be con-sidered “ringworm” not only by the nonderma-tological physician but by the layman or thepharmacist.

The Iesions were scraped with a scalpel orslide, and the scrapings, sealed between two glassslides, were sent the same day to Dr. WilIiamEpstein, Department of Dermatology, Universityof California Medical Center, for examinationand culture to identify any fungus present.

Biopsies

Biopsies were taken only from adults whocould provide consent. With lesions on the heador neck, ordy those were biopsied that were clin-ically suggestive of malignancy or of a diagnosisof grave importance such as lupus erythema-tosus, the grarndomatous diseases; tuberculosis;leprosy; sarcoid; and simikw conditions. On thecovered areas of the body, any significant Iesionor any lesion of obscure or uncertain identifica-tion was biopsied as needed by the examiner,but ordy if the examinee understood the reasonsfor the procedure and consented to biopsy inwriting.

3

Photography

Lesions biopsied were photographed when-ever possible (but always with the examinee’spermission) and especially if they occurred in acosmetically significant area, or if, after ex-cision, the defect would require suturing, or ifthere were some question about the dia~osis.These photographs were used in later review tosupport the diagnoses when the biopsy findingswere available.

Classification of DiseaseConditions

Both the significant skin pathology and theskin conditions of concern to the examinee wereidentified and classified by the dermatologistexaminer using the Code of Skin Diseases of theDepartment of Dermatology, New York Univer-sity School of Medicines For a glossary definingthe more prevalent of these conditions seeappendix 111.

Quality Control

From the National Academy of DermatoI-o~, Dr. Marie-Louise Johnson, Chairman of theData Collection Unit for the Committee on Plan-ning for their National Program was primarilyresponsible for recruiting the 101 survey derma-tologists and for training them in the standarddermatology examination procedures used at the65 examination locations of the Health andNutrition Examination Survey in 1971-1974.

After concluding the examinations, findingsfrom the mycological studies and biopsies wereused to complete and modify the diagnosticimpressions of the dermatology examination.A full review was then made with Dr. Johnsonto ensure that all examiners followed the exami-nation protocol for identifying the varioustypes of skin pathology and for diagnosingsignificant conditions.

As might be expected, despite the standardprotocol, frequent review, and constant surveil-lance, there is considerable variation amongexaminers in the observations recorded. Closerinspection would indicate that these reflect to agreater extent geographic and environmentallyrelated differences in the distribution amongthose examined rather than a true examiner vari-

ability. However, the conscientiousness of someexaminers in recording all freckles, for example,was apparent in cont;ast to others who tendedto underreport banal lesions and normal varia-tions. However, there was also a considerabledifference among examiners in numbers ofpatients considered to have significant skinpathology. The given guide of significance, acondition that should be seen at least once by aphysician for assessment or care, permittt!d arange of interpretation according to the ex-aminer’s training and personal experience. Whenthe effect of any difference in the distributionamong those examined by the 101 dermatolo-gists was removed by direct adjustment (apply-ing the age-sex-specific rates for each exardineragainst the total number of examinees in $achage-sex group ), there were substantial differ-ences among examiners in the findings of si~nifi-cant skin pathology and in conditions aboutwhich the examinee expressed concern. Age-adjusted prevalence rates of significant skinpathology range from O to 90.4 percent,, theaverage being 31.2 percent. Half of the, ex-aminers found between 14 and 46 percent oftheir examinees to have such pathology. Therange in the proportion expressing compl$ntsabout skin conditions to the ex~miner was fromO to 70.8 percent per examiner, the avdragebeing 11.4 percent with half of the examinersshowing rates between 2.7 and 19.8 percent.Further detail on examiner variability is given inappendix I.

FINDINGS

Prevalence

Skzk pathology. –Nearly one-third (312.4per 1,000 population), or an estimated 60.6million of the U.S. population age 1-74 yearshave some skin pathoIogy–one or more signifi-cant skin conditions (table 1) that should beevaluated by a physician at least once. Thesenational estimates are based on findings fromthe standardized examination given by a derma-tolo~st among a natiomd probability sample ofthe civilian noninstitutionalized population inthe Health and Nutrition Examination Survey of1971-1974.

4

The prevalence of significant skin pathologyincreases rapidly with age from a rate of 142.3per 1,000 chddren age 1-5 years to 362.0 per1,000 youths age 12-17 years and to 365.1 per1,000 young adults age 18-24 years, due primar-ily to the increase in acne .vulgaris associatedwith endocrine changes occurring around thetime of pubertyg’1 z (table 2 and figure 1). Aftera slight decline at age 25-34 years, the preva-lence of skin pathology again increases with agebut at a slower rate than among children andadolescents, reflecting the rapid increases withage in the prevalence of such diagnoses as psoria-sis and vitiIigo and such problems as malignantand benign tumors, actinic and seborrheic kera-toses.

Skin pathology is consistently more preva-lent among males than among females from 6through 74 years (tables 3, 4, and figure 2),although the differences in the rates across theage range are too small to be consistently sta-tistically significant (at the 5-percent probabilityIevel) among children and young to middle-ageadults; among youths age 12-17 years and adultsage 35-44 years the differences are negligible(less than 3 per 1,000 difference). About one-fifth of the population (21.7 percent or 42.0

600

200

I I I 10 20 40 60 80

AGE IN YEARS

Figure 1. Prevalence rates for significant skin pathology andsignificant skin conditions among persons 1-74 years, byage: United States, 1971-1974

‘rMale

Female

1 20 40 eo so

AGE IN YEARS

Figure 2. Prevalence rate$ for significant skin pathology amongpersons 1-74 years, by age and sex: United States, 1971-1974

million persons) have only one such skin condi-tion, 6.4 percent or 12.4 milhon have two, and3.2 percent or 6.1 miUion persons have threesignificant types of conditions (table 5). Becausethe dermatologist examiner was limited to iden-tifying no more than the three most serious con-ditions, the true prewdence rates of some of thespecific conditions in the population may beslightly underestimated.

Types of conditions. –The increase with agein the prevalence of significant skin conditions ismore rapid than that shown for skin pathologyin the individual. This is true among youths age12-17 years, young adults age 18-24 years, andadults age 35-74 years, indicating that over theage of 12 years the individuals with essentiallynormal skin are somewhat less likely to developskin pathology than those with some skin pa-thology are to deveIop a new problem. Further-more, males age 12-74 years are abo more Iikelythan are females of comparable age to have morethan one type of significant skin condition(figure 3).

The most frequently occurring groups ofsignificant skin conditions are those affectingthe sebaceous glands (84.8 per 1,000 persons);dermatophytoses or fungal diseases (81.1 per1,000); malignant or benign tumors (56.5 per1,000); seborrheic dermatitis (28.5 per 1,000);atopic dermatitis and eczema (18.4 per 1,000);and contact dermatitis (13.6 per 1,000). Among

5

MALEam —

~ew””*#e

f Slgnlficant,[ skin conditions

600 — )1/’-%

/ /)%

! -%*’

s l“ /

8:. 4(M /’

E 1’Personswith

~significant skin

/pathology

?~

/

200 —

FEMALEc?oor

I ./”

I/“

r-w% /’ $Ignificmt-w6H~ skincondition%

;.%/’-’-

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I I I0 20 40 60 80

AGE IN YEARS

Figure 3. Prevalence rates for significant skin pathology andsignificant skin conditions among persons 1-74 vears, bv. . .age and sex: United States, 1971-1974

males, the most prevalent skin conditions are thedermatophytoses, diseases of the sebaceousglands, turn ors, and seborrheic dermatitis;among females, the diseases of the sebaceousglands are the most prevalent followed bytumors (malignant and benign), dermatophyto-ses, and seborrheic dermatitis (figure 4).

Among the individual types of significantskin pathology diagnosed, the most prevalent areacne vulgaris (68,1 per 1,000 population); fungalconditions on the feet, tinea pedis (38,7 per1,000); benign tumors (38.2 per 1,000); sebor-rheic dermatitis, type not identified (28,2 per1,000); fungal conditions around the nails, tines

unguium (21.8 per 1,000); precancerous andunspecified tumors (12,4 per 1,000); vmrucavulgaris (8.5 per 1,000); folliculitis (8.0 per1,000) and atopic dermatitis (6.9 per 1,000,).

The trend with age in the prevalence ~f theprincipal types of skin conditions shows therapid increase in diseases of the sebaceous glands(primarily acne vulgaris) to age 12-17 years,when it is most prevalent, followed by a steadydecrease from age 18-45 years with essentiallyno change from age 55-74 years. The rates forthe dermatophytoses increase with age from6-54 years then decline slightly, while ~umorprevalence generally increases from age 6 yearson with the most rapid increase observed amongolder adults ages 55-64 and 65-74 years (table A~figures 5 and 6).

Among males and females, the trends withage in the prevalence rates for the mo~t fre-quently occurring skin conditions show a gemerally similar pattern of peak preval~nce fordiseases of the sebaceous glands (primarily re-flecting the pattern for acne vulgaris) itt age12-17 years for both males and females (figure7), The prevalence rates for the derm@o:phyto~ses increase substantially more rapidly with agefrom 12-54 years among males and remainhigher among nm.les than among females acrossthe age range 6-74 years. Among men, thd prev-alence of tumors increases consistently with agefrmn 35-74 years, the rate of increase with agebeing more rapid than that for worncn at age35-54 years, but similar for both sexes frqm age55-74 years.

Occupational exposure. –Nearly one-fourth(23.9 percent) of adults 18-74 years of age withsignificant skin pathoIogy indicate an exposurein their work environment to various types ofchemicals, fumes, vapors, oils, or insecticides, orto prolonged immersion of the hands or feet titwork. Except for contactants and allerg~s, nodata were generated to infer causal relationships.

The proportion with skin conditions hssoci.ated with occupational exposure is more thantwice as high among men (32.4 percent) aswomen (14.4 percent ). There is a general in-crease with age in this rate among women butnot men age 18-64 years, Among both sexes therates drop off at age 65-74 years (figure 8).

Suppressed conditions, -In addition to thesignificant skin conditions active at the time of

6

150r Iz?Male

El Female

100 —

50 —

o Y/xl “ 1 P//a “i

Diseasesof Dermato. Tumors seborrheic Atopic contact Ichthyuis,sebaceous phytoses dermatitis dermatitis, dermatitis keratosisglands eczema

Figure 4. Prevalence rates for the 7 most frequently occurring types of skin pathology among persons 1-74 years, by sex: United States,

1971-1974

Table A. Rank order and rates (qreater than 10.0 per 1,000 population) of the most prevalent types of skin pathology, within each ane

1-5 years

Actopic dermatitis, eczema (24.9)

Tumors, malignant and benign (21 .7)

Contact dermatitis (13.9)

18-24 years

Diseases of sebaceous glands (191.1)

Dermatophytoses (61 .7)

Tumors, malignant and benign (43.0)

Seborrheic dermatitis (38.7)

Folliculitis (18.9)

Atopic dermatitis, eczema (1 5.4)


Verruca vulgaris (1 2.4)

45-54 years

Dermatophytoses (155.7)





Atopic dermatitis, eczema (13.9)

Psoriasis (11 .4)

group: United States, 1971-1974

6-11 years




Ichthyosis, keratosis (15.5)

Verruca vulgaris (13.1 )

25-34 years



Seborrheic dermatitis (41 .9)



‘olliculitis (15.4)

Ichthyosis, keratosis (1 1.5)

55-64 years

Dermatophytoses (1 50.8)

rumors, malignant and benign (100.2)


;eborrheic dermatitis (28.7)

2ontact dermatitis (23.6)

Seborrheic keratosis (18.3)

ltopic dermatitis, eczema (12.8)

Vitiligo (12.6)

12-17 years



Tumors, malignant and benign (31 .3)



Ichthyosis, keratosis (16.7)

Verruca vulgaris (15.5)

3544 years




Seborrheic dermatosis (41 .6)



Folliculitis (12.8)

65-74 years

Tumors, malignant and benign (184.1 )







Vitiiigo (13.6)

7

— Diseases of sebaceous glands

‘r

----- Dermatophytoses

. . . . . . . . . . . Tumors

----- .%borrheic dermatitis

o

...

[20 40 60 80

AGE IN YEARS

the examination and diagnosed by the dermatol-ogist examiner, those previously diagnosedsignificant skin conditions that were suppressedor in remission at the time of the examinationwere also recorded for each examinee. Record-ing was limited to the two most serious of suchconditions.

One in eight, persons (124.9 per 1,000) hasat least one such clinically inactive condition,the rate increasing with age from 69.6 per 1,000at age 1-5 years and 69.1 per 1,000 at age 6-11years to 162.6 per 1,000 at age 35-44 years thendeclining slowly to 123.4 per 1,000 at age 65-74years (table 5). The proportion of persons withsuch conditions is slightly higher among femalesthan among males, but the pattern across the agerange is not consistent. Less than 15 percent of

Figure 5. Prevalence rates for the 4 most frequently occurring

types of skin pathology among persons 1-74 years, bv aqe: the;e persons have two significant co;dltions inUnited States,” 1971-1974 - remission.

300 —

$Gs3 200$

i--ak 100:~

EElo1.5years 6.11 years 12.17 yearn 18.24 years 25.34 years

❑ Amdcclemmtkk

T❑ Contactdwmatitls ~ Tumors ~ Sebwrheickeratosls

~ Dwmatophytoses ❑ Dkeasesof sebaceo.sgla”d$ ❑ Seborrheicdermatltis

$

$i~ 20Q0

i,-.K

v$

0 m Fz ENWl

3544 years 45.54 years 55.64 years a5.74 years

AGE

Figure 6. Prevalence rates for the principal types of skin pathology within each age group among persons 1-74 years: Unitecl States,

1971-7974

_ Diseasm of sebaceous glands iflALE300 . --- Dermatophytos?s

. . . . . . . . Tumors---- Seborrheic dermatitis

my 200<

;.

a

2/’

g 100 — /’K

I

o 20 40 60 80

3CQ r FEMALE

o

//

/

....I

?0 40 60 80

AGE IN YEARS

Figure 7. Prevalence rates for the 4 most frequently occurring

types of skin pathology among persons 1-74 years, by ageand sex: United States, 1971-1974

‘0r

~Do

AGE IN YEARS

Figure 8. Prevalence rates for significant skin pathology with

occupational exposure among persons 18-74 years, by ageand sex: United States, 1971-1974

Approximately one in six persons with.active- ~ignificant “skin pathology diagnosed alsohas a significant skin condition suppressed or inremission at the time of the examination; amongthose with si~ificant skin conditions in remis-sion, about one-third also have active pathology.The prevalence rate of significant active and sup-pressed pathology is 47.4 per 1,000 persons, therate generally increasing with age from 12.4 atage 1-5 years to 68.4 per 1,000 at age 55-64years.

The coexistence of active and suppressedskin pathology is greater among males thanamong females from age 6-64 years (table 5).

The most prevalent of the specific types ofskin condition s-u~pressed or in remission are thecontact dermatltldes (31.9 per 1,000 persons),diseases of the sweat and sebaceous gkmds (19.3per 1,000), atopic dermatitis and eczema (16.0per 1,000), dermatophytoses (1 1.0 per 1,000),benign and malignant tumors (10.5 per 1,000),and infections of the skin including evidence ofa history of verruca vulgaris (10.4 per 1,000) asshown in table 6.

Aronsignificant pathology. –The dermatolog-ists recorded all skin pathologies identified invarious stages of the examination, whether thecondition was considered significant or not. Mildseborrheic dermatitis, for example, would not beconsidered sufficiently serious to warrant a visitto a physician. Nevertheless, it wouId be recog-nized as an other-than-normal scalp conditionand its presence recorded. By gathering suchdata it is possible to determine the total preva-lence of the various types of skin conditions inthe U.S. population as identified in this surveyexamination and the extent to which each wasconsidered a si~ificant health problem (tabIe6).

The most prevalent of the skin conditions, asshown in tabIe B, is the group of disorders thatincludes traumatic and surgicaI scars, ephelides,and other derrnatitides that affect more thanhalf the population age 1-74 years; ichthyosisand keratosis, 43 percent; malignant and benigntumors, 36 percent; diseases of the sweat andsebaceous glands, 21 percent; diseases of the cir-culatory system, other than the veins, includingOsler-Weber’s disease, telangiectasis, and simiIar

9

Table B. Prevalence ratas for selectad significant and nonsignificant types of skin conditions and Drooortion of each tvoe rated as

significant among persons 1-74 years: United States, 1971-1974

Condition and NYU codel

Other skin disorders (vitiligo, traumatic scars, ephelides, etc.) ... ... .. ..... . ... .... .. .. .... .... . ..... .. ....716

Ichthyosis, keratosis . . ..... ... .. ..... . ... .... .. .. .... ... .. .... .. ... ... ... .. .... ... .. ..... . .. .... ... .. ..... . ... .... .. .. ..... ... ..71 O

Tumors, malignant and benign, and Ieukemias .. .. .... .. .. .. .... 19x,2(jx,22x,23x,23y, e)(~l”ding

22X,44XMalignant tumors ... .... .. .. .... .. .... .. .. .. .. ... . .. .. .... .. .. ... . .... .. .. .. . .... ..... ..... . ... ..... .. .. .... . ... ..... 19X

Diseases of swaat and sebaceous glands ..... ... .. .... .. .. .... ... .. .... .. .. . ..... . ... .... .. .. .... ... .. ..... .. .. ... ... ...7l4

Other diseases of circulatory system (Osler’s disease, telangiectasis, etc.) ... .... ... .. .... .....467-468

Corns, callosities .. .... .. .... .... .. .. .. .. ... . ..... .. ... ..... . .. .... .... . ..... .. ... ... .. .... .. .... .. .... .. .. .... ... .. ......c.. .... ..7Og

Lichen planus ........................................................... ..........................................................7o7

Seborrheic karatosis . .. .. .. ..... . .. .. .... . ... .... .. .. ..... .. ... .... .. .. .... .. . .. ..... .. .. ..... . .. .. .. .. .. . ..... .. .. ..... 22X44X

Seborrheic dematitis ... .. .. ..... ... . ..... .. .. .... .. .... ... ... .. .... .. ... ..... .. .. ... .... . ...... . ... .... .. .. .... .... . ..... .. ..$o7OO

Diseases of veins (varicosa veins, phlebitis, etc.) . . ... ... ... . ..... .. .... .... . .. ...... . .. ..... . ... .....o. .. ...46O~66

Darmatophytoses . ... .. ..... .. ... ..... .. .. .... .. .. ..... .. ... .... . ... .... ... .. .... .. ... ..... .. .. ... ... .. ..... ... . ...c..$. ..... ... ..l3l

Diseases of buccal cavity, salivary glands, lips, pancreas, etc. .. ...<........,.. ... ... ... .... . .. . .....530-587

Infections of skin (boils, impetigo, infectious warts, etc.) .. .... .. .. .... ... .. ..... .. .. ... ... .. .. .... ...69O698

Contact dermatitides .. ... .... .. ... ... ... .. ...... . .. .... .. ... .... ... .. ... .. ... ..... .. .... ... .. .. ..... .. .. ..... . .. ..... ... .. .....7o3

Diseases of hair and hair follicles .. .. ..... ... . ..... . .. . ..... .. . ..... ... .. .... .. .... ... ... .. ... ... .. ..... .. .... ... .. .. .....7l3

pruritus .... .. ... .... .. .. .... .... .. .... .. .. .. ... .. .... ... .. .. .... .. .. .. .... .. .. .... ... .. ..... ... . ..... . .. ..... ... . ....$. ....m... .. . .....7O8

psoriasis ... ... .. .... .. .. ..... ... .. .... ... .. ..... . ... .... ... . ..... ... .. ..... . ... .... ... .. ....<. ... .... .. ... .... .. . ...... . ....c... .. .....7O6

Malignant tumors . .. .. .. .... .. .... .... . .... . .... .... .. .. .. .. .. .. . ..... .. ... ..... ... ..... .. .. .... .. .. .. ... .. ... .... ... .. .... .. .. ..lgX

Deep fungal infections .. . .. .... .... . ..... ... . ..... . .... ... .... . .... .. ... ..... . ... ..... . .. ..... .. ... .... .. .. .... ... .. ....l32.l34

Injuries, adverse effacts of chemicals and other external conditions ... . .... .... .. .... .. ... .. ....850-999

Zoonoses ...... . ... .... .. .. .... .... .. ..... . .. .... ... .. .... . .... .... .. .. ..... .. . ...... . ... ..... . ... .... ... . .... .. .... .... .. .. ...l35.l37

Leishmaniasis and other parasitic diseases .. ... .... ... . .... ... ...r ... . ... ..... . ... ... ... ... ..... . ... ..... . ... ..l2O.l3O

lSee reference 8.

Skin conditions

EEIEz

Rate per 1,000 population

516.2

432.7

357.1

11.6

209.5

182.7

156,9

140.6

124.1

116.7

95.6

81.1

62.0

60.0

53.9

50.5

25.8

14.3

11.6

4.4

3.8

1.0

0.2

27.5

21.8

56.7

5.9

87.0

1.0

3.2

0.8

5.2

28.5

7,5

81.1

2.4

15.9

13.6

15.8

13.7

8.8

5.9

2.4

3.7

0.8

0.1

488.7

410.9

300.4

5.7

122.5

181.7

153.7

139.8

118.9

88.2

88.1

59.6

44.1

40.3

34.7

12.1

5.5

5.7

2.0

0.1

0.2

0.1

Pro-portion:Iassed

as sig-nificant.—

Percent

5.3

5,0

15.9

50.9

41.5

0.5

2.0

0.6

4.2

‘24.4

7.8

100.0

3.9

26.5

25.2

31.3

53.1

‘61.5

50.9

54.5

97.4

80.0

50.0

conditions, 18 percent; corns and callosities, 16 Extent of Concern for Skin

percent; lichen- pkmus, 14 percent; seborrheic Pathology

keratoses, 12 percent; and seborrheic dermatitis, Nearly one-eighth (11 8.2 per 1,000 persons)nearly 12 percent. or an estimated 22.9 million of the U.S. popula-

10

tion 1-74 years of age have one or more skinconditions about which they complain or ex-press concern (table 7). For most of these per-sons (96 percent with such conditions or a rateof 113.6 per 1,000 in the population), a specificcondition affecting their hands, feet, or otherpart of the body was identified as the cause oftheir concern (table 8). For the remaining 4 per-cent (rate of 4.6 per 1,000 in the population)with multiple types of skin complaints, thepathology was more generalized, not limited toone or two specific areas of the body.

For some 9 percent of those who com-plained about an identified type of skin condi-tion, it is one that affected their hands; for 16percent, their feet; and for 75 percent, theirface, neck, or other area of the body.

Nearly one-third (31 percent) of personswith significant skin pathology diagnosed by thedermatologists express concern about thesespecific skin conditions; nearly 18 percent ofthose who complain about their skin conditionsare concerned about conditions not consideredserious or significant by the dermatologists(table 7).

Skin complaints are more prevalent amongyouths and adults than among children age 1-11years, the prevalence rates being 2% to 3%!timesgreater than those among children, but showingno other significant trend with age. Rates forsignificant pathology not of concern to theaffected individual increase with age from 1-24years, drop back at age 25-44 years, then stead-ily increase with age; the proportion with non-significant pathology of concern tend to de-crease slightly with age among adults (table 7and figure 9).

Skin conditions of concern to the affectedindividual are slightly, but not significantly,more prevalent among males and among females(rates of 128.2 per 1,000 and 108.8 per 1,000,respectively), but only from 18-74 years of ageare the rates among males consistently thehigher (figure 10).

Males are slightly more likely to be con-cerned about a significant type of skin pathol-ogy at age 35-64 years than are females, andpreschool-age girls are somewhat more likely tobe concerned than a-e boys of like age. “Concernregarding nonsignificant skin pathology is aboutas likely to be expressed by males as by femalesexcept at ages 1-5 years, 12-17 years, and 55-64

1Significant patholcgy “d **

of concern 0“”0

~4*\ //0

i \\ /“””

/\

-.””

h-——i/’

Skin condition of concern,/”

,/

~............................... ...........

20 40 60 80

AGE IN YEARS

Figure 9. Prevalence rates for skin conditions of concern (com-

plaints), significant skin pathology not of concern, andnonsignificant skin pathology of concern among persons1-74 years, by age: United States, 1971-1974

0 20 40 so aoAGE IN YEARS

figure 10. Prevalence rates for skin conditions of concern

(complaints) among persons 1-74 years, by age and sex:United States, 1971-1974

years where these rates are higher among femalesand age 45-54 where the rate among males is thehigher.

Types of conditions of concern. –The mostfrequently reported skin complaints axe thoseaffecting the sebaceous glands (28.2 per 1,000persons 1-74 years of age), dermatophytoses(fungal conditions–21.6 per 1,000 persons),atopic dermatitis and eczema (allergies and re-lated conditions–10.8 per 1,000 persons), malig-nant and benign tumors (8.1 per 1,000 persons),

11

Table C. Rank order and rates (greater than 3.0 per 1,000 population) of the most prevalent types of skin conditions of concern

(complaints), within each age group: United States, 1971-1974

1-5 years



18-24 years

Diseases of sebaceous glands (71 .4)

Dermatophytoses (1 5.6}



Foilicuiitis (4,6)


Psoriasis (3.1 )

45-54 years




Psoriasis (10.4)


Malignant tumord (7.5)


6-11 years

Actopic dermatitis, eczema (14.5)




25-34 years



Atopic clermatitis, eczema (16.4)

Seborrheic dermatitis (!3.9)


Psoriasis (3.9)

55-64 years


Tumors, malignant and benign ( 19.6)



Psoriasis (7.2)


Malignant rumorsl (5.2)


lSubgroup of tumors, maIignant and benign.

contact dermatitis (6.4 per 1,000 persons),seborrheic dermatitis (chronic inflammation—5.4 per 1,000 persons), and psoriasis (3.8 per1,000 persons) (table 8). These are the principalconditions of concern among both males andfemales, although the proportion of females con-cerned about fungal conditions (8.2 per 1,000)is substantially less than that of males (35.9 per1,000), consistent with the lower prevalence ofsuch conditions among females.

Among children 1-11 years, atopic derma-titis is the most prevalent skin complaint; at ages12-34 years the major complaint is aboutdiseases of the sebaceous glands; from 35-64

12-17 years






Ichthyosisr keratosis (3.4)


3544 years


Diseases of sebaceous glands (1 7.6)




Folliculitis (5.2)


65-74 years




Malignant tumorsl (8.5)



Psoriasis (4.9)


Vitiligo (3.3)

years, the dermatophytoses; and in the oldestgroup 65-74 years, rn~ignant and benign tumors(tables 9-11, C, and figure 11). The trend withage for the more prevalent skin conditions o“fconcern is generzdly similar to that for the si@&if-icant conditions dia~osed, although the ratesfor the former are, as expected, consistentlylower (figures 5 and 12).

Persons with significant skin conditions diag-nosed in the survey examination are most Ii,kelyto express concern if the condition is psoriasis(of those diagnosed 69 percent expressed con-cern), atopic dermatitis (59 percent concerned),contact dermatitis (47 percent concerned),

12

~ Atoplcd.gnnatitis W Disemesof sebamo.sglands ~ p~~i.~is

~ mrmavaphyroae$ @ T.mom,malig.anta.d k.ign

~ Oamactderrmtitls ~ Seborrhdcdenn.titis

c-1.5 6-11 12.17 18.24 25.24 3a-44

years years years yem yews yam

!3--K

2 ITnTnrl...,:0

45.s4 55.84 65.74years yenri years

AGE

Fiaure 11. Prevalence rates for the major types of skin condi-tions of concern (complaints) within each age group amongpersons 1-74 years: United States, 1971-1974

100r Direamof ScbaCZOUs91*WS

---- Dermtophytoses

0

t h -=J=J..........

20 40 60 80

AGE IN YEARS

Figure 12. Prevalence rates forthemajor types ofskincondi-tions of concern (complaints) among persons 1-74 years,by age: United States, 1971-1974

malignant tumors (34 percent concerned) anddiseases of the sebaceous glands (33 percent con-cerned) (tables 1, 8, and D).

Males are the most likely to express concernabout conditions of psoriasis (64 percent con-cerned), atopic dermatitis and eczema (60 per-cent concerned), contact dermatitis (50 percentconcerned), malignant tumors (36 percent con-cerned), and diseases of the sebaceous glands (33percent concerned). Among females, the most

Table D. Proportion of persons with saiected specific types of significant skin pathology who complained about the condition, withineach age group: United States, 1971-1974

1-5 years

None

18-24 years

Seborrheic keratosis (225%)

Psoriasis (207%)

Contact dermatitis (61%)

Atopic dermatitis, eczema (50%)

Harpes simplex (50%)

45-54 years

Psoriasis (91%)

Ma/ignant tumod (79%)


lsubg~~up of tumom, malignant and beni

6-11 years 12-17 years

Contact dermatitis (76%) Psoriasis (88%)

Atopic dermatitis, eczema (72%) Contact dermatitis (64%)

Verruca vulgaris (52%) Urticaria (56%)


Seborrheic keratosis (1 75%) Atopic dermatitis, eczema (63%)

Contact dermatitis (70%) Contact dermatitis (61 %)

Psoriasis (63%)


Vitiligo (53%)


Folliculitis (71%) Ichth yosis, keratosis (100%)

Atopic dermatitis, eczema (70%) Atopic dermatitis, eczema (57%)

Psoriasis (66%) Psoriasis (52%)

1.

13

eczema ceous glands

Figure 13. Percent of persons 1-74 years with selected significant skin pathology who are concerned about the condition, by sex:

United States, 1971-1974

frequently cited conditions of concern are pso-riasis (74 percent ), atopic dermatitis and eczema(58 percent), contact dermatitis (44 percent),urticaria (38 percent), malignant tumors (34 per-cent), diseases of the sebaceous glands (34 per-cent ), and vitiligo (32 percent) as shown intables 1 and 8 and figure 13.

Recurrence and Duration ofSkin Pathology of Concern

An estimated 62.8 per 1,000 in the U.S.civilian noninstitutionalized population age 1-74years or 56 percent of those with skin com-plaints indicate that the condition or conditionsare recurrent. Those conditions affecting thehands and feet are slightly more likeIy to berecurrent (66 and 64 percent, respectively) thanthose on the face or other parts of the body (54percent) (tables 7, 12, and E).

Skin conditions affecting the feet are si~ifi-cantly more likely to be recurrent among males(70 percent) than among females (45 percent) asare those affecting the hands (70 percent com-pared with 60 percent for females); those skinconditions affecting the face and other parts ofthe body are only slightly less likely to be recur-rent in males (52 percent) than in females (56percent).

The recurrence of skin conditions of concernshows no consistent increasing or decreasing

trend with age among youths or adults. For alltypes of such conditions the proportion thatrecurred is highest at age 25-44 years and lowestamong children age 1-5 years. Conditions affect-ing the hands are the most likely to be recurrentamong young children age 1-5 years (100 per-cent ) and adults age 45-54 years (78 percent),but least likely to be recurrent among the oldestadult age group in this study (46 percent alt, age65-74 years) and children age 6-11 years (50 per-cent). Skin conditions affecting the feet are themost likely to be recurrent among you~geradults age 25-44 years (77 percent at 35-44years and 70 percent at 25-34 years) and leastlikely to be a (recurrent) problem among chil-dren 1-11 years (O percent at 1-5 years and 35percent at 6-11 years). The recurrence rate forconditions affecting the face and other parts ofthe body is highest among young adults 18-34years (66 percent at 25-34 years and 56 percentat 18-24 years) among whom acne vulgaris andother diseases of the sebaceous glands (althoughjust past the peak prevalence for such conditionsat 12-17 years) are still the most prevalent of theskin conditions of concern in those age groups,making up about one-half and one-quarter of allskin conditions of’ COTrem at 18-24 and 25-34years, respectively.

Nearly half (49 percent) of recurrent skinconditions have been active in the preceding7-12 months, 30 percent longer ago than 12

14

Table E. Percent of persons 1-74 years with skin conditions of concern (complaints), by the recurrence and duration of condition, the degree ofresultant handicap or disf igurement, part of body affected, and sex, showing selected standard errors: United States, 1971-1974

Recurrence, duration, and handicap

Condition recurrent ...................................

Recurrent condition active in:Past 12 months . ..................................Past 3 monthsl .....................................Past 6 monthsl .....................................

Condition present:Less than 2 years ..................................2-4 years ...............................................5 years or more .....................................

Condition limits activity:To any extent .......................................10 percant or less..................................More than 25 percent .......... .................

Degree of handicap to employment orhousework:

Severe ...................................................Minimal ................................................None .....................................................

Dagree of handicap to social relations:Severe ...................................................Minimal ................................................None .....................................................

Condition recurrent ...................................

Recurrent in past 12 months ......................

Present-less than 2 years ...........................

Condition limits activity ............................

Employment-housework handicap:Severe ...................................................Minimal ................................................Nona ......................... ............................

Social handicap:Severe ...................................................Minimal ................................................None .....................................................

One or more areas ofbndy affected II

i-landsI

Feet I Other area(s)

Percent of persons with skin condition of concern

56.3

69.711.820.7

16.821.561.6

6.96.00.8

1.48.5

90.1

1.331.467.3

. . .

..-

. . .

. . .

. . .

. . .-..

. . .

. . .

. . .

67.5

69.710.620.1

16.119.070.1

7.75.40.5

1.3

8;:;

0.727.072.3

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

55.0

69.613.321.4

17.624.657.7

10.36.81.1

1.66.5

91,9

1.836.561.7

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

65.8

73.222.036.2

23.820.158.1

74.910.4

1.0

2.423.674.0

1.127.471.5

8.39

5.96

2.84

4.53

1.416.156.09

1.404.194.26

70.2

71.422.438.1

23.314.062.7

12.07.71.1

1.614.683.8

25.874.2

60.0

75.521.433.6

24.626.147.3

18.714.0

0.8

3.535.960.6

2.528.458.1

63.5

70.89.6

18.1

10.014.775.3

8.25.61.4

1.47.7

90.9

0.79.0

90.3

69.6

77.910.621.0

8.914.876.3

6.65.60.3

0.36.6

93.1

::91.3

7.35

7.72

3.67

3.72

1.634.824.72

2.354.334.33

Standard error of percent

6.01

7.72

3.55

7.73

2.429.228.97

2.458.428.49

4.99

5.17

3.08

2.85

0.792.062.38

3.611.861.92

5.12

4.97

3.86

3.04

0.302.952.96

2.242.24

46.2

49.76.19.6

13.414.372.3

13,06.24.9

4.711.064.3

2.510.287.3

8.08

8.o4

2.62

4.01

3.204.724.51

2.623.033.59

53.6

69.011.019.3

17.423.259.4

6.3

%:

1.36.8

91.9

3Z62.0

3.05

3.52

1.08

1.69

0.801.581.72

0.823.373.37

51.8

88.88.9

17.2

17.421.061.6

7.44.90.5

1.67.2

91.2

1.132.966.0

3.57

3.48

1.73

1.19

0.611.982.26

2.532.712.67

55.5

71.113.221.4

17.525.357.2

9.16.10,7

1.0

9:::

1.740.166.2

3.77

2.86

1.34

2.33

0.731,561.66

2.424.885.01

lperc.nt of tho~e ~h~se skin condition is mcu~ent.

months, and 21 percent within the preceding 6 concern that have persisted at Ieast 5 years (70months (table E): percent) than are f;males (58 percent),- the rates

Duration. –The majority of skin complaints being significantly lower among females only forhave been present for 5 years or longer (62 per- skin conditions affecting the hands (table E).cent). Those affecting the feet are more likely tohave been present this Iength of time (75 per-cent ) than those affecting the hands (56 per- Handicap From Skin Condition

cent ) and other parts of tie body (59 p-erce~t). Activity limitation. –Skin complaints areMales are more likely to have skin conditions of reported to limit activity of 10.5 per 1,000 of

15

the population age 1-74 years or 9 percent ofthose persons with such skin conditions (tableE). However, only about one-third of these per-sons indicated that their activity is more thanminimally limited (more than 10 percent) bytheir skin condition(s). Males are slightly lesslikely than females are (8 percent comparedwith 10 percent) to report any limitation butamong those with some degree of this the pro-portion with more than minimal limitation issimilar in both sexes (3 percent). No consistenttrend with age is evident in the proportion withsuch limitation from a skin condition, althoughadults 55-64 years of age and children 6-11 yearsof age are slightly more likely than those ofother ages to have such limitation (12 percentcompared with 5-10 percent).

Conditions affecting the hands are morelikely to limit activity (15 percent) than arethose affecting the feet (8 percent) or otherparts of the body. Females are more likely thanmales are to have skin conditions affecting theirhands and feet, which limit their activity.

Degree of handicap to employment orhousework. –About 10 percent of those personswith skin complaints consider the condition(s)to be a handicap to their employment or house-work (table E). Only 1 percent indicate theywere severely handicapped, and the remaining 9percent consider the handicap to be minimal.Conditions on the hands are more likely thanthose on the feet or other parts of the body tobe considered a handicap (26 percent of skinconditions of concern on the hands comparedwith 9 percent of those on the feet and 8 per-cent of those on other parts of the body) andsuch conditions on the hands are somewhatmore likely than those on the feet or elsewhereto be considered a severe handicap (2 percent onthe hands compared with 1 percent elsewhere).

The proportion with handicapping (foremployment or housework) skin conditionsamong all those with skin complaints is, asexpected, lowest among children age 1-11 years(less than 3 percent) and highest at 25-34 years(12 percent), 55-64 years (12 percent), and18-24 years (11 percent) (figure 14). Amongmales, only at age 18-24 years does the propor-tion considered handicapping exceed 1 in 8,reaching the maximum of 15 percent; amongfemales, this proportion is exceeded at ages 25-

60

Employ rrtent-houswvork- handicap

L:..:.... . . . . . . . . . . Social handicap

; .-.+Oifigurement–.. .

‘-- - moderase-s?vm%./ %

1/! , , ,0

20 40 60 So

AGE IN YEARS

Figure 14. Percent of skin conditions of concern (complaints)

considered social or employment-housework handicap bythe individual or to be disfiguring to at least some extentby the examiner, by age: United States, 1971-1974

34 years (16 percent) and 35-54 years (13 per-cent ) (tables 7 and 12).

Although there is no consistent age-relatedtrend in the proportion with handicapping’ (foremployment or housework) skin conditions,girls of age 12-17 years are more likely to con-sider skin conditions of the hands and feet t’o bea handicap than not (58 percent of those ‘skinconditions affecting the hands are rated as ahandicap compared with 42 percent not sorated, and 60 percent of conditions affecting thefeet are considered handicapping). Adult women55-64 years of age are also more likely to con-sider skin conditions on the hands (but not thefeet ) as being handicapping than not (63 pe~centcompared with 37 percent not considered h~di-capping); about one-half of those women 1,8-34years of age consider skin conditions on theirhands to be handicapping.

The handicap from skin conditions of ‘con-cern is substantially more likely to be miriimalthan severe, except for those affecting the handsand feet of girls 12-17 years of age and thoseaffecting parts of the body other than hands andfeet of men age 45-54 years.

Social handicap. –An extimated 35.1 per1,000 of the U.S. population 1-74 years of ageor about one-third (33.0 percent) of those per-sons with skin conditions that concern themindicate that the condition(s) is (are) a handicap

16

in their social relations (tablesproportion increases with age

12 and E). Theamong children

from less than 10 percent among those of pre-school age to a maximum of 47 percent amongyouths age 12-17 years, then decreases withincreasing age among adults to less than 17 per-cent at age 65-74 years (figure 14). The propor-tion sociaIly handicapped from their skin condi-tion is substantially greater among females (34percent) than among males (25 percent), thepattern being consistent across the age range inthis study.

Extent of disfigurement. –More than two-thirds (68. 1 percent) of the skin conditions ofconcern to the individual affected are rated asdisfiguring by the dermatologist examiner (tableF). The disfigurement is substantially morelikely to be minimal (48 percent) than moderateor severe (20 percent). Skin conditions on theface and parts of the body other than the handsand feet and skin conditions on the hands aremore likely to be rated as disfiguring (71 percentand 69 percent, respectively) than skin condi-tions on the feet (54 percent). The examiners areslightly more likely to rate skin conditions offemales as disfiguring to any extent and asmoderately or severely disfiguring than those ofmales whether the hands, feet, or other parts ofthe body were affected. For each sex, skin con-ditions on the feet are the least likely of thethree sites to be considered (by the examiner) asdisfiguring to any extent, as well as the leastlikely to be considered moderately or severelydisfiguring.

Children ages 1-11 and adults 45-54 yearsare least likely to have skin conditions rated asdisfiguring to any extent by the examiner (about50 percent of those with skin conditions of con-cern to person affected); these rates are highestamong youths age 12-17 years and adults 55-74years of age. Moderately or severeIy disfiguringskin conditions are least prevalent among pre-school-age children 1-5 years old and adults age45-54 yeas, but most prevalent among thoseolder adults age 55-64 years (figure 14).

Discomfort From Skin Condition

Pain or burning. –An extimated 22.6 per1,000 in the U.S. civilian noninstitutionalizedpopulation age 1-74 years or nearly one-fourth

(22.8 percent) ofindicate thev felt a

those with skin complaintsburnirw sensation or ~ain to

some degre~ from the co~dition(s) (ta~les 12and F). The pain or burning sensation is rated asmoderate or severe for nearly one-third of thesepeople (6.4 percent of those with skm condi-tions of concern). Conditions affecting thehands or feet are less likely than those affectingother parts of the body to be reported to causeat least some pain or burning.

School-age children 6-17 years old =e the,least likely to have these symptoms (16 percentat 6-11 years and 14 percent at 12-17 years);preschool age children are the most likely (32percent). Young adults age 25-34 years areslightly more likely to have these symptoms (25percent) than older or younger adults.

Males are less likely than females to reportsymptoms of burning or pain from skin condi-tions on their hands and feet, but are slightlymore likely to do so for conditions affecting theface or other parts of their bodies.

Itching. –Nearly one-half (45.4 percent) ofpersons with one or more skin complaints indi-cate that the condition(s) itched minimally (25percent) or to a moderate or severe degree (20percent ). Preschool-age children 1-5 years of ageare most likely to have such symptoms (58 per-cent) and, when they do, to have moderate orsevere itching (64 percent) than minimal (36 per-cent); young adults age 18-24 years are the leastlikely to indicate that the skin condition(s)itched (26 percent), but those 25-34 years of ageare the least likely to have a moderate or severeitching (30 percent). Males are slightly morelikely to report such symptoms (48 percentcompared with 42 percent of femzdes) but, whenthey do, to consider the itching minimal(table F).

Motion limitation. –Skin condition(s) areextensive enough or Iocated in areaa so that theycause limitation of motion for nearly 6 percentof persons who have skin conditions that con-cerned them (table F). The rates are highestamong the oldest aduIts, age 65-74 years and thelowest among adults age 45-64 years. Males areabout as likely as femzdes are to have such limi-tation from skin conditions that concerned them(5 percent of males, 6 percent of females) andboth sexes are more likely to have a minimal (4percent) than moderate or severe limitation (1

17

Table F. Percent distribution of persons 1-74 years with skin conditions of concern (complaints) by extent of discomfort from condition, according topart of body affected end sex, showing selected standard errors: United States, 1971-1974

Extent of discomfort

Extent of disfigurement:ModeratPswere ....................................Minimal ................................................None .....................................................

Causing pain or burning:Moderate+evere ................................ ....Minimal .................................................None .....................................................

Causing itching:Moderate$evare ....................................Minimal ..................................... ...........None .....................................................

Ceusing motion limitation:Moderate-sewre ....................................Minimal ................................................Ndne .....................................................

Causing ovatall discomfort:Moderate.severe ....................................Minimal ................................................

Disfigurement:Motferate-savere ....................................Minimal ................................................None .....................................................

Pain or burning:Modetate.sevare ....................................Minimal ................................................None .....................................................

Itching:Moderate+evere ....................................Minimal ................................................None .....................................................

Motion limitation:Moderat&severe,., .................................Minimal ................................................None .....................................................

Overall discomfort:Moderate*evere ....................................Minimal ................................................None .....................................................

One or more areas ofbody affected

Hand Foot Other area(s)

BothMale Female

BothMale Femala

BothMale Female

Bothsexes sexes sexes

Malesexes Female

Percent distribution of persons with skin conditions of concern

20.4 19.147.7 46.431.9 34.5

6.4 5.916.4 17.377.2 76.8

20.4 19.325.0 28.954.6 51.8

1.3 1.14.3 4.3

94.4 94.6

16.3 14.447.7 44.442.0 41.2

. . .

. . .

. . .

..-

. . .

. . .

. . .

. . .-..

-....-..-

. . .

. . .

. . .

. . .

. . .

. . .

-....-. . .

.-”

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

21.749.428.9

7.015.277.8

21.720.258.1

1.64.2

94.1

18.638.443.0

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .-..

..-

. . .

.-.

.-.

. . .

. . .

18.8 19.450.0 48.1311.2 32.5

7.9 6.5311.6 28.66(1.5 84.9

2(L6 10.840.2 46.939.2 42.3

0.5 0.29.8 11.2

89.7 88.6

1 ‘1.4 6.452.8 56.335.8 37.3

. . .5.195.42

2.424.90

,.. .

3.314“74

,,. .

0,342 A4

-..

2.704.87

.-.

---7.076.61

3.836,06

..-

4.106.30

..-

0.183.53

..-

2.285.49

. . .

18.152.529.4

9.735.754.6

33.831.135.1

1.07.7

91.3

18.548,033.5

12.1 9.741.5 41.746.4 48.6

9.8 7.025.6 25.764.6 67.3

18.5 19.635.7 40.045.8 40.4

1.4 -3.8 2.9

94.8 97.1

14.2 12.952.8 55.033.0 32.1

Standard error of percent

. . .5.955.95

3.637.82

. . .

5.305.58

. . .

0.603.49

. . .

5.457.52

.-.

. . .4.154<64

2.344.92

. . .

2.704.74

. . .

1.071.12

---

3.104.08

. . .

. . .5.955.92

2.415.67

. . .

3.605.68

. . .

1.07---

5.105.09

. . .

19.240.740.1

18.325.256.5

14.922.163.0

5.66.7

87.7

18.246.035.8

. . .

9.507.77

4.916.34

. . .

2.906.05

. . .

4.492.48

. . .

6.906.80

. . .

22.348.828.9

5.512.582.0

20.820.858.4

1.43.7

94.9

17.437.944.7

.-.

2.072.33

0.901,22-..

1,351.48. . .

0.280.43

.-.

2.102.48

.-.

22.147<630.3

5.413.181.5

20.422.856.8

1.53 .s

94.7

16.039.344.7

---

2,333.23

1.201.88. . .

2.012.62

..-

0.520.61

---

2.693,54

..-

22.450.027.6

5.511.982.6

21.118.860.1

1.33.6

95.1

18.736.644.7

.-.

2.702.55

1.021.69.-.

1.981.73---

0.310.86

. . .

2.302.87

-..

~ercent of males and nearlv 2 ~ercent of vears and lower at age 12-17 Years than at other;emales).

. L~ges (table F). Only” about one-fourth (28 per-

Overall discomfort. –More than half (58.0 cent ) of those with some overall discomfortpercent) of those persons with skin complaints from the skin condition(s) indicate the discom-have some overall discomfort from the condi- fort was more than minimal; this proportiontion, the rates being slightly higher at age 1-5 ranges from a maximum at age 6-11 years (60

18

percent) to a minimum at 12-17 years (46 per-cent). Females are nearly as likely as males tohave some overall discomfort from a skin condi-tion (57 for females, 59 for males), but whenthey do to indicate moderate or severe discom-fort (33 percent compared with 24 percent).

Disfigurement–handicap or disability. –Nearly all (89 percent) of those persons whoconsider their skin condition(s) a social handicapto some degree are also rated as disfigured bythe examiners. This agreement is slightly closeramong adults age 45-64 years and youths age12-17 years (nearly 95 percent) than other per-sons among whom the proportion rated as dis-figured of those considering themselves sociallyhandicapped by their skin condition ranges from80 percent at age 35-44 years to 88 percent atage 65-74 years with no consistent age-relatedtrend. The agreement is slightly better forfemales (92 percent) than for males (86 percent)(table G and figure 15).

The agreement between the examiner’s rat-ing of some disfigurement and the individual’sindication that his or her skin condition is ahandicap to employment or housework isslightly less than that for social handicap, theproportion being 80 percent and again beingsomewhat higher among females (82 percent)than among males (77 percent).

More than two-thirds of those persons withsome overall discomfort from their skin condi-

So

60

40

20

0 IMale Female

pJ %&%%wjsk’nasdisfiguring

lzhzJMale Female htde Female

condition rstsd Condition Condition Condition causssby examinerasdisfiguring

considered considered overalldiscomfortemployment. socialhouwvork handicaphandicap

TO SOME DEGREE

Figure 15. Percent of males and females 1-74 years with skinconditions of concern (complaints) rated as disfiguring byexaminer or causing some type of handicap to the affected

person: United States, 1971-1974

tion(s) are also rated as disfigured to somedegree by the examiners. No consistent trendwith age is evident in this agreement, the propor-tion with some discomfort who are also rated asdisfigured ranges from 57 percent at ages 6-11years and 45-54 years to 82 percent at age 55-64

Table G. Percent distribution of persons 1-74 years with skin conditions of concern (complaints) reporting some degrea of resultant handicap-employment-housawork, social, or overall discomfort-by examiner’s rating of extent of disfigurement, age, and sex: United States, 1971-1974

Type of handicap and degree of disfigu rement

Employment.housework handicap with dis-

figu rement rated:

Moderate~evere .. . .. . .. . . . . . . . . . . .. . .. . .. .. . .. . . . . .. . . . . . . . .Minimat .,, . .. . .. . .. . . . . . . . . . . . . .. . .. . .. .. . . .. .. . . .. .. . . . . . . . . . . .Ntme .. . .. .. . . .. .. . . . . .. .. . . .. .. . . . . .. . . . . .. .. . . .. .. .. .. .. . . .. .. . .

Social handicep with disfigurement rated:

Moderate.sewre . . . . .. .. . . .. .. . . . . . . . . . . .. .. . . .. .. . . .. . . . .. . .

Minimel .. .. .. . . . . .. .. . . .. .. . . .. .. . .. . .. . . . . . . .. . . .. .. . . .. .. .. . . .

None .. . . .. . . . .. . .. .. . . . . . .. . . . . . . . . . .. .. . . .. .. . . . . . . . . . . .. . . . . . . .

Overall discomfort with disfigurement rated:

Moderate%evere . . .. .. . . .. . . . . . . .. . . . . .. .. . . .. .. . . .. .. . . . . .. .Minimal .. . . . .. . .. . . . . .. . .. . .. .. . . .. . . . .. . . . . . . . .. . .. . .. .. . . . . .. .

None ... . .. . . . .. . . . . .. . . . . .. . .. .. . .. . . . . . . . . . . . . . . . . .. .. . . .. .. . . . .

Bothsexes 1-5 6-11 12.17 18-24 25-34 3544 45-54 55-84 65-74

1-74 years

1-74 years years years years years years years ~ear.s yaars

yearsMale Femele

Percent distribution of persons with some degree of specified handicap from skin complaint

139.3 -40.7 -

20.0 100.0

37.2 73.251.9 8.1

10.9 18.7

25.6 19.243.8 43.630.6 37.2

100.0

31.6

52.8

15.6

21.536.1

42.4

63.226.4

10.4

34.460.2

5.4

37.2

38.124.7

34.247.3

18.5

34.551.2

14.3

24.850.1

25.1

37.2 35.644.8 32.2

18.0 32.2

39.5 36.447.4 44.1

13.1 19.5

22.7 20.950.1 43.3

27.2 35.8

36.341.8

21,9

31.7

62.6

5.7

17.538.6

42.9

34.049.2

16.8

53.741.1

5.2

38.144.0

17.9

42.4

37.2

20.4

39.648.4

12.0

25.646.9

27.5

35.841.6

22.6

35.6

50.114.3

23.843.6

32.6

42.4

39.9

17.7

38.453.4

8.2

27.844.2

28.0

19

years and is slightly lower among males (67 per- 1-74 years of age or nearly one-fifth (18.9 per-cent) than among females (72 percent). cent) of those persons with skin condition(s)

about which they express concern are now

Adequacy of Treatment forSkin Condition

under the best care pos;ible for the condition(s)(tables 13 and H). The proportions are slightlyhigher among children age 1-11 years and lower

More than 2 percent (21.5 per 1,000) of the ~ong young adults age 18-24 years than amongU.S. civilian noninstitutionalized population adults age 35-74 years. The proportion that the

Table H. Percent of persons 1-74 years with skin conditions of concern (complaints), by tYPa Of cam sought, edBqUeW of prasent treatment, radons forpot seeking care, part of body affected, and sex, showing selectad standard error$: United Stetas, 19714974

Care status

Cara sought from:Nonprofessional ................................... .Pharm~y ....... ........ .............. .... ...... .......Physician ..............................................Dermatologist .......................................

Undar bast care now ............................... ...

Expert cara would improve ........................

No advice sought........................................

inadequate edvice given .............................

Did not cooperate with doctor ...................

Other raeaons for not seeking medicalcare:

Too far to doctor ..................................No transportation .................................Insufficient money ...............................Other ....................................................

Care sought from:Nonprofessional ....................................Phamacy ................ ..............................Physician ........... ...................................Dermatologist .... ............................ .......

Under best care now ..................... .............

Expart care would improve .....................

No edvica sought........................................

Inadequate edvica given .............................

Did not cooperate with doctor ...................

Other “reastms for not seeking medicalcare:

Too far to doctor ..................................No transportation .................................Insufficient money ...............4...............Other ....................................................

One or more areas ofbody affoctad II

Hands I FactI

Other area(s)

EEzEiiEllMa’elFama’e”‘~41Ma’elFamaX4”a’al;iiizpemant of person$ with skin conditions of concern

16.25.1

24.118.2

18.9

93.7

50.1

14.9

6.1

0.90.53.77.9

...

.-.

.-.

...

...

...

1.69

1,44

0.82

0.240.210,681.10

17.55.4

21,315.6

15.1

93.8

55.8

13.9

6.3

0L70.33.27.0

...

...

...

...

...

...

2.37

1.72

1.19

0.350.270.910.98

14.74.7

27.521.3

23.5

93.4

43.7

16,0

5.9

1.10.84.29.0

...

...

...

...

-..

..-

2.14

1.79

1.02

0.400.330.801.53

18,5

2:::1g,,4

21.0

91.9

...

..-

.-.

...

...---...

4.522.504.083,82

3.16

2.68

,,..

,..-

...

...

...

...

..--—

18,72.2

27.818.6

17.2

88.2

-..

..-

-..

. . .

. . .

. . .

. . .

18.27.5

30.320.5

26.0

97.2

. . .

. . .

.-.

. . .-... . .. . .

17647.9

19.69.2

10.2

t12.3

. . .

. . .

. . .

. . .

. . .

. . .

. . .

19.810.418.010.6

6.5

92.-4

...

..-

...

...

...

...

...

5,381.855.834.33

3.92

3.80

. . .

. . .

-..

. . .

. . .

. . .

.-.—

Standard error of Pemeflt

6.195.495.185!35

6.23

1.77

. . .

. . .

.-.

. . .

. . .-... . .

3.7(3.3[2.9’2,3!

3,()[

2.3”

. .

.-

. .

. .

. .

. .-.

—

4.574.513.212.96

2.95

2.49

. . .

. . .

..-

.-.

. . .

.-.

. . .—

10.20.524.35.0

21.0

91.9

. . .

. . .

. . .

. . .

. . .

. . .

2.715.446,622.86

6.02

4.30

. . .

. . .

..-

. . .

. . .

. . .

. . .

15.74.6

24.519.9

20.5

94.2

. . .

..-

-..

. . .

.-.

. . .

2.361.321.581.17

1.73

1.18

. . .

. . .

. . .

. . .

. . .

. . .

. . .

16.64.3

21,416.8

17.5

b5.1

. . .

. . .

. . .

. . .

. . .

. . .

.-.

2.941,302,011.99

2,68

1.35

...

...

-..

...

...

...

...—

14.84.8

27.623.1

23.5

93.2

. . .

. . .

..-

. . .

. . .

2.821,452.421.61

1.47

. . .

. . .

. . .

. . .

. . .

. . .

. . .

20

dermatologist examiner consider as now receiv-ing the best care ranges from 27 percent of pre-school children age 1-5 years to 13 percentamong young adults age 18-24 yearn (table Hand figure 16). Females are more likely thanmales are to be receiving the best care possible(24 percent compared with 15 percent of thosewith skin complaints).

Skin conditions affecting the feet are sub-stantially less likely than those on the hands orother parts of the body to be receiving the bestavailable treatment (10 percent for those on thefeet compared with 21 percent for those on thehands and 20 percent for those on the face orother parts of the body). Males are less likelythan females are to have skin condition(s) underthe best care, regardless of the location of thecondition(s), the difference being greatest (andlarge enough to be statistically significant) forthose on the feet (6 Percent for males compared.with 21 percent fo; f;males).

‘a Not under bestcare now

❑ SOmec;iititxo”ld

Is Under besrcare now

n1.5 6.11 12.17 1S-24 25.34 3544 45.54 55.64 65.74

years Yin-s yem years years years years years years

AGE

Figure 16. Percent distribution of persons with skin conditionsof concern (complaints), by adequacy of treatment forcondition(s) and age: United States, 1971-1974

Among the remaining (81 percent) persons1-74 years of age with skin conditions that con-cern them but who are not now receiving thebest care available for the condition, about 94percent of the persons with complaints haveconditions that could be improved with expertcare. These proportions range from 84 percentamong preschool-age children 1-5 years to 96percent in the oldest age group 65-74 years(table J). The proportion that could be im-proved is similar among males and females and isnearly as high for conditions affecting the handsor feet (92 percent) as those on other parts ofthe body (94 percent).

About one-half of the U.S. population 1-74years of age with skin conditions of concern tothem have not sought medical advice for theproblem. The proportion is lowest among chil-dren 1-11 years of age (37 percent) and adults55-64 years (38 percent), and highest amongyouths 12-17 years (66 percent).

Males are more likely than females are tohave not sought medical care for skin conditionsthat concern them (56 percent compared with44 percent) and across the ages from 12-74 yearsthe proportion who had not sought such care isconsistently higher among maies.

In addition to those (50 percent) not seekingmedicaI care, nearly 15 percent have been givenmedical advice that the dermatologist examinerconsidered inadequate. This proportion rangesfrom 8 percent at age 12-17 years to 20 percentat age 55-64 years but shows no consistent trendwith age (table J). Males are about as likely asfemales are to have received inadequate medicaladvice concerning their skin problem (14 per-cent compared with 16 percent).

About 6 percent of those with skin condi-tions that concern them did not cooperate withthe doctors they had consulted, the proportionbeing simikr among males and females.

Other obstacles to improvement cited by thepersons with skin conditions of concern are thatthey were too far from the doctor (0.9 percent),that transportation to the doctor was not avail-able (0.5 percent), that they had insufficientmoney for such medlcaI care (3.7 percent), anda variety of other reasons (7.9 percent) including“not being aware the condition could betreated, “ “under care but discouraged because

21

Table J. Percent of persons with skin conditions of concern (complaints), by rea$on no care was sought and adaquacy of treatment sought, according to age and

sex: United Statm, 1971-1974

~,T

Both

Treatment statussexes 1.5 6-11 12-17 18-24 25.34 3644 46.54 55.64 65.74

7-j4 Yeats

1-74 years years yew’s yaerg years yaars years years yearsyears

Male I Female

Total .. .. . . . . .. .. . . .. .. .. .. .. .. . . .. .. . . . . .. .. . . .. .. . . .L ‘00’0 w

Percent of persons with skin complaints

a=-100.0 100,0=36.5 6fi.9

10040~

49.4

100do~

55,1

100.0=

49.1

100.0~

43.3

100.0~

37,7

100.0

6!245

100,0

66,8

100,0

43,7.—

1.10.84.2

9.028,6

56,3

16.05.9

23.510.9

43,7

38475’0

56,3

No medical advice sought . .. .. . . . . . . . . . . .. .. . .. . 50,1 36.8

Too far to doctor .. . . . . .. .. . . .. .. . . . . .. .. . .. . .. . . . . .. . .. .. . .. . . 0.9 2,8No transportation .. . . . .. .. . .. . . . . .. .. . .. . . . . .. . .. . .. . . . .. . . . . . 0.5 1.0Insufficient mOney .. . .. . .. .. .. .. .. . . . . . . .. . . .. . . . . . . .. .. . . .. .. 3.7 3.5Other reason .. . . .. . . . .. . .. . .. . .. .. . . . . .. . .. .. . .. . . . . . . .. . .. . . . . .. 7.9 11.0No reason given .. . . . .. .. . . . . . . . .. . .. .. . .. . .. . .. . .. . . . .. . . . . . . . .. 37.1 18,6

Medical advice sought..., . . .. . . . .. . . .. .. . .. . . . . . . . 49,9 63.2

Care inadequate . . . .. .. . . . . .. .. . . . . . . . .. . .. . . . .. . . . . . .. . . .. . .. . . 14.9 14.8Did not cooperate with doctor.., . . . . . . . . .. .. . . . . . . . . . . . 6.1 4.7

Under best care now .. . . . . .. .. . . .. .. . . . . .. . .. .. . . . . . . . .. . .. .. 18,9 30.4Care could be improved .. . .. . . . . .. .. . .. . .. .. . . .. .. . .. . . . . . . 10,0 13.3

No madical advice sought..., .. .. . . . . . . . . . . .. .. . 50,1 36.8

Expert care would improve,.,.,...,..,., . . . .. .. . . . .. . . .. . 44.9 25.9

Expert care would not improve . .. . . .. .. . . . . .. .. . . .. .. . . 5.2 10.9

Medical advice sought .. .. . . . . .. . .. .. . . . . . . . .. .. . .. 49.9 63.2

Under best cara now .. . .. .. . . . . . . . .. .. . . . . . . . .. . .. . . . .. . . . . .. 18,9 30,4

Expert cara would improve .. . . . . . . . .. .. . .. . . . . . . . .. . . . .. . 31,0 32.8

Total not utldar best care .. . . .. .. . . . . .. . .. . 81.1 89.6

Could be improved with axpert oare . .. . .. . . . . . . . . . . . 75.9 58.7Could not be improved with expart care . .. .. . . . . .. 5.2 10,9

0.40.45,8

3;::

50.6

i 5,07.6

14.313.7

49.4

1.00$52.0

4X

44.9

14.73,4

17.79.1

55.1

1,2

0.32.2

12.832.6

50.9

18.1

2?89.$

49.1

1.81,74.9

2;::

66,7

17,59.0

19,610.7

43.3

0.9

5.0

2:::

62.3

20.2

2%15.1

37.7

;::2.1

3::;

47,6

14.911.520,9

0.2

52,5

0.7Q.33.27.0

44,6

44.2

13.96.3

15.18,9

56,6

5.7 u.99.2 7,1

16.6 56,9

T63.6 34.1

16.7 [Lo8.2 3.4

23,7 16,7

14.9 6.0

36.51 6$.9

33.1 60.4

3.4 !L5

44.4

5,0

60.6

50.34.8

44.9

43.3

6,8

50.9

33,9

9,4

56.7

32.8

4,9

62.3

49413.4

47.5

50.55.3

44,2

16.129.1

84.9

63.5 I 34.1

23.7 16.7

39,8 1:7.4

14.336.3

85.7

80.75,0

17.7

27.2

62,3

20.8

30,1

79.2

19.537,2

80,5

20.6

41,7

79.4

20.926.6

7!9.1

23,532.Q

76,5-1-”76.3 83.3

72.9 77,8

3.4 15.5

77.5

4.8

73.45.8

71.19.4

74.64.9

75.73.4

79.6543

71,5

540

there was no improvement so stopped, ” “treat-ment was too painful, “ “medication needed forother condition was causing the skin eruption, ”“condition does not bother person that much, ”“person knows cause,” and “person is treatinghimself or herself.” In each category of otherobstacles to improvement the proportions areslightly higher among females than among males.

Care for skin conditions is most likely tohave been sought from a nondermatologistphysician (24. 1 percent of those with skin con-ditions that concerned them), a dermatologist(18.2 percent), or a nonprofessional (16.2 per-cent), and least likely from a pharmacist (5.1percent) or from a podiatrist or osteopath (lessthan 1 percent) (table H). As expected, physi-cians are usually consulted for such conditionsof preschool-age children 1-5 years (42, percentcompared with 17 percent for whom care wassought from a dermatologist, pharmacist, ornonprofessional). Among school-age children6-11 years, a nondermatologist physician (3 1

22

percent) or dermatologist (21 percent) is morefikely to have been consulted than is a norlpro-fessional (8 percent) or pharmacist (0.4 per-cent). Among youths, a nonprofessional is themost likely to have been consulted rather Wan anondermatologist physician or dermatolo&st.Females are more likely than males are to haveconsulted either a nonderrnatologist physician(25 percent for females compared with 21 ,per-cent for males) or a dermatologist (2 O percentfor females compared with 15 percent formales); the males are more likely than fenialesare to have sought care from a nonprofessitmal(17 percent compared with 14 percent forfemaIes).

Comparison With PreviousStudies

Published national estimates of the preva-lence of various types of chronic skin conditionsamong the U.S. civilian noninstitutionalized

population of all ages based on findings from theHealth Interview Survey of 196918 are availablefor comparison with the findings in this reportfrom the dermatology examination of the1971-1974 Health and Nutrition ExaminationSurvey. In comparing the estimates based onfindings from the national probability samples inthe two surveys, it should be kept in mind thatthe Health Interview Survey data were obtainedthrough household interview of a responsibleadult for all members of the household inanswer to the question “During the past 12months did anyone in the family have any ofthese conditions?” Skin conditions on the listused by the interviewer included tumor, cyst, orgrowth; eczema or psoriasis; trouble with dry oritching skin; trouble with acne; skin ulcer; anykind of skin allergy; dermatitis or other skintrouble. These conditions were later classifiedusing the Eighth Revision International Classifi-cation of Diseases, Adapted for Use in theUnited States (ICDA). 14 Conditions consideredchronic irrespective of onset and those whichhad their onset more than 3 months prior to theweek of the interview and lasted more than 3months were all considered chronic.

The national prevalence estimates for the 10groups of skin conditions identified in theHealth Interview Survey (HIS) and the rates forthese groups based on significant pathoIogy,nonsignificant pathoIogy, and skin complaint

findings from the dermatology component ofthe Health and Nutrition Examination Surveyare shown in table K. Estimates for the fungalconditions—dermatophytoses or dermatomy-coses—and for chronic infections of the skinand subcutaneous tissue are substantiallyless, and the rates for corns and callosities anddiseases of the nails are substantially higher fromHIS than the HANES estimates based on signifi-cant pathology or skin complaints. The preva-lence of corns and callosities and diseases of thenails, which increase markedly with age, wouIdalso be expected to be somewhat higher fromHIS than from HANES since only the formersurvey included persons 75 years and older.

The national prevalence estimates for acneamong youths 12-17 years of age from the1971-1974 Health and Nutrition ExaminationSurvey and that from the standard physicianexamination in the 1966-1970 Health Examina-tion Survey among a probability sample ofyouths are in close agreement-25.O per 100youths from the present HANES data and 28.3per 100 youths from the 1966-1970 HES datawhen the latter are limited to the moderate tosevere (II-IV) grades of acne. 15

Information on the extent of medical carereceived by the civilian noninstitutionalized U.S.population, characteristics of the persons seek-ing such care, and the type of care given byphysicians (doctors of medicine and doctors of

Table K. Prevalence of selacted skin conditions from the Health Intewiew Survey (HIS) of 1969 and the dermatology component of the Health and NutritionExamination Survey (HANES) of 1971-1974: United States

Condition

Derrrmtophytosasand dBmtatomycoses..............................................Chronic infections of skin and aubcutanaoustissue..,..........................Eczema,,dermatitis, and urticaria ........................................................Psoriqsisand similar tisorders .............................................................OJher inflammatory conditions of skin and subcutaneoustissue.........Corns and callositiM............................................................................Othar hypartrophic and atrophic di$aasesof skin..,,...,, .......................Diseasesof nail....................................................................................Diseasasof sebaceousglands...............................................................Othar disaaaasof skin and subcutaneoustisaua...................................

ICDA codausad in

HIS, 1969

110,111680-662,&64.688

690-693,708696

694,695,697,6967W701703708

702,704,705,707,709.op,708.l ,708.9

NYU coda used inHANES, 1971-1974

131680-S98

700,701 ,703,704P,243706

704P,705,707,706708710712

7141-7149713,7140,715,

716

mPrevalence ratas per 1.000

2.7

3:::6.57.2

41.56.8

22.919.7

5.4

population 1

81.1 --- 21.615.9 44.1 22.8

53.8 161.5 17.66.S 5.5 23.8

19.3 166.5 ---153.7 0.6

2::: 410.9 1.32.7 --- 0.5

64.8 120.4 282

45.7 525.5 ---

lNati~nal estimates for the civi]ian noninstitutionaIized population of aI1ages from HIS and for ages 1-74 years from HANES.2prevaIe”ce of complaints for these 2 groups will slightly exceed these value~.

23

osteopathy) in their offices is obtained throughnational probability samples of physician prac-tice in the NationaJ Ambulatory Medical CareSurvey (NAMCS). From the 1975 findings ofNAMCS,l 6 there were an estimated 28.6 millionvisits to physicians offices for conditions inwhich the primary diagnosis was a disease of theskin and subcutaneous tissue (ICDA codes680-709). Nearly half of these (49 percent) werereturn visits to the same physician.

The prevalence of chronic conditions andrelated information among the U.S. institution-alized patients living in nursing homes is ob-tained through national probability samples ofsuch homes in the National Nursing Home Sur-vey (NNHS). From the findings of the NNHS ofAugust 1973-April 1974,17 an estimated 6,000of the 1,075,800 residents or 5.6 per 1,000 resi-dents had a primary dia~osis at their last exami-nation of a disease of the skin and subcutaneoustissue (ICDA codes 680-709). At that time, 75percent of the residents of such homes were 75years or older.

SUMMARY

Skin condition findings as well as the extentof resultant handicap and related need for medi-cal care among persons 1-74 years of age in thecivilian noninstitutionalized population of theUnited States as determined through the Healthand Nutrition Examination Survey of1971-1974 are described and analyzed in thisreport. Age and sex differences in these factorsare included.

The dermatology examination component ofthis survey was planned and cIoseIy supervisedby the Data Collection Unit of the Committeeon Planning for the National Program of theNational Academy of Dermatology. For the sur-vey, a national probability sample of 28,043 per-sons was selected to represent the 194 million ofthat age at midsurvey time in the target popula-tion. Of these sample persons, the 20,749 or 74percent examined by the survey dermatologists(when the data are adjusted for the differentialsampling ratios used in the age-sex-income-defined population sub~oups) represent aneffective response rate of 75 percent.

Nearly one-third (312.4 per 1,000 popula-

tion) or an estimated 60.6 milIion of the U.S.civilian noninstitutionalized population age 1-74years have some skin pathology that shoukl beevaluated by a physician at least once.

The most prevalent of the significant skinconditions are those affecting the sebaceousglands (84.8 per 1,000 population) incIudingacne vulgaris; dermatophytoses or fufigaldiseases (81.1 per 1,000); malignant or behigntumors (56.5 per 1,000); seborrheic dermatitis(28.5 per 1,000); atopic dermatitis and eczema(18.4 per 1,000); and contact dermatitis (13.6per 1,000).

The prevalence of significant skin pathologyincreases rapidly with age from 142.3 per 1,000preschooI-age children to 365.1 per 1,000 youngadults age 18-24 years due primariIy to theincrease in acne vulgaris; then decreases sIightIyat 25-34 years before starting the consistentincrease with age from such skin conditions aspsoriasis, vitiIigo, malignant and benign tumors,and actinic and seborrheic keratoses.

NearIy one-eighth (118.2 per 1,000) or anestimated 22.9 milIion of the U.S. populationage 1-74 years have one or more skin conditionsabout which they complained or expressed con-cern. Nearly one-third of the persons with skinconditions that the survey dermatologists d&er-mined should be evaluated by a ph ysicia,n atleast once express concern about their condi-tion; an additional one-fifth (18 percent) com-plain about skin conditions the examiners didnot feel were serious.

The majority of skin complaints have Oeenpresent 5 years or longer, with skin conditionsaffecting the feet more likely than those affect-ing the hands or other parts of the body to havebeen present this long.

Among persons with skin complaints, 9 per-cent indicate the condition limited their activityto some extent, 10 percent consider it a handi-cap in their employment or housework, andabout one-third feel it was a social handicap toat least some extent.

The dermatological examiners rated morethan two-thirds of those persons with skin com-plaints as disfigured to some extent from thecondition; about one-fifth of those were ratedmoderately or severely disfigured.

More than half of those persons with skin

24

complaints report some overall discomfort fromthe condition, such as itching or burning. Fornearly 6 percent of those with skin complaints,the condition is extensive enough to cause Imit-ation of motion.

Nearly one-fifth of those persons with skincomplaints are receiving the best possible carefor the condition, Of the remaining 81 percentwho are not, nearly all (94 percent) could, in thejudgment of the survey dermatologist examiners,be improved with more expert care; this propor-tion ranges from 84 percent among preschool-age children to 96 percent among the oldest agegroup in this study (65-74 years).

About one-half of those persons with skin

complaints have not sought medical advice forthe condition; an additional 15 percent who didare, in the opinion of the dermatologist ex-aminer, given inadequate medical advice. About6 percent did not cooperate with the doctorsthey had consulted. Other obstacles to improve-ment are cited by 13 percent of persons withskin complaints, including insufficient money(nearly 4 percent), too far from the doctor ortransportation not available (1.4 percent), notbeing aware the condition could be treated, dis-couraged with the treatment, treatment was toopainful, medication needed for other conditionwas causing eruptions, and persons were treatingthemselves.

000

25

REFERENCES

1National Center for Health Statistics: Prevalence ofdermatological disease among persons I-74 years of age:United States. Advance Data From Vital and Health Sta-tistics. No. 4. DHEW Pub. No, (HRA) 77-1250. Health

, Resources Administration. Rockville, Md,, Jan. 26, 1977.2National Center for Health Statistics: Origin, pro-

gram, and operation of the U.S. National Health Survey.Vital and Health Statistics. PHS Pub. No. 1000-Seriesl-No. 1. PubIic Health Service. Washington. U.S. Govern-ment Printing Office, Aug. 1963.

3National Center for Health Statistics: Plan andinitial program of the Health Examination Survey. Vitaland Health Statistics. PHS Pub, No. 1000-Series l-No. 4.Public HeaIth Service. Washington. U.S. GovernmentPrinting Office, July 1965.

4National Center for Health Statistics: Cycle I of theHealth Examination Survey: sample and response,United States, 1960-1962. Vital and Health Statistics.PHS Pub. No. 1000-Series 1 l-No. 1. Public Health Serv-ice. Washington. U.S. Government Printing Office, Apr.1964.

5National Center for Health Statistics: Plan, opera-tion, and response results of a pro~am of children’sexaminations. Vital and Health Statistics. PHS Pub. No.1000-Series l-No. 5, Public Health Service. Washington,U.S. Government Printing Office, Oct. 1967.

6National Center for Health Statistics: Plan and oper-ation of a health examination survey of U.S. youths 12-17 years of age. Vital and Health Statistics. PHS Pub.No, 1000-Series l-No. 8. Public Health Service. Washing-ton. U.S. Government Printing Office, Sept. 1969.

7 National Center for Health Statistics: Plan and oper-ation of the Health and Nutrition Examination Survey,United States, 1971-1973 (extended through mid-1974).Vital and Health Statistics. Series 1-Nos. 10a and 10b.DHEW Pub. Nos. (HSM) 73-1310. Health Services andMental Health Administration. Washington. U.S. Govern-ment Printing Office, Feb. 1973.

8DePartment of Dermatology, New York University

School of Medicine: Code of Skin Diseases, 1st rev. NewYork. New York University, Feb. 1968.

9 Nelson, W. E. (cd.): Textbook of Pediatrics, 8th ed.Philadelphia. W. B. Saunders Co., 1964.

10 Reisner, R. M.: Acne vulgaris. Symposium ofAdolescent Medicine. The Pediatric Clinics of NorthAmerica. 20(4):85 1-864, Nov. 1973. (W. B. SaundersCo., Philadelphia.)

11 Ebling,F.j.G.,and Rook, A.: The sebaceous gIand,

in A. Rook, D. S. Wilkinson, and F. J. G. Ebling, eds.Textbook of Dermatology, 2d ed. Vol. II. Ok ford.Blackwell Scientific Publication, 1972. pp. 1545-1553.

12 Freinkel, R. K.: Medical intelligence-current con.cepts, pathogenesis of acne vulgaris. N, Engl. J. Meal,280(21):1161-1163, May 22, 1969.

13 National Center for Health Statistics: preva~erice of

chronic skin and muscuIoskeletal conditions, UnitedStates, 1969. Vital and Health Stati&s. Series 1O-NO.92. DHEW Pub. No. (HRA) 75-1519. Health ResburcesAdministration. Washington. U.S. Government PrintingOffice, Aug. 1974.

14National Center for Health Statistics: Eighth, Revi-sion International Classification of Diseases, Adapted forUse in the United States. PHS Pub. No. 1693. PublicHealth Service. Washington. U.S. Government PrintingOffice, 1967.

15National Center for Health Statistics: Skin condi-tions of youths 12-17 years, United States. Vital andHealth Statistics. Series 1 l-No. 157. DHEW Pub. No.(HRA) 76-1639. Health Resources .4dminist~ation.Washington. U.S. Government Printing Office, Aug.1976.

16NationaI Center for Health Statistics: The NationalAmbulatory Medical Care Survey: 1975 Summary.United States, January-December 1975. Vital and @eqlthStatistics. Series 13-No. 33. DHEW Pub. No. (PHS) 78-1784. Public Health Service. Washington. U.S. Govern-ment Printing Office, Jan. 1978.

17 National Center for Health Statistics: Profiles ofchronic illness in nursing homes. United States: NationalNursing Home Survey, August 1973-April 1974. Vitaland Health Statistics. Series 13-No. 29. DHEW P~b, No.(PHS) 78-1780. Public Health Service. Washington. U.S.Government Printing Office, Dec. 1977.

18 National Center for Health Statistics: Replication:

An approach to the analysis of data from complex sur-veys. Vital and Health Statistics. PHS Pub. No. 1000-Series 2-No. 14. Public Health Service. Washington. U.S.Government Printing Office, Apr. 1966.

19 National Center for Health Statistics: PseudorepIica-tion: Further evaluation and application of the balancedhalf-sample techniques. Vital and Health Statistics. PHSPub. No. 1000-Series 2-No. 31. Public Health Service.Washington. U.S. Government Printing Office, Jan.1969.

26

LIST OF DETAILED TABLES

1. Prevalence of significant skin pathology of all types and the most frequently occurring types of conditions among parsons1-74 years, by sex, showing rates, number of persons affected, and selected standard errors: United States, 1971 -1974 ... .. ... ..

2. Prevalence of significant skin pathology of all types and the most frequently occurring types of conditions among pemons1-74 years, by age, showing rates and selected standard errors: United States, 1971-1974 ... .. .... .. ... ... ... .... .. .. ... . ... ... ... ..... .. .. .... ..

3. Prevalence of significant skin pathology of all types and the most frequently occurring types of conditions among males 1-74

years, by age: United States, 1971-1974 .... . ... ... .. . .... .. ... ... . .. ..... . . .... .. .. ... ... .. ... . ... ... ... ... .. . .. .... .. . ... .... . .... . . ..... .. .. ... .. .. ... ... . ..... .. .......

4. Prevalence of significant skin pathology of all types and the most frequently occurring types of conditions among females1-74 years, by age: United States, 1971-1974 ... .. .... . .. ..... . .. .... . .. ... ... .. .. .. . .. ... .. .. ... .. .. .... .. . .... .. ... ... . .. .... .. . .... . ... ... .. . .... .. . .. .... .. . .... ....

5. Prevalence of significant active skin pathology, significant skin pathology now in remission, and the coexistence of significantactive skin pathology and condition(s) in remission, among persons 1-74 years, by age and sex, showing rates, selected stand.ard errors, and number of persons affected: United States, 1971-1974 .. ... .. . .... .. ...... ... ... .. . ..... .. . .... .. . .... .. .. .... . .. ... ... ... ... ... ...... ... ..

6. Prevalence of significant active skin pathology, significant skin pathology in remission, and nonsignificant skin pathologyamong persons 1-74 years, by type of condition, showing rates and number of persons affected: Unitad Statas, 1971 -1974...

7. Prevalence of skin conditions of concern (complaints), significant skin pathology of concern and not of concern to theaffected individual and nonsignificant skin pathology of concern to the individual among persons 1-74 years, by age andsex, showing rates, selected standard errors, and number of persons affected: Unitad States, 1971-1974 .. . .. .... .. ... .. .... . ..... . .. ... .

8. Prevalence rates for skin conditions of concern (complaints), all types and the most frequently reported tyPa& amon9 Par-sons 1-74 years, by sax and part of body affected: United States, 1971-1974 ..... . ... ... .. .. ... .. ... ... ... ... ... . ..... .. .... . ... ..... . .. ..... . .. .... ..

9. Prevalence rates for skin conditions of concern (complaints), all types and the most frequently repotted types, arnon9 Pfsr-

sons 1-74 years, by age and part of body affected: United States, 1971-1974 .. .. . .. .... . .. .... .. .. .... .. . ... ... . .... .. .. .... .. .. .... . .. ... ... .. .... ...

10. Prevalence rates for skin conditions of concern (complaints), all types and the most frequently reported types, among males1-74 years, by age and part of body affected: United States, 1971-1974 ... . .. ... .. . .... .. .. .... ... .. . ... .. . ... .. . ..... . ... .... . .. ... .. .. ..... .. ... . .. .. . .

11. Prevalence rates for skin conditions of concern (complaints), all types and the most frequently rePortad MM% amon9females 1-74 years, by age and part of body affected: Unitad States, 1971-1974 ... .. . ... ...?. ... . ... ... .. . ..... . ... ... ... . .... ... . ... ... .. ..... .. ...

12. Prevalence of skin conditions of concern (complaints) among persons 1-74 years, by recurrence, duration, handicap, dis-figurement and discomfort from condition, age and sex of person affected, showing rates, selected standard errors, andnumber of persons affected: United States, 1971-1974 ... . .. .... .. ... ... .. . ... ... .. .... ... .... .. .. .... . .. .. .. .. .. ... ... . .... .. .... .. ... ... .. .. .... . .... ... .. . .....

13. Type of care sought and adequacy of treatment for skin conditions of concern (complaints) among parsons 1-74 years, byage and sex, showing rates, selected standard errors, and number of persons affected: United States, 1971-1974 .... .. ..... ... . .... .

28

29

30

31

32

33

34

35

36

39

45

46

27

Table 1. Prevalence of significant skin pathology of all typas and the most frequently occurring types of conditions among persons 1-74years, by sex, showing rates, number of persons affected, and selected standard errors: United States, 1971-1974


Persons with one or more significant skin conditions ... .. ..... . ... ... .

Significant skin conditions, all types .. .. .. .... .. .. ...... .. . ..... . .. ..... .. .. ...

Diseases of sebaceous glands . .. . ...... .. .. .... .. . . .... .. .. .... ... . .... .. .. . .... .. ..7l4l.7l49Acne vulgaris .. ... .. .... . ... ..... .. . ..... . .... .... .. .. ..... .. . .... ... .. .... ... . .... .. ... ...7l4l5OCystic acne . ..... .. .. ...... .. .. .... .. .. .... .... ..... . .... .... .. .. .... .. .. .... ... . ..... ... ...714180Acne scars .. ... .... . ... .... .. .. ..... .. . .. .... .. .. .... .. .. . .... . .... .... .. . ..... .. .. ... .. . ...7l4l9OXerosis . ..... .. .. .... .. .... .... .. .. .... ... . .. .... . ... .... ... . .... .. ... ... ... . ...... .. . ..... ...7l493O

Dermatophytoses .. .... .... ..... .. ... ..... . ... .... ... . ..... . ... ..... .. . .... ... .. .... .. .. ..... .. . ...l3lTinea pedis . ... .. ... .... .. .. ...... .. . ..... .. .. ...... . .. ... .... .. .... .. ... .. ... .. .... .. ... ..... . .1310Tinea unguium .. .. .... .. ... .... .. ... .... .. .. ..... . .... .... .. . ..... .. .. ...... . . .... .. ... ..... . 1312Tinaa versicolor .. .. ..... .. ... .... . ... ...... . .. .... ... .. .... ... .. .... .. .. .... .. .. .... ... . .131910Tinea cruris ... .... .. .... ... .. ... .... .. .. ...... . ... .... .. .. .... ... .. ..... . . ..... ... . ..... .. ...13131

Tumors2 .. . .... .... .. .. .. .. .. ... ..... .. ... .... .. . .. .... ... . .... .. .. .. .... .. .. ... 19 X,22 X,23 X,23YMalignant ..... .. ... .... ... .. .... .. ... .... .. ... .... .. .. .... ... .. ..... . .. .... .... . ..... . ... ... ... ..l9x

Basal%ell epithelioma ... .. .... .. .... .... .. ... ... ... . ..... ... . .... .. . .. .... .. .. .....l9XlBenign2 .... .. ..... .. .. ..... . .... ..... . ... ... .. .. .. .... .. .. ..... .. . .... .... . ..... .. .. .... .. .. ..t...22X

Lipoma “22X959, .. .... .. .. .... .. .. . ..... .. .. ...... . .. ... .. .. .. .... .. ... .... . ... .... . .... .... ..Precancerous and not specified ...... .. .. .... .. .. .... .... . ..... . ... .... .. .. ... 23 X,23Y

Actinic keratosis . ...... .... ..... . .. .... .... ...... .. .. .... .. .. .... .. ... .... .. . .. ...23XO8l

Seborrheic dermatids .... . ... .... .. .. ..... ... .. .... . .. ...... . ... .... . ... ..... .. . ..... ... . .... .. ..7OOSeborrheic dermatitis, type not indicatad .... . ... .... ... . ..... . ... .... .....700010

Atopic dermatitis, eczema ... . ...... .. .. .... .. .. ..... ...701.708300.7083 lO.7O832OAtopic dermatitis .... .. ... .. .... .... .. .. .. .. .. .. ..... ... .. .... .. .. ... .. .... ... ... ... ....7 0831 O

Lichen simplex chronicus .. .. .... .. .. ..... .. .. .... .. ... ..... . ... .... .. . ..... .. ... ...7 O832OHand eczema.. ............................................................................7oloooNummular eczema ... ... . ..... .. .. .... .... .. ... ... .. ... ... .. .... .. ... .... .. .. .... ... ...7'0101 ODyshidrotic eczema ... .. ... ..... . ... ..... . .. ..... .. .. .....+... .... ... . .... .. ... .... .. ..7olo3o

Contact dermatitis .... .. .. ..... .. ... .... .. . ...... .. .. ..... .. .. .... .. .. ..... . .... ... .. .. .... ... .. ...7O3

Ichthyosis, keratosis . .... .. .. .... .. .. .. .... .. .. .... .. .. .. .. .. .. .. .... . ... .... ..71 O130.71 Ol5O

Verruca vulgaris .. .... .. .. ..... .. .. ..... .. .. ..... .. .. ..... . .. ..... .. ... .... .. . ..... .. .. ..... ...696O3O

Follicul itis . .. ..... .. . ...... ... . .... ... ... .... .. .. .... .. ... ..... .. .. .... .. .. .... .. ... .... .. . ......l~l39O8

Psoriasis .. .... ... . ..... . ... ..... .. .. .... ... .. .... . .. ... .... . ... ... ... . ...... . ... .... .. . ..... ... .. ...~O6O9O

Seborrheic keratosis .. ..... ... .. .... .. .. .... ... . .. .... .. .. .... .. .. .. .. .. .. ..... . ... ..... . . 22X44X

Vitil igo ... ... .. .... ... . ..... . ... ..... .. .. ..... .. . ..... .. ... .... ... . .... ... .. .... ... ..... ... . ..... ..1~1621 O

Urticaria (hives. etc.) .. ... .. .... .. .. ...... .... .... .. ...... .. .. ...... .. ..... ... .. .... .. .. ...242.243

Herpes simplex .. ... . ... ..... .. .. .... .. .. .... .. .. .. .... .. ... ... ... . .... .. .. .. .... .. . .... ... .. ..t . .. ..O96

All other skin conditions .... . ..... ... .. ..... .. ..... ... .. .... .. .. .... .. .. ..... . ... ..... . .. ..... ... .. .

Persons with one or more significant skin conditions ... ... .. .. .... .. ..

~ate per 1,000 population

312.4439.7

84.868.1

1.91.7

6.5

81.138.721.8

8.46.7

56.55.94.1

38.22.1

12.4

9.6

28.528.2

18.46.94.51.61.72.1

13.6

9.5

8.5

8.0

5.5

5.2

4.9

4.8

4.2

106.2

339.8499.4

87.970.5

3.32.05.3

131.468.430.310.912.9

59,66.44.7

35.82.6

17.413.9

26.7

26.4

19.58.24.7

1.11.03.1

13.8

9.3

10.3

12.3

5.9

4.6

3.6

3.8

4.0

106.7

286.6383.4

81.965.9

0.61.3

7.7

33.710.713.9

6.00.9

53.75.33.5

40.5

1.67.9

5.5

30.129.9

17.45.64.42.12.41.2

13.4

9.6

7.2

4.0

5.1

5.8

6.2

5.8

4.5

105.0

Number in thousands

60,60185,287

16,46513,217

375321

1,260

15,7337,5094,2321,6231,301

10,9681,136

7967,412

4012,4201,858

5,5205,476

3,5751,332

882311332405

2,641

1,835

1,684

1,553

1,070

1,010

957

933

824

20,519

31,98847,018

8,2796,638

312192497

12,3726,4382,8561,0221,214

5,606602445

3,372244

1,6321,306

2,5142,490

1,B37771441105

92288

1,303

880

967

1,154

556

431

347

354

376

10,048

Standard error of rate

20.05 21.06

28,61338,269

8,1866,579

63129763

3,3611,0711,376

60187

5,362534351

4,040157788552

3,0062,986

1,738561441

206240117

1,338

955

717

399

514

579

616

578

448

10,472

. . .

lSee reference 8.z~xclude~ seborrhej~ keratosjs (22x44X) which is listed with benign tumors in the NylJ classification.

28

Table 2. Prevalence of significant skin pathology of all types and the most frequently occurring types of conditions among persons 1-74 years, by age,showing rates and standard errors: United States, 1971-1974


Personswith one or mora significant skin conditions ...........Significant skin conditions, all types....................................

Diseasesof sebaceousglands...............................................7l4l.7l49Acne vulgaris......................................................................7l4l5OCystic acne ................................................................. ........7l4l8OAcne scars..........................................................................7l4l9OXerosis ...............................................................................7l493O

Dermatophytoses ...................................... .....................................l3lTinea pedis .............................................................................1310Tinea unguium ....................................................... .. ..............1312Tinea versicolor ..................................................................131910Tinea cruris ..........................................................................l3l3l

Tumors2 ................................................................l9X.22Xz3X23YMalignant ........<...#...................................................................l9x

Basal+ell epithelioma ....................................................... 19X1Benign2 ...................................................................................22X

Lipoma ................... .....................................................22X959Precancerous and not specified ...... .......................... ........ 23 X,23Y

Actinic keratosis ..........................................................23XO8l

Seborrheic dermatitis ................................................................ .....7ooSeborrheic dermatitis, type not indicated ...........................7WOl O

Atopic dermatitis, eczama ......................701 ,7083 OO,7O831O,7O832OAtopic dermatitis ............... ................................................7 0831 OLichen simplex chronicus ...................................................7 O832OHand eczema ............................ ..........................................7oloooNummuiar eczema ..............................................................7 0101 ODyshidrotic eczema ............................................................701 O3O

Contact dermatitis .........................................................................7O3

Ichthyosis, keratosis ...................................................71 Ol3O.7lOl5O

Verruca vulgaris ............................ ...........................................696O3O

Folliculitis ...............................................................................7l39O8

Psoriasis...................................................................................7MO9O

Seborrheic keratosis...............................................................22X~X

Vitil igo ....................................................................................7l62lO

Urticaria (hives, etc.) ........................................ .... ..................242.243

Herpes simplex ..............................................................................O96

All other skin conditions .....................................................................

1-5 6-11 12-17 18-24 25-34years yaars years yaars years

142.3166.4

6.30.4

2.8

3.40.4

1.1

21.7

21.7

9.89.6

24.919.3

1.9

13.9

8.6

4.7

1.2

3.1

0.2

0.6

3.1

3.4

61.5

174.2195.4

21.411.9

6.7

8.44.00.91.5

18.9

18.90,8

6.76.7

20.013.8

1.7

1.31.9

4.9

15.5

13.1

3.2

1.9

5.5

1.8

5.3

68.8

362.0468.5

249.923? .9

2.04.53.9

33.214.1

1.910.24.7

31.30.5

30.7

0.1

18.818.5

17.010.74.10.20.60.4

8.6

16.7

15.5

5.3

2.5

1.0

3.4

5.1

60.2

3544 45-54yaars years


365.1499.9

191.1172.2

5.45.23.7

61.724.9

7.017.86.7

43.00.10.1

40.70.92.2

38.738.7

15.45.11.20.34.92.6

14.2

8.8

12.4

18.9

1.5

0.4

3.6

4.3

3.2

82.7

318.0452.9

99.683.6

5.20.94.0

87.749.113.49.9

10.2

39.60.1

38.90.60.6

41.941.9

28.06.05.84.92.55.9

9.6

11.5

6.3

15.4

6.2

0.4

3.0

4.6

5.2

93.9

328.2475.2

44.125.4

2.61.76.8

121.562.024.913.011.7

46.83.23.2

38.21.65.41.5

41.641.1

14.71.45.53.70.11.3

17.0

7.7

6.2

12.8

4.9

4.5

3.4

3.6

4.8

141.6

356.8529.7

21.5B.7

0.95.4

155.780.946.2

7.213.1

64.99.59.1

52.95.3

22.515.9

31.931.9

13.92.45.21.50.74.0

16.7

2.7

8.9

5.5

11.4

9.7

5.9

8.8

2.8

149.4

55G4 65-74years years

161.0i63.9

32.02.5

15.3

150.857.968.5

7.38.9

100.218.913.344.9

4.436.432.8

28.727.4

12.81.09.41.90.6

23.6

7.0

2.4

2.1

10.9

18.3

12.6

7.6

3.3

151.6


Personswith one or more significant skin conditions ........... 13.03 18.45 28.57 27.50 24.90 25.28 23.08 23.27

409.5654.8

25.50.70.1

14.9

126.859.654.7

2.31.3

184.136.419.968.1

7.779.665.1

36.436.3

18.31.7

10.30.93.20.4

20,4

1.5

3.6

1.1

9.5

24.4

13.6

7.4

4.9

177.3

24.91

lSee reference 8.2Exc]udes ~ebOmheic keratosjs (22X44X) which is listed with benign tUmOrSin the NyLJ classification.

29

Table 3. Prevalence of significant skin pathology of all types and the mosl; frequently occurring types of conditions among males 1-74 Years, by age:United States, 1971-1974


Persons with one or more significant skin conditions ...........Significant skin conditions, all types ...................................

Disease of sebaceous glands ................................................7l4l.7l49Acne vulgaris ......................................................................7l4l5OCystic acne .........................................................................7l4l8OAcne scars............!.......................................<.....................7l4l9oXerosis ...............................................................................7l493O

Dermatophytoses ...........................................................................l3lTinea pedis .............................................................................l3lOTines unguium .......................................................................l3l2Tinea versicolor ..................................................................13191 OTines cruris .... ......................................................................l3l3l

Tumors2 ................................................................l9X.22X.23X.23YMeiignant ................................................................................l9x

Basal-cell epithelioma .......................................................l9Xl8enign2 .............#................. .................... ................................22x

Lipoma ........................................................................22X959Precancerous and not specified ........................................ 23 X,23Y

Actinic keratosis ...... .... ........................ ........................23XO8l

Seborrheic dermatitis .....................................................................7OOSeborrheic dermatitis, type not indicated ...........................7 0001 O

Atopic dermatitis, eczema ......................701 ,708300,708310,708320Atopic dermatitis ...............................................................7O83lOLichen simplex chronicus .... ...............................................7O832OHand eczema ......................................................................7oloooNummuler eczema ..............................................................701 OlODyshidrotic eczema ............................................................701 O3O

Contact dermatitis .........................................................................7O3

Ichthyosis, keratosis ...................................................71 Ol3O.7lOl5O

Verruca vulgaris .......................................................................696O3O

Folliculitis ...............................................................................7l39O8

Psoriasis...................................................................................7O6O9O

Seborrheic keratosis...............................................................22X44X

Vitiligo. ...................................................................................716210

Urticaria (hives, etc.) ..............................................................242.243

Herpes simplex ..............................................................................O96

All other skin conditions .....................................................................

I&l&[email protected]

4.9

3.1

3.60,8

1.0

14.5

14.5

7.17.1

21.217.0

11.2

10.7

5,2

2.0

%8

CI.2

41.4

:!.7

62,3

182.4209.7

19.56.7

9.1

12.47.11.22.5

22.1

22.1

5.55.5

29.319.73.0

2.62.5

5.7

18.4

12.8

3.5

1.2

4.3

1.7

4.8

68.5

363.6477.2

248.0232.5

2.43.53.9

54,026.0

3.710.99.2

25.51.0

24.3

0.2

13.913.9

19.415.52,5

6.9

12.7

14.8

7.5

1.1

1.3

7.4

64.7

Male

Rate per 1,000 males

393.4564.7

206.6182.8

9.38.92.7

101.846.710.024.713.8

44.9

42.11.82.8

37,637.6

to.75.61.1

3.5

19.5

10.3

21.5

29.9

3.1

4.0

0.5

74.3

lSee reference 8.2Exclude~ ~ebOrrhei~ ker~tO~is (ZZX44X) which is Iiated with benign tumors in the NyU classification,

358.4532.8

102.685,110.8

1.5

152.994.021.411.519.3

41.4

.40.11.31.3

40.540.5

28.95.76.93.12.98.1

9.6

10.4

7.4

25.4

9.9

2.1

2.0

7.6

92.1

335.8508.4

38.217.73.53.15.5

198.4106.434.217.721.8

41.13.53.5

30.80.96.81.8

28.828.8

10.1

1.14.3

2.4

14.2

6.8

8.5

22.2

3.1

4.3

0.8

3.1

128.8

45-54years

438.0677.4

30.015.3

1.24.6

268.5153.464,7

9,424.6

92.311,310.748.0

5.733.025.4

40,140.1

17.43.64.7

1.27.7

14.1

3,1

8.7

6.3

10.4

10.4

3.5

10.5

4.4

157.7

E_l&-424.4717.9

31.75.3

9.6

247.598.8

103.210.218.5

128.420.615.550.2

8.157.653.2

32.029.3

14.2

11.92.3

33.1

3.5

2.6

1.2

15.2

15.3

9.5

4.8

0.6

178.3

467.8782.4

25.71.60.2

11.8

186.595.971.3

4.92.9

222.744.027.165.510.9

113.296.3

39.339.3

23.31.6

18.0

1.60.2

18.0

2.0

4.5

2.5

14.4

24.4

16.4

7.1

1.8

193.8

30

Table 4. Prevalence of significant skin pathology of all types and the most frequently occurring types of conditions among females 1-74 years, by age,United States, 1971-1974

Condition and NYU codal

Persons with one Or more significant skin conditions ...... .. ...Significant skin conditions, all types ........................ ..........

Disease of sebacaous glands . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . ..7l4I.7I49

Acne vulgaris ......................................................................7l4l5OCystic acne .........................................................................7l4l8OAcne scars..........................................................................714l9OXerosis ...............................................................................71493O

Dermatophytoses ...........................................................................l3lTinaa pedis .. ..........................................................................l3loTinea unguium .......................................................................l3l2Tinaa varsicolor ...........<......................................................l3l9loTinea cruris ........... ...............................................................l3l3l

Tumorsz ....................................................... ......... 19X,22X,23 X,23YMalignant ................................................................................l9X

Basal+ all epithelioma .................... ................................... 19X1Benignz ................................. .......... ........ ................................22x

Lipoma ........................................................................22X959Precancerous and not specified ........................................ 23 X,23Y

Actinic keratosis ..........................................................23XO8l

Seborrheic dermatitis ... ..................................................................7ooSeborrhaic dermatitis, type not indicated ................. ..........7 0001 O

Atopic dermatitis, eczema .... .... ..............701 ,708300,706310,708320Atopic dermatitis ...............................................................7O83lOLichen simplex chmnicus ...................................................7 O832OHand aczema ......................................................................701 OOONummular eczema ..............................................................7ololoDyshidrOtic eczema ......................... .................................701030

Ccmtact dermatitis .........................................................................7o3

Ichthyosis, keratosis ...................................................7lol3o.7lol5o

Verruca vulgaris .......................................................................696O3O

Foliiculitis ... ...........................................................................7l39O8

Psoriasis...................................................................................7O6O9O

Seborrheic keratosis............................................................... 22X44X

Vitiligo ....................................................................................71621 O

Urticaria (hives, etc.) .............................................................242.243

Harpes simplex ..............................................................................O96

All other skin conditions .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

~See reference 8.

1-5 I 6-11years years

148.9177.4

7.70.7

2.5

3.2

1.0

29.2

29.2

12.612.3

28.721.4

4.0

16.8

6.4

4.1

0.4

0.2

0.5

1.1

1.8

4.1

60.6

166.0180.7

23.517.3

4.1

4.10.80.70.6

15.7

15.71.7

7.97.8

10.67.70.4

1.3

4.1

12.5

13.4

2.8

2.8

6.7

1.9

5.9

68.8

12-17years

360.4159.3

251.8231.3

1.65,53.9

11.41.5

9.4

37.4

37.4

23.823.3

14.45.55.70.31.20.7

10.4

20.8

16.4

3.1

5.1

0.8

5.6

2.8

55.5

Famale

Rata per 1,000 females

338.5439.2

177.1162.2

1.71.94.5

22.34.54.2

11.4

41.10.20.2

39.4

1,5

39.839.8

19.74.61.20.79.61.7

9.2

7.3

4.0

8.7

3.1

0.8

4.0

4.6

5.6

91.9

281.2380.0

96.762.2

1.86.4

28.38.36.16.51.7

38.10.2

37.9

43.243.2

27.26.34.76.62.13.9

9.4

12.6

5.1

6.1

2.6

0.9

3.9

6.9

2.9

96.1

321.1$44.8

49.532.4

1.80.48.0

51.121.316.38.52.4

52.13.03.0

45.22.43.91.2

53.352.4

18.92.69.63.20.20.3

19.5

8.2

4.1

4.1

6.5

4.7

6.5

6.2

6.5

53.6

282.3394.0

13.72.7

0.76.2

52.214,529.2

5.12.5

78.38.07.6

57.54.9

12.87.3

24.324.3

10.81.35.72.90.20.7

19.1

2.3

9.2

4.7

12.4

9.1

8.2

7.3

1.2

141.2

55-84years

306.1426.5

32.2

20.7

64.621.137.7

4.70.4

75.217.511.440.3

1.017.414.6

25.725.7

11.71.97.11.61.1

15.3

10.1

1.1

2.8

7.1

21.1

15.4

10.1

1.5

132.6

65-74years

365.5558.5

25.3

17.5

81.832.242.2

0.4

154.830.514.670,2

5,254,141.6

34.234.1

14.61.64.41.64.40.4

22.3

1.1

2,1

5.8

24,5

11.5

7.7

7.1

165.7

‘Excludes seborrheic keratosis (22X44X) which is listed with benign tumors in the NYU classification.

31

Table 5. Prevalence of significant active skin pathology, significant skin pathology now in remission, and the coexistence of significantactive skin pathology and condition (s) in remission among persons 1-74 years, by age and sex, showing rates, selected standdrderrors, and number of persons affected: United States, 1971-1974

Significant active skinconditions

=_L=E

Significant skin pathology

Age and sex


216.7 124.9 106.4 18.5 47.4Both sexes, l.74years . .. .. .. .. .. .. .... .. .. .... .. .. .... .. .. .... .. .. .... . 31.6 64.1

*4.1*:2.7

“18.4*3 1.6*2!LI.9●3!5.7

46.7

63.270.1

43.2

16.015.769.771.675.175.779.475.6

105.1

73.3

122.2155.8273.9261.9213.0216.8230.7223.1

234.3

223.3

69.669.194.1

131.2156.1162.6161.3145.5123.4

121.4

65.063.582.7

117.8133.6131.1

131.1123.8111.2

104.4

*4.6*5.6

*11.4+13.4●22.5*3 I .5*30.3*2 I .7*12.2

*17,0

*’12.4*’16.7

41.151.160.452.462.568.462.3

51.4Male, 1-74 years .. .. .... ... .. .... .. .... ... .. . ...... .. .. .... .. ... ... ... . ..... .. .. .

l.5years ... .. .. .. .... .. .. .... .. . . ...... .. .. .... .. .... .. .. .. .. .... .. .. .... .. .. .. .... .. . ..... ....

6-11 years ... .. .. .. .. .. .. .. .. .. .. .. .... .. .. ...... .... .... .. .. .. .. .. . . .... .. .. .. .. .. .. .. .... ....12-17 Vears .. .. .... .... .. .... .. . .. ... .. .. ...... ... .. ..... . . .... .... . ..... .. ... ... .. .. ..... . ...

18-24 Vears .. .. .. .... .. .. .. .. .. .. .. .... .. .. .... .. .... .... . ... .... .. . ...... . .... ... ... ..... . .. .25-34 years ... .. ..... . ... .... .. .... .... .. .. .... .. .. ..... . .. .... .... .. .... .. ... ... .. .. ..... . ...35-44 years .. .. .. .. .. .. .. .. .... .. .. .. ..c. .. .... .. .. . ..... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .... .. .45-54 years . .. . ... .... .. . ..... .. .. ...... . . .. .. ... ... ..... .. . .... .. .. . ..... . ... . ... . .. ..... .. ..55-64 yaars .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .... .. .. ...... .. .. .. ... . .. ..... ... .. .... .. .. .... .. .65-74 years .. .. .. .. .. .. .. .. .... .. .. .... .. . ... .. .... .. .... . ... ...... .. ...... .. . ..... .. .. .... ...

*3.3*4.6

*’24.6*43.7●4,1 .0●4.8.2

‘85.099.592.5

*20.7

“13.3*18.1

64.4

84.092.576.2

109.494.6

129.7

55.4

119.3

159.7274.6

265.7224.9211.4263.6230.3245.6

210.5

62.453.692.5

132.1145.5176.4159.5152.7116.1

128.3

59.546.9

87.5118.3132.3137.3122.9131,3101.8

110.3

*2.9‘6.7‘5,0

*13.8*13.2*39.1*36.6*21.4*14.3

*18.O

*12,0*17.5*4 I .9

51.7

71.356.4

66.888.3

62.4

43.6Female, 1-74 years ... .... .. . ..... ... . ..... .. ... .... .. . ..... .... . .... .. ... .. ....

1-5 years .. .... .. .. .. .. .. .. .. .... .. .. . ... .. .. ... ... .. .. .... .. ... ..... . . ..... .. ... .... .. .. .... .. .6-11 years .. ... . .. .. .. .. .. .. .... .... .. .. .. . ... .... .. . ... .. .. ... .... . ... ..... .. .. .... .. .. .... .. .12-17 years ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .... .. .. .... .... .. .... .. .. ... ...18-24 years ... ... .. ... ... . ...... ... . ... .... .. .... .. .. .... . .... .... .. . ..... ... . ... .... .. ... .. ..25-34 years ... .. .. .. .. .. .. .. .... .. .. .... .. .. .. .... .. .. .... .. .. ..... . .. .... .. ... .... .. . .. .... ..35-44 Vears .... .. .. .... . .. . .... ... . ...... .. . .... ... .. ..... .. .. .... .. .. .... .... . .... . .... .... ..45-54 Vears ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .... .. .. ......cc.... .... .. .... ...c.. .. ..55-64 Vears .... .. .. ..... . .. ...... .. . ..... .. ... .... ... . .... .. .. ..... . ... ... .... . .... .. ... .... ..65-74 years ... .. .. .. .... .. .. .... .... ...... .. .. .... .. .. ..... .. . .. .. ... ... ... ... .. .... . ... ..... .

‘~4.8“0,8

*’11.8●20.3●’19.8*124.2*:29.9“30.8

!53.2

*18.9*13.2

75.360.059.275.351.958.786.6

125.2152.0273.3258.2

202.2221.6200.5216.6225.7

77.185.095.7

130.4165.8149.9162.9139.1128.9

70.780.677.5

117.4134.9125.4138.6117.2118.3

*6,4*4.4

‘18.2*13.O*30.9“24.5‘24.3*2 I .9‘10.6

*12.8“15.940,350.550.348.758.5‘50.662.2


Both sexes, ‘I-74 years ... .... .. .. .... .. .. ...... .. .. .. .. ... ..... .. .. .... .

+-

7.46 15.10=

8.65 14.706.50 17.40

31.301 ---l ---l ---1 ---

Maler 1-74 years . .... ... .. .... ... .. .... ... .. .... ... . ..... .. . ..... . .. .. .... .. .. .... . ... .... ..Female, 1-74 years . .... .. .. .. .. .. .... .. .. .. .... .. .. .. .. .. .. .. .. .. .. .... .... ...... . ... .. .. . :Ml :::1 :::I :::1 :::

Nun }er of persons affectad in thousands

8oth sexes, 1-74 years .. .... .. .. .... .. .. .. .... .. .. .. .. .. .. .... . ... .... .. 6,127

*

12,433=

4.,063 6,904;!,064 5,529

42,044 24,236 20,834 3,402 9,193-

21,021 11,427 9,826 1,601 4,839

21,020 12,809 11,008 1,801 4,354Male, 1-74 years .. .... .. .. .. .. .. .. .. .... .. .. .... .. .. .. .. .. .. .. .... . . ...... .. .. .... .. .. .... ..Female, 1-74 years ... .. ..... ... .. ... .. .... ... ... ... .. ... ... .... . ... .... . ... .... .. .. .... .. .

32

Table 6. Prevalence of significant active skin pathology, significant skin pathology in remission, and nonsignificant skin pathology among persons 1-74years, by type of condition, showing rates and number of persons affected: United States, 1971-1974


Syphilis . .. .. .. . . .. . . .. .. .. . . . .. . .. .. .. . . .. . . .. .. . .. . . . .. .. .. . . . .. . .. .. .. . . . . .. . . .. . . . . .. .. .. . .. . . . .. . . . .. . . .. . . . . ... . ...O2O429Other venereal diseases .. . .. . . .. . . .. . . . .. . .. .. . . .. . . .. .. .. . .. . . . .. .. .. . . . .. . .. .. . .. . . . .. .. . .. . . . .. . . . .. .. . .. . . . ..O3O039Bacterial diseases .. .. .. .. .. . . .. .. .. .. .. .. . . .. .. .. . . . .. . .. .. .. . . . .. . .. .. . . .. . . .. .. . .. .. . .. .. .. . .. .. . .. . . . .. . . . .. . . . ..O5O~59Other spirochetal disemes .. . .. .. .. . . . . .. .. .. . . .. . . .. .. .. .. .. .. .. .. . . .. . . .. .. . .. . . . .. .. . .. .. . . . .. .. . .. . . . .. .. . ..O7O~79Viral diseases .. . . .. . . .. .. .. .. . . . . .. .. .. .. . .. . ... . .. . . . .. . .. .. . . .. . . .. .. .. .. . . .. .. .. . .. . . . .. .. . . .. . .. . .. .. . . .. . . .. .. . ..O84~96

Rickettsial diseases .. . . .. .. . . . .. . . .. . .. .. .. . .. . .. .. .. . . . . .. .. .. . . .. . . .. . . .. . . . . .. .. .. . . . .. . .. .. .. . .. .. . . . .. . . . .. . ..l OO.lO8Leishmaniasis and other parasitic diseases .. .. . . .. . . .. .. . . .. . . .. .. .. . . .. . . .. .. .. .. . . .. .. . .. . . . .. .. .. . ..l2O.l3ODermatophytoses. .. .. . . .. . . .. .. . .. .. .. . .. .. . .. . . . .. .. .. .. .. .. .. .. .. . . . . .. .. . .. . . .. .. . .. .. . .. . .. . . .. . . . .. . . . . .. .. .. .. . .. ..l3lDeep fungal infections ... . .. .. . . . .. . .. .. .. . .. . .. .. .. . .. . . . .. .. .. .. . . . . .. .. . ... . .. . . . .. .. . .. .. . . . .. . . . .. . . . . .. . . ..l32.l34ZOOnOses .. . .. .. .. .. .. . . . . .. .. .. . . .. .. .. .. .. . .. . .. .. . .. .. . . .. . .. .. .. . .. . .. .. .. . . . . .. .. .. . . . . .. .. .. .. . . . . .. .. . .. . . .. . .. ..l35.l37Sarcoidoses and other parasitic diseases.. .. . .. . . . .. .. .. . . . . .. .. .. . .. . . . .. .. . .. . . . .. .. .. . .. .. . .. . . . .. . . . .. . . . ...l3sMalignant tumors ... .. .. . . .. . . .. . .. .. . .. .. . .. . . . .. .. .. . .. .. . .. . . .. . . . . ... . .. . .. . . . .. .. . .. . . . .. .. . .. . . .. . .. . .. . . . .. .. .. . .. 19X

Bowen’s disease, Paget’s disease, erythrophasia .. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . . . .. .. .. . . .. .. .. .. . 19X0

Basal-cell epithelioma, fibroepithelial tumor . . .. . . . . .. . . .. .. .. . .. . . . .. .. . . .. . . .. .. .. . .. . .. .. . .. .. .. . 19X1Base-squamous epithelioma or carcinoma and related conditions .. . . .. . .. .. . . . .. . .. .. . .. 19X2Malignant melanoma, lentigomaligna .. . .. . . . . .. .. .. . .. . .. .. .. .. . . . .. . . . .. . . . .. . .. .. . .. . . .. . .. .. . . . .. . ..l9X6Squamous+ell carcinoma .. .. .. . . .. . . .. .. . .. . . . .. . . .. . . . . .. .. .. .. . .. . .. .. .. . . . .. . .. .. . .. .. . .. .. .. . . . . .. . . .. . ..l9X8Adenocercinoma and related conditions .. . .. .. .. . .. . .. .. .. . .. . .. .. . . .. . . . .. . .. . .. .. . . . .. .. .. . . . . .. .. . 19X9Malignant tumor, skin, NOS ... .. .. .. . . .. .. .. . . .. .. .. .. .. .. . . .. .. .. . . . . .. .. .. .. . . .. .. .. .. . . .. .. .. .. . .. . .. .. . 19XX

Lymphoma, leukemia . .. . .. . . . .. .. .. . .. . .. .. .. .. . . . . .. .. .. . . .. . . .. .. . .. . . . .. .. .. . .. . .. .. .. .. . . . . .. .. .. . . . . .. .. .. . .. . ...2oxBenign tumor3 .. .. . ... .. . .. . ... .. .. .. . . .. .. .. . .. . . . .. .. . . .. . . .. .. . .. . . . .. .. . .. . .. . . .. .. .. . . . . .. .. .. . .. . .. .. .. . . .. . . .. .. .. . . 22x

Seborrheic keratosis . .. .. . . . . .. .. .. . . .. . . .. .. .. . . . . .. .. .. . . .. . . .. .. . .. . . . .. .. .. . . .. . . .. .. . .. . . . .. .. .. . .. . . . .. .. ..22X44XPrecancels .. .. .. .. .. . . .. .. .. .. . . . . .. .. .. .. .. .. .. .. .. . . . . .. .. .. . . .. . . .. .. . . . .. . .. .. .. . . . .. . .. .. . .. . . . .. .. .. . . .. . . .. .. . . .. .. ...23XTumor, malignancy unknown .. .. .. .. . . . . .. .. .. . . . .. . . . .. . . . . .. .. .. . .. . . . .. .. .. . . . . .. .. .. .. .. . . .. .. .. .. . . .. .. .. . . ..23YUrticaria< . . .. .. . .. .. .. . .. .. .. . . . ...<. .. .. . . . .. . .. . . . .. .. . .. . . .. . .. .. . . . . .. . . .. . . . . .. .. .. . . . .. .. . .. .. . . . . .. . . .. . . . .. . ....242.243

Allergic eczema or dermatitis due to extarnal sgant .. . .. . . . .. . . .. . .. . .. .. .. . .. .. . .. .. . .. . . . .. . . .. . .. ....2aOther allergy . . .. . . .. .. .. . . .. . . .. .. .. . .. . .. .. .. .. . . . . .. .. .. .. .. .. .. .. .. . . .. .. .. . .. . . . .. .. . .. . . . .. .. .. . .. . . . .. .. . .. . . . .. .. ....245Diseases of thyroid glands .. . .. .. .. . .. . . . .. .. .. .. . . .. .. .. .. . . . . .. .. .. . . . . .. . . .. . . . . .. .. . ... . . . . .. .. .. . . . . .. .. ..25O.2WDiabetes mellitus .. .. .. .. ....!... .. . . .. .. .. .. .. .. . . .. .. .. .. .. .. .. .. .. .. .. .. .. . . .. .. .. .. .. . . . . .. .. .. .. . . .. .. .. .. .. .. .. .. .. . .2643

Other endocrine disorders .. . . . .. . .. .. .. . . . . .. .. .. . .. . .. .. .. . . .. . . .. .. . .. . . . .. .. .. . . . .. . . . .. . .. . . . .. .. .. . . . .. ..27 O.277Avitaminosis and nutritional deficiencies .. .. .. .. .. .. .. .. . . . .. . .. .. .. .. . . .. .. .. . . . . .. .. .. .. . .. . .. .. .. ..28O.2B6

Lipoidoses and other metabol ic diseases .. . . .. . .. .. . .. .. .. . .. .. . .. .. . . . .. . .. .. . . . .. .. . .. . .. . . . .. . . .. . . . .288-289

Anemias . .. .. .. . . .. .. .. .. . . .. .. .. .. . . .. . . .. .. .. . . .. .. .. .. .. . . .. .. .. .. .. .. .. .. .. . . . . .. . . .. . . .. . . .. .. .. . . . . .. .. .. . . . .. . ...29O.293

Other blood dyscraaias .. . .. .. . .. .. . .. .. .. . .. .. .. . . . . .. . . .. .. . .. . .. . ... . . . . .. .. . .. . . .. . .. .. . .. .. . .. .. .. . . . .. . ...294.299Psychophysiological and related conditions ... .. .. .. .. .. .. .. .. . . .. .. .. .. .. .. . . .. .. .. .. . . . . .. .. .. . . .. ..32 O.324Diseases of nerves .. . .. .. .. . . .. .. . . .. .. .. . .. . .. .. . . .. .. .. .. .. .. .. . . .. .. .. .. . . .. .. .. .. .. .. .. .. . .. . . . .. .. .. . . . . .. .. ...36O.369Diseases of eyes (arcus senil is, etc.) .. .. . .. . . . .. .. .. .. .. .. .. .. .. .. . . .. .. . . .. . . .. .. .. . . . .. . .. . . . .. .. . .. .. . ..37O.3B9Diseasas of ear .. . .. .. .. . . . .. . . .. . . .. .. . .. . . . .. . . .. . .. .. . . .. . . .. .. .. . . . . .. .. .. . . .. . . .. .. .. . . . . .. .. .. . . . .. . .. .. . . . .. . ..390-398Rheumatic fever .. . .. .. . . .. . . .. . . .. . .. .. . .. .. . .. . . . .. .. .. .. . .. .. . . . .. . . . .. . .. .. .. . .. .. . . . .. . . . .. . . . .. . . . .. . .. .. .. . ..4OO4O2

Diseases of arteries, connective tissue .. .. . .. .. .. . . . .. . .. .. .. . . .. .. .. .. . . .. . . .. .. .. . .. . .. .. .. . . . . .. .. . .. ..45O4%Diseases of veins 460-466.. .. . . . . .. .. .. . . . . .. .. . . . .. . . .. . . . .. . .. . ... . .. .. . . . . .. . . .. . .. .. . .. . . .. . .. .. . . . .. . .. . .. .. .. . .. . . .. . . .Other diseases of circulatory system .. .. . . .. . . .. . . . .. . . .. . .. .. .. . . . . .. .. . ... . .. . .. .. . .. .. . .. .. .. . . . . .. ....467468Diseases of digestive Wstem ... .. .. . . .. . . .. .. . . .. . . .. .. .. .. . . . . .. .. .. .. . .. . .. .. .. . . .. .. .. .. . . .. .. .. .. .. . . .. .. ..53 O.567

Diseases of genito-urinary system .. .. .. .. . .. . . . .. .. .. . .. . .. .. .. .. . . . . .. .. .. .. . . .. .. .. .. .. . . .. .. .. . . . . .. .. ..6 OO+37Infections of skin, subcutaneous tissue .. .. .. .. .. . .. .. . .. .. .. . . .. .. .. .. .. . . . . .. .. .. . . .. .. .. .. .. . . . . .. . . ..69O.698Seborrheic dermatitis .. . .. .. .. . .. . . . .. .. .. . . . .. . .. .. . .. . . . .. .. .. ... . .. .. .. . ... . . .. .. .. . .. .. . .. .. . . .. . . .. .. .. .. . . .. .. .. ..7wEczema .. .. . . .. .. .. .. .. . . .. . . .. .. . .. . .. .. .. .. . . . .. . .. .. .. .. . . .. .. .. . . . .. . .. .. . .. . . . .. . . .. .. . . .. .. .. . .. . . . .. .. . .. . . . .. .. .. . . . . ...7Ol

Contact and other dermatitides .. . . . .. .. . .. .. .. .. . ... .. . . .. . . . .. . . . . ... . .. .. . .. . .. .. . .. .. .. . .. . .. . . .. . .. .. . .. . . . . ..7O3Pemphigus and relatad conditions .. .. .. .. .. .. . . .. .. .. .. . . .. . . .. .. .. . . . . .. .. .. . . . .. . .. .. .. .. . . .. .. .. .. .. . . .. . . .. ..7M

Ewthemas .. .. . . . . .. .. .. .. . . .. .. .. .. . . . . .. .. .. .. .. . . .. .. .. . .. . .. .. .. . . .. . . . . .. . .. . . . .. .. .. . . . . .. .. .. .. .. . . .. .. .. .. . . .. .. .. . . ..7O5

Psoriasis ... . . ..d. .. .. . . . . .. .. .. .. .. . . .. .. .. . . .. . . .. .. ...c. . .. .. .. . . .. . . .. .. . . . .. . .. .. .. .. .. .. .. .. . . .. . . .. .. . . .. . . .. .. . . .. . . .. ...7W

Lichen planus and related conditions ... . . .. .. .. . . . . .. .. .. .. .. .. .. .. .. . ... .. .. .. . . .. . . .. .. .. . . . .. .. .. .. .. .. .. ..7o7Pruritis and related conditions .. . .. . . . . .. .. .. .. .. . . .. .. .. . . . . .. .. .. . . . .. . .. .. . .. . . . .. .. .. . . . .. . .. .. . .. .. . .. .. .. . . . ..7O8

Corns, callosities .. .. .. . ..<. . .. .. ...! . . .. .. .. . . .. . . .. .. . .. . . . .. .. .. .. .. .. .. .. . . .. . . .. .. . .. . . . .. .. .. . . . . .. .. .. . . .. . . .. .. .. . ..7o9Other hypertrophic and atrophic skin conditions ... .. . .. . .. .. .. . ... . . .. .. . . . .. . .. .. . .. . . . .. .. .. . . .. .. .. ..71 ODiseases of nails . . . . .. . . .. . .. . .. .. .. .. . . .. .. .. .. .. . . ... . .. .. . . . .. . .. .. . . . .. . . . .. . .. .. .. . . . . .. .. . .. .. .. . ..<. . .. .. . . .. . . .. .. ..7l2Diseases of hair, hair follicles . .. . . . .. .. .. .. . . .. .. .. .. . . . . .. .. .. . . . .. . .. .. . .. .. . .. .. . .. . . . .. . . .. . . . .. . . . .. . .. .. . .. .. ..7l3

Diseases of sweat, subcutaneous glands ... . . .. .. .. .. . . . .. . .. .. .. .. .. .. .. .. . . . . .. .. .. . . .. . . .. .. .. .. .. .. .. .. .. . ..7l4Chronic ulcers of sKn .. .. .. . . .. . . .. .. .. . . . . .. .. .. .. .. .. .. .. .. . . .. .. .. .. . . . . .. .. .. . . . .. . .. .. .. . .. . .. .. .. . . . . .. .. .. .. . .. ..7l5Other skin diseases ... . . .. . . .. .. .. . .. . .. .. . . .. . . . . .. .. .. .. .. ... . .. .. . . . . .. .. .. . . . .. . . . . .. . . .. . .. .. . .. . . .. . .. . .. . . . .. . . .. ..7l6Diseases of bones, organs of movement .. . . . .. .. .. . .. . .. .. .. . .. . . . .. .. . .. . . . .. .. . .. . . . .. .. .. . .. . .. .. .. ..74O.744Congenital malformations . .. . ... . . .. .. .. .. .. .. .. .. .. . . .. .. .. .. . . . . .. .. .. .. . . .. .. .. .. . .. . .. .. .. . . . . .. .. .. .. . . ..751 .759

Diseases of early infancy ... .. . .. . . . .. .. . . . .. . .. .. .. . .. . .. . . . . . . .. . .. .. .. . . . .. . .. . .. . . .. . .. .. . .. . . . .. .. . .. . . . ..766.7BOSymptoms, senility, and illdefined conditions .. .. .. . . .. .. .. . . .. . . .. .. . . .. . . .. .. . .. . . .. . .. .. . . .. .. ..78l.795

Injuries, adverse effects of chemicals, and other external conditions such as sun-burn .. .. .. . .. . . . .. .. .. .. . . . . .. .. .. .. .. .. .. .. .. .. . . .. .. .. .. .. . . .. .. .. . . . . .. .. .. . . . . .. .. .. . . .. . . .. .. .. . . . . .. .. . .. . . . .. . . ..850.988

lSce reference 8.

Significant skin I Nonsig-pathology n ificant

ActiveRemis-

. sion

skinpathol-

09Y


0.12.5

0.24.5

0.30.1

81.12.40.8

5.90.24.10.70.40.30.2

3:;

5.212.1

0.44.80.3

0.90.10.0

1.2

0.63.6

0.60.10.11.0

7.5

1.02.40.3

16.928.5

6.8

13.60.24.7

8.80.8

13.7

3.221.8

2.715.867.0

0.227.5

0.2

4.1

1.9

3.7

0.70.1

0.10.0

5.9

0.111.0

0.70.10.0

5.6

3.4

0.20.61.10.20.04.80.4

2.50.15.93.30.10.00.3

0.10.2

0.1

0.00.40.0

0.1

0.1

1.10.0

1.4

10.44.1

6.331.9

0.00.7

5.10.1

7.7

0.21.1

0.22.1

19.30.34.10.1

0.40.00.3

1.3

2.s

(21F)(21

F)(2)

0.1

2.00.20.1

5.7

F)F)(2)[2)F)(2)F)0.1

158.6118.9136.0

(=’121.8

(2)(2)F)(2)(2)0.14.7

(2141.5

F’)P)

17.00.4(2,

7.5

88.1181.7

59.61.8

44.188.2

11.240.3

[2)6.6

5.5139.8

12.1

153.7410.9

(2134.7

122.5

F)488.7

(2)12.1

(2)20.7

0.1

Significant skin I Nonsig-path.dogy nificant

Number of persons affectedin thousands

8494

4

878

6223

15,734

463164

1,13636

796145

726136

127,412

1,0102,347

72

93352

18429

1235

116703

1232924

195

1,4641s8462

563,0815,520

1,3252,841

48

915

1,710156

2,663

6224,234

5223,067

16,87832

5,34035

789

378

713

1361321

71,141

242,126

14016

4

1,077

668

47111219

32

92;74

49316

1,141639

205

57

1131

145

692

27

24

2189

26B

2,008BO1

1,608

6,1S42

139

99220

1,500

41211

44

4083,735

63

78814

729

53

260

537

(2}

(21(2)

F)(2)14

3803527

1,112

(2)F’)(2)F’)(2)F)(2)12

30,770

23,07313,704

(2)4,235

PI(2)(2)

F)[2)26

904

[2)8,053

F’)F)

3,298

l?1,449

17,08732,25011,557

358

8,55217,101

2,1767,810

[2)1,285

1,07627,122

2,349

29,81879,708

(2)

6,72923,754

(2)

94,7B7[2)

2,339

F’)4,016

29

‘Conditicm not-specifically identifiable On record,3Hxcludes seborrheic keratosis (2 2X44X) which is listed with benign tumors in the NYU classification.

NOTE: NOS= not othwwise specified.

33

Table 7. Prevalence of skin conditions of concern (complaints), significant skin pathology of concern and not of concern to the affected individual, andnonsignificant skin pathology of concern to the individual among persons 1-74 yeara, by age and sex, showing rates, selected standard errOrs, and number ~f

persons affected: United States, 1971-1974

Age

Total, 1-74 years.. .. .. .

1-5 year. . . . . .. . . . . .. .. . . .. .. . . .. .. . . .. .. . . .

6-11 years . .. . . . . .. .. . . .. .. . . .. . . . . .. .. .. .. .12-17 years . . .. . . . . .. . . . . .. . .. . .. .. . . .. .. . .

18-24 veals .. .. .. .. .. .. . . . . .. . . . . .. . . . . .. . .25-34 years .. .. .. .. . . .. . . . . .. . . . . .. . . .. .. . .

35-44 years . .. .. . . .. .. . . .. .. .. .. .. . . .. .. .. .

45-54 years .. . . .. .. . . . . .. . . .. .. . . .. . .. . .. . .

56-84 years .. . .. . . .. . . . . .. .. . . .. .. . . . . .. . . .65-74 years .. .. . . .. . . . . .. . . . . .. . . . . .. .. .. ..

Total, 1-74 years . . . . .. .

Total, 1-74 years .. .. . . .

6oth sexes

m

118.2

40.446.2

148.1150.0

134.0

130.6

141.0122.6138.6

7.58

97.1

30.840.4

126.8

116.5

107.1

108.9

113.4

97.3126.2

6.23

215.3

111.5

133.8

235.2248.6

210.9

219.3

243.4

284.6283.3

13.82

21.1

9.65.8

21.333.5

26.9

21.7

27.6

25.310.4

1.35

-Male

Skin

IzI

Significant skin Nonsig-

con - patholcgy of: nificant

ditivn skinof

Con.No pathol-

cOn- cOn- Ogv oftern

terntern concern


128.2

33.2

51.3139.2159.0

148.8

146.5

184.51

130.5155.:1

108.0

28.046.0

120,5

124.5

121.8

125.0

152.7

111.8144.1 T

231.8 20.2

107.9 10.2136.4 5.3

243.1 18.7

268.9 34.5

236.6 27.0

210.8 21.5

285.3 31.8

312.5 18.7323.6 11.7


7.94 j 6.69 1 14.36 I 1.25

Skin

cOn-dition

of

cOn-

cern

108.8

47.9

41,0

157.3

141.5

120.5

116.0

100.9

115.4122.2

Female

m:

Significant skin Nonsig-

pathology of: nif icantskin

COn -No pathol-

cOn- Ogv oftern

tern concern

86.9

33.834.6

133.4

109.1

93.6

94.2

77.3

84.4112.6

7.64 I 6.10

199.7

115.0131.3

227.0229.4

187<6

226.9

205.0

221.8252.9

21.9-

14.16.4

23.9

32.4

26.9

21.8

2!3.6

31.09.6

14.02 I ‘1,61

Number of persons (in thousands) with one or more such conditions

22,929 18,841 41,760 4,088 12,072 10,168 21,820 1,904 10,857 8,673 19,940 2,184

34

Table 8. Prevalence rates for skin conditions of ccmcern (complaints), all types and the most freauentlv reDorted tvPes, am.mg persons 1-74 years, by sex and Part of bodyaffected: United States, 1971-1974


Skin conditions of concern, total ... .. .. ... .. .. .. ... .. .. .. ... .. .... ..Skin conditions of concern with site and type specified.,

Diseases of sebaceous glands .... .. .... ... .. ... .... ... .. .... .. ... .... ..7l4l.7l49Acme vulgaris .... .. .. .. .. .. .. .. .. .. .. .. .. ..... ... .. ... . .. ..... ... .. .. .. .. .... .714150Cystic acne ... ... .. .. ... ..... .. .. .. ... .... ... .. .. ..... ... . ... .... ... .. .. .. ... ..7l4l8OAcne scars ..... .. .. .. .... .. .. .. .. .. .. .. ... ... .. .. .. .. .... .. .. .. .. ... .. .. ... .. ..7l4l9oXerosis .. .. .... .... .. .. .. .. .. .. .. .. .. .. ..... ... .. .. .. ..... ... .. .. .. .... . .. .. ... ..7l493O

Tumors2 .. .. .... .... .. .. ... .... ... .. .. ... ... .. .. .. .. .. .. ...... .. ...l9X.22X23X.23YMalignant .. .. ... ... .. .. .. .. ... .... ... .. .. .. .... .... .. .. .. .. .... .... .. .. .. . .... .... . 19X

Basal-xdl epithelioma ... .. .... ... ... ... ... ..... .. .... .. ... .... ... ... ...l9XlBenign2 .. .. .... .. .. .. .... .. .. .. .. .. .. .. .... .. .. .. .. ... ..... .. .. .. .. ... ..... .. .. .. .. ..22x

Lipoma .. .. ..... ... .. .. .... .... .. .. .. .. ..... ... .. .. .. .. ... .... ... .. .. .. ...22X959Precancerous and not specified ..... .. .. .. .... .... .. .. .. .. ... ... ..23 X.23Y

Actinic keratosis .. ... .. ... .. .. .. .. ... ... ... ... .. .. ... .. .... ... .. .. ...23XO8l

Seborrheic dermatitis . ... .. .. .. .. .... .. .. .. ... ... .... .. .. .. .. .. ..... ... .. .. .. .. ... ...7OOSebmrheic dermatitis, type not indicated .. .. ... .. .. .. ... .. .. ..7 OOOlO

Atopic dermatitis, eczema ... .. .. .. .. .. ....701 ,708300,708310,708320Atopicdermatitis . .. ... ..... .. .. .. .. .... .. .. .. .. .. ... ... .... .. .. .... .. .....7 0831 OLichen simplex chrOnicus ..... ... .. .. ... ... .. .... .. .. .. .. ... .... .. ... ..7O832OHand eczema ... ... .... ... .. .. .. .. .. .... .. .. .. .. .. . ..... .. .. .. .. .... .. ... ... ..701 OOONummular eczema .... .. ... ..... .. .. .. ... .. . .... .. .. .. .... ... ... .. .. .. .. ...7ololoDyshidmtic eczema .. .... .... .. .. .. .. ..... ... .. .. .. .. .... .... .. .. .. .. ... ..7OlO3O

Contact dermatitis ... .. .. .. ..... ... .. .. .. .... ... ... .. .. .. ... .... .. ... .. .. .. ... .. .. ....7o3

Ichthyosis, keratosis .... .. .. .. .. .... .. .. .. .. .. ... .... ... .. .. .. ....71 O130.71 Ol5o

Seborrheic keratosis . ... .. .. .... .... .. .. .. .. .... . ... .. .. .. .. .... .... .. .. .. .. ..22X44X

Vitiligo . ... .. ... .. .... ... .. .. .... .. .. .. .. .. .... .. .. .. .. .. .. .. .. ... ... .. .. .. .... ... ....71621 O

Urticaria (hives, etc.) . .... .... .. .. .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. ....242.243

Herpes simplex . . .. .. ... ... .. .. .. .. .. .... .. .. .. .. .. .. ... ..... .. .. .. .. .... .... .. .. ...O96

All other conditions .. .. .. .. .. ... ..... .. .. .. ... .. ..... .. .. .. ... ... .... .. .. .. ... . ..... . .... ..

Type and location not specified .. .. .. .. .. ..... ... .. .. ... . ..... ... .. .. .. .. ..... .. ... ..

8oth sexes

~

118.2113.6

28.223.6

1.70.30.9

21.69.74.52.73.2

8.12.01.72.40.13.73.1

5.45.4

10.84.51,91.10.81,6

6.4

1.3

1.4

1.B

3.8

0.7

1.4

1.4

0.8

20.5

4.6

10.810.8

0.10.1

0.0

1.10.10.2

0.60.0

0.1

0.50.5

0.10.1

3.10.60.11.10.21.0

2.5

0.8

0.5

0.1

1,9

. . .

17.917.9

0.10.10.0

0.1

12.59.33.1

0.40.10.10.20.00.1

0.00.0

1.30.10.2

0.20.5

0.4

0.2

0.0

0.0

3.0

. . .—

Other

64.984.9

28.023.4

1.70.30.8

8.00.31.22.73.2

7.11.91.62.10.13.12.6

5.35.3

6.43.81.6

0.40.1

3.5

1.3

0.4

1.8

3.3

0.7

1.3

1.4

0.8

15.6

. . .—

Male

Total Hand Foot Other


128.2[27.7

29.023.1

3.1

o.B

35.917.8

5.73.56.3

8.32.32.11.50.24.53,8

4,84.8

11.75.12.11.00.82.1

6.9

1.3

0.9

2.7

3.8

0.4

0.7

0.6

0.6

20.1

0.5—

12.612.6

1.80.20.3

0.5

0.50.5

0.20.2

3.40.8

1.00.31.0

2.7

0.3

0.7

0.1

2,9

. . .—

27.627.6

0.0

0.0

0.0

21.317.1

3.8

0.20.20.2

0.10.1

1.90.10.4

0.31.1

0.6

0.1

0.1

3.3

. . .—

87.587.5

29.023.1

3.1

0.8

12.B0.51.63.56.3

7.62.11.91.50.24.03.3

4.64.5

6.44.21.7

0.2

3.6

1.3

0.5

2.7

3.1

0.4

0.5

0.6

0.6

13.9

. . .

Female

Total IIHand Fcmt I Other

108.8100.3

27.524.1

0.30.70.9

8.22.03.22.00.2

8.11,81.33.40,02.92.4

5.95.9

10.03.81.81.20.81.2

5.9

1.3

1.8

0.9

3.8

1.1

2.0

2.2

0.9

20.7

8.5

9.09.0

0.20.2

0.0

0.40.00.2

0.80.1

0.3

0.40.4

3.00.30.11.2

1.0

2,3

1.3

0.2

0.0

0.8

. .

8.88.8

0.20.1

0.1

4.42.02.3

0.5

0.40.00.1

0.60.10.0

0.0

0.2

0.2

0.1

0.0

2.6

. . .

82.582.5

27.123.8

0.30.70.8

3.40.00.72.00.2

6.81.71.32.70.02.42.0

5.95.9

6.43.41,7

0,80,2

3,4

1.3

0,3

0.9

3.5

1.1

2,0

2.2

0.9

17,3

. . .

lSec reference 8.‘Excludes seborrheic kcrstmis (22 X44 X) which is listed with benign tumors inthe NYU classification.

35

Table9, Prevalence rates far skin conditions of concern (complaints), all types and themmtfrequently repoited tvpes, among persons l-74 year$, byageandpart of bodyaffected: United States, 1971-1974

Condition and NY Ucodel1.5 years

40,434,8

1.7

0.8

0.8

2.5

2.5

2.72.7

10,98.3

0.7

3.9

0.1

0.6

1.2

0.9

9.5

. . .0.5

0.1

0.4

. . .1.1

0,5

0.5

0,50.2

0.1

. . .33.2

1,7

0.8

0.8

2,0

2.0

2.72.7

10.38.1

0.7

3.9

0.1

0.6

1.2

0.8

9.0

6-11 years I 12.17 years

TotalII

Hand Foot Other Total Hand Foot Other


46.242.6

2.20.8

1.3

3.12.1

0.2

1.9

1.2

0.7

0.60.6

14.510.0

1.31.9

3.7

2.7

6.8

0.3

0,6

0.5

5.7

. . .6.2

1.7

1.0

0.6

3.9

. . .5.7

1.71.7

2.30.3

1.30.2

0.9

0.8

. . .30.7

2.20.8

1.3

1.40,4

0.2

1.8

1.2

0.7

0.60.6

10.59.7

0.7

3.1

2.7

2.0

0,3

0.8

0.5

4.8

148.1141.6

86.479.3

1.20.90.1

9.02.4

3.22.8

4.4

4.4

2.02.0

8.45.s1.7

0.6

5.5

3.4

3.1

O.g

2.2

0.2

1.9

1.9

12.7

. . .8.3

0.70.7

0.7

0.8

0.8

1.91.5

1.4

1.3

1.5

. . .6.5

2.42.4

0.8

0.8

0.4

0.4

0.7

0.6

1.6

. . .126.8

85.778.6

1.20.90.1

5.9

3,22.8

2.8

2.8

2.02.0

6.14.31.3

0.6

3.4

3.4

1.2

0.5

2.2

0.2

1.9

1.9

9.6

36

Table9. Prevalence rates forskinc onditionsof concern (complaintsl, all types and themost frequently reported Wpes, among penon$l-74 years, byweatipa~ofbody

affected: United States, 1971-1974-Con.

Condition and NYU ~Odel

Skin conditions of concern, total . .. ..... .. .. ... .. .. ... .. .. .. .. ..... .Skin conditions of concern with site and type specified.,

Diseases of ssbaceous glands ... .. .... .... .. .... .. ... .. .. .. ... .. .. ... ..7l4l .7I49

Acne vulgaris .. ... .... ... .. .. .. .. .. ... ... .. ... .. .. .. ... .. .... ... .. ... .. .. .....7l4l5aCY$tic aCnC.. .. .... .. .. .. ... .. ... .. .. .. ... .. ... .. .. .. .. ... .. .. ... .. .. .. .. ... ...7l4l8OAcne scars .... .. .. ... ..... .. .. .. .... .. .... ..! . .. .. .. ... .. ... .. .. .. ... .... .. ....7l4l9oXerOsis . ..... ... .. .. ... ..... .. .. .. ... ... ... ... .. .. .... . .. .. .. ... .... .. ..... .. ....7l493o

Dermatophytoses ... .. ... .. .. ... ..... .. .. .. .. .... ... ... .. .. .. .. ... ... . ... .. .. ... . .... ..l3l_finea pedis .. ... .... ... .. .. ... .. .. .. ..... .. ... .. .. ... .. .. ..... .. .. .. .. ... .... .. ... .1310

Tines un9uium .... . ... .. ... .. ..... .. .. .. .. ... ..... .. .. .. .. .. .... ... ... .. .. .. ....l3l2Tineaversicolor .... ... .. .. .. .... .... .. .. .. .. ..... ... .. .. .. .. .... .. .... .. .. ..13191 OTinBacruris . . .. ... ..... .. .. .. .. .... .... .. .. .. .. .... .... .. .. .. .. .. . .... .. ... .. .. 13131

Tumors2 .... .... ... .. .. ... .. .. .. ... .. .. ... .... ... .. .. .. .... .... . ...lgx.22x23x.23yMalignant .. .. .. .. .. .. .. ... ... .. .. .. .. .. .... .. .. .. ... .... .. ... .. .. .. .. ..... ... .. .. ...lgx

Ba~al-cell epithBlioma .... .. .. .. ... .. ..... .. .. .. .. ... ..... .. .. .. .. ... ...l9xlBenignZ ... .. .. .. .. .. .. .....!...... .. .. ..... ... .. .. .. .. .... .... .. .. .. .. .... . ..... .. .. . 22x

Lipoma ..... .... .. .. .. .. .... .. .. .. .. .. .. ... ..... .. .. .. .. ... ... .. .... .. .. ..22X959precancerous and not specified .. . ... .. .. .. .. .. .. .. .. .. .. .. .. .. ... 23x,23y

Actinic keratosis . .... ... ... .... .. .. .. ... .... ... .. .. .. .. ... .. . .... .. ..23XOSl

Seborrheic dermatitis .... ..... .. ... .. .. ... .... .. ... .. .. ... .. ... . ... .. .. .. .. ... ... .. ..7ooSeborrheic dermatitis, type not indicated .. ... ..... . ... .. .. ....700010

Atopic dermatitis, eczema .. ..... . .... .. ...701 ,70 B300,70B310,708320Atopic dermatitis . .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .... .. .. .. .. .. .. .. ...7O83l oLichen simplex chronicus ... ... .. .. ... .. .... ... .. .. .. .. .. ... .. ... .. .. ..7W32OHand eczema .... .... ... .. .. .. .....<.... .. .. .. ... ... .... .. .. .. .. ... ... .... .. ..7oloooNummular eczema .. .... .... .. .. .. ... ... .... .. .. .. .. .. ..... ... .. .. .. .. .. ...7ololoDyshidrotic eczema ... ..... . ... .. .. ... .. .. .. .. ... .... ... .. .... ... .. .. ..!..7olo3o

Contact dermatitis ... .. .. .. ... .. .. .. ... .. .. ... .. .... ... .. .. ... .. .. .. ... .. .... ... .. .. ..7o3

Ichthyosis, keratosis .. .. .. ... .. .. ... . ..... .. ... . ... .. ... .. .. .. ....7 10130,710150

Verruca vulgaris .. .. .... ... .. .... .. ... .. .. ... .. .... ... .. .. .. ... ... .... .. .. .. .. ....696o3o

Folliculitis .. .. .. ... .. .... ... .... ... .. .... ... .. .. ... . ... .. ... .. ... ... ... .. ..... .. ....713906

p$Oriasis.. .. ..... .. .... ... .. .... .. ..... .. ... .... .. .. ... .. .. ... .. .... ... .. .. .. .... . ....7O6WO

S&borrhoic keratOsis .. ... .. ... .. .. ... .. .. .. ... .. .. ... ... .. .. .. .. .. .. .. .. ... ...22Xwx

~tili90 .. ... .. .. .. ... .. ..... .. .. .. ... . ..... . .... .. .... ... .. ..... .. .. .. .. .... ... ... .. ..7l62lO

Urticaria (hives, etc.) .... .. .. .. .. ... ... ... ... .. .. .. .. ..... . .. .. .. .. .. .. .... ...242.243

Herpes simplex ... .. .. ... .... .. ... .. .. .. ... ... .... .. .... .. ... .... .. ... .. .. .. ..... .. ... ..W6

All other skin conditions .... .. .. .. ... .. .. ... .. .... ... .. .. .. .. ... .. .... ... .. .. .. .. ... .. ..

See footnotes at end of table.

18.24 years

Total II Hand Foot

150J141.1

71.,64.(

4.[0.!0;

15.(3.(2.:33

5.’

4:

3.,

0.[(7.,

2.(2.[

7.74.f0.1

o?Z:i

8.7

0.6

1.C

4.G

3.1

0.6

1.1

1.6

1.6

16.1

. . .9.1

0.3

0.1

0.1

2.31.10.1

1.2

4.6

1.0

0.8

. .132

5.[3.5z<..

0.4

0.4

1.70.1

1.6

0.8

4.5

I 2534 wars I 35-44 vearsI I ---

Other Total Hand Foot Other Total IIHand Foot Other

. .118;

71.4

84.(4.[rJ,$

0;

9.!0.1O.d3.$

5.1

3.i

37..

0.40.4

2.EZve

3.73.40.0

0.3

3.3

0.6

4.6

3.1

0.9

1.1

1.6

1,6

10.8


134.(131.’

35.428.!

4.!OJ

0:

27;13.!

4.!4.(5.1

1.5

1.!

9J9.$

16.45.32.04.C0.42.7

6.7

0.5

0.2

2.0

3.9

0.7

1.6

0.3

0.4

23.9

.-165

0.1

0.1

0.1

7.51.20,34.0

1.4

3.6

0.1

1.8

3.0

. .22.:

0.10.1

14.s13.8

1.1

0.20.2

2.40.40.4

1.3

0.7

3.9

. .92.;

35.228.t

4.50.$

0:

12.70.13.44.C5.1

1.4

1.4

9.79.7

6.53.71.3

0.4

2.4

0.5

0.1

2.0

2.1

0.7

1.6

0.3

0.4

17.0

130.[130.!

17.(12;

2:0.10.!

39.Z20,i

?:5.5

3.EO.i0.21.E

1.E0.2

5.s5.9

9.20.62.71.20.43.4

10.3

0.8

0.4

5.2

1.8

1.0

1.2

1.7

32.4

. .15.3

5.0

1.6

3.9

1.20.42.0

3.3

0.4

2.7

. .31;

0>0.,0.

23.’18.i

3.!

1.4

1.4

O.e

5.6

. . .84.3

17.112.32.60.10.5

11.71,9

3,65.5

3.60.20.21.8

1.60.2

5.95.9

3.90.62.7

6.2

0.8

.-

5.2

1.8

1.0

1.2

1.7

24.2

37

Table 9. Prevalence rwes for skin conditiomof concern (complaints), all types and themOst frequently reported types, amOngpepOns l.74years, byageandpart0fb0dy

affected: United States, 1971.1974–cOn,

COnditio” and NYIJcOdel

Total

141.C137,2

2.90.7

2.2

49.625.612,8

3.92.9

14.67.57.52.4

4.74.7

12,312.3

9.01.33.01.70,72.2

4.4

0.8

10.4

0.9

2.9

2.8

26.6—

45-54 vears

iand

. .13.6

2.30.9

1,1

1.11.1

0.90.9

3.8

1.7

2.1

2.3

0.9

2,3

. . .39,4

37.524.712.1

0.3

0.2

0.1

1.6


)ther Total Hand Foot Other TotalII

Hand Foot Other

. . .84.2

2.90.7

2.2

9.8

0.73.92.9

13.57,57.52.4

3.63,6

11,411.4

4.91.32,8

0.7

2.1

0.8

9.5

0.9

2.9

2,8

22.7


122.6114.4

5.40.2

1.2

22,95.88.24.14.3

19,65.23.91.40,2

13.011.5

4.44.4

8,91,84.41.61.1

8,3

1.6

1,5

7.2

1.2

2,7

2.5

43.9

. . .15.1

0.5

0,2

1.5

1.51.5

3.60.8

1.61.1

4.2

1.2

0.2

-1

3.9

. .18.1

0,4

0.4

10.15.84.2

1,11.11.1

0.7

0.7

5,8

. .81.2

5.00.2

0,8

12.3

3.84.14.3

17.04.12.61,40.2

11.510.0

4.44.4

4.71.03.7

4.1

1.6

1.5

6.0

1.2

2.5

2.5

18.4

136.6134.5

2.70,2

1.8

21.811,0

8,00.40.8

34.68,56.73.71.2

22,420.4

7.67.6

10.51.24.81.02.50.2

5.8

1.5

4,9

4,7

3.3

1.4

35.7

. . .9.7

0.2

0.2

0.3

0,1

3.20.6

0.1

2.52.5

1.3.,

1.0

0.2

1.7

0.6

I

2.4

. . .22.1

0.3

0.3

16.311.0

5.3

0,5

0.60,1

0.5

0.6

0,6

3.3

. . .102.7

2,20.2

1.3

5,2

2.60.40.8

30,97.96.13.11,1

79.917.9

7.67.6

8.71,24.9

2.5

4,1

1,5

4.3

4.7

2.1

1,4

30.0

lSee reference 8,‘Excludes seborrheic dermatosis (22X44X) which is listed with benign tumorsin the NYU classification,

38

Table 10. Prevalence rates forskin conditions of concern (complaints), all types and the most frequently repofled Wpes, among males l-74years, byageandpartof bodyaffected: United States, 1971-1974


Skin conditions of concern, total .. .. .. ... ... .. .. .. .. ... .. ..... .. .. ..Skin conditions of concern with site and type specified..

Diseases of sebaceous glands ... .. .. ... ... .. .. ... ..... .. .. .. .. .... .....7l4l.7l49

Acne vulgaris ... .... ... .. .. .... .... . ... .. .. ... .. ... .. .. .. ... .. .. ... ..... .. ....7l4l5oCystic acne .. .. .. .. .. .. .. . ..... .. .. .. .. .. .. .. .. .. ... ... .. .. .. .. .. .... .... .. .. ..7l4l8OAcne scars . .. .. .... .. .. ...... .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. ... ..... .. .. ..7l4l9OXerosis .. .. ... .. .. .... .... .. .. .. ... ... . ... .. .. ... .. .. ... .. .. .. ... .... ... .... ... ..714930

Dermatophytoses .... .. .. .. .... .... .. .. .. .. ... .. ... .. .. .. ... ..... .. .. .. ... .. ... .. .. .. ..l3lTineapedis ... .. .. .... .... .. .. .. .... .. .. .. .. .. .. .. .... .. .. .. .. ..... ... .. .. .. ... ....131 OTineaunguium .. . .. ... .. .. .. .... . ... .. .. .. .. ... ..... .. .. .. .. ..... .. ... .... ... ..1312Tinea versicolor ... .. .. .. .... .... .. .. .. ... .... ... .. .. ... .... ... .. .. .. .... ....?3191 OTineacr.ris . .. .. .. .. .. .. .. .... .... .. .. .. .. .. .... .. .. .. .. .. .. .... .... .. .... .... ..l3l3l

Tumorsz ... .... .. .. ... ..... .. .. .. .... .. .. .. .. .. .... .. .... .. .. .. .. ..l9X.22X23X.23Y

Malignant .. .. .. ..... ... .. .. ..... ... .. .. .. .. .... .... .. .. .. .. .... .... .. .. .. .. ... ..... . 19X8asal-cell eptthelioma ... .. .. .. .. ... .. .. ... .. .. .. ... .... ... .... .. ... ....l9Xl

Benign2 ... .. .. .. .. .... .. .. .. .... .... .. .. .. .. .... .... .. .. .. .. .. .. .... .. .. .. .. .... .....22xLipoma .. .. ...... .. .. .. .... .... .. .. .. .. .... .... .. .. .. .. ... ..... .. .. .. .. ...22X959

Precancerous and not specified ... .. .. .. .. .... .... .. .. .. ... .... ... 23x,23YActinic keratosi$ .. .. .... .... .. .. .. ... ... .... .. .. .. .. .. ...... .. .. .. ...23XO8l

Seborrheic dematitis ...... .... ... .... ... .. .. .. .... ... ... .. .. .. .... ... ... .. .... .. ....7ooSeborrheic dermatitis, type not indicated ...... ... .. .. .. ... ....7ooolo

Atopic dermatitis, eczema .. .... .. ... .. ....701 ,708300,708310,708320Atopic dermatitis ... .. .. .... .... .. .. .. ... ..... .. .. .. .. .... .... .. .. .. .. .....7O83lOLichen simplex chronicus .. ... .. .. .. ... ..... .. .. .. ... .. ..... .. .. .. .. ...7o832oHand eczema .. .... ... ... ..... .. .. .. ... .. .. ... .... ... .. .. .. ... .... .. ..... ... ..7OlOOONummulnr eczema ..... .... .. .. .. .... .... .. .. .. .. .... .... .. .. .. .. .... .. ....7OlOlODyshidrotic eczema .. . ... .. ... .. .. .... ... ... .... ... .. ..... . ... .. ... .. .. ...701 O3O

Contcct dermatitis. . .. .. .. .. .. .. .. .. .. .... .. .... .. .. .. .. .... .... .. .. .. .. .. .. .... .. .. ..703

lchthyosis, keratosis ... .... ... .... ... .. .. .. ... .... ... .... .. .... ...7lol3o.7lol5o

Verruca vulgaris .. .. ..... ... .. .. .. .. .. .. .. .. .. .. .... .... .. .. .. ... .. ..... .. .. .. ....696o3o

Folliculitis . .. .. .... .... .. .. .. .. .... .. .. .. .. .... .... .. .. .. .. .... .... .. .. .. .. .. .. .... .713908

PsOriasls.... ... .. .. ... ..... .. .... .... ... ... .... .. ..... .. ... ..... .. .. .. ... .... ... .. .. ..706090

‘Seborrheic keratosis . ..... .. .. .. .... ... ... .. .. .. .... ... ... .. .. .. .... ... .. ... .. 22X44X

Vitiligo. .. .. .. .. .... .... .. .. .. .. .. .... .. .. .. ... .. ... .. .... .. ..... ... .. .. ... .... ... .. ..7l62lO

Urticarta [hives, etc.) .. .. ... ... . ... .. .. ... .. ... .. .. .. .. ... ... .. ... ... .... .. ...242.243

Herp% simplex .. .. .... .... .. .. .. .. .. .. .... .. .. ... .. .... ... .. .. .. .... .... .. .. .. .. .... ...o96

At” other skin conditions .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. ..

See footnotes at end of table.

Male

Total

33.228.9

0.2

0.2

0.2

1.3

1.3

0.60.5

6.15.0

4.8

0.2

1.3

1.7

1.0

11.6

1-5 years I 6-11 wars I 12-17 years

Wmd I Foot I other

. . .0.7

0.7

. . .0.1

0.1

. . .28.1

0.2

0.2

0.2

1.3

1.3

0.50.5

6.15.0

4.8

0.2

1.3

1.7

1.0

10.8

1

Total Hand Foot Other Total Hand


61.348.0

1.9

1.9

4.14.1

1.9

0.4

1.5

1.21.2

22.315.8

2.62.3

4.2

3.2

3.8

0.7

1.2

1.1

2.4

. . .6.1

3.4

2.0

1.2

1.5

. . .7.3

3.33.3

2.9

2.60.3

1.1

. . .34.6

1.9

1.9

0.80.8

1.9

0.4

1.5

1.21.2

16.015.8

3.0

3.2

1.2

0.7

1.2

1.1

2.4

139.2139.0

83.374.1

2.1

0.2

14.74,6

3.25.5

2.72.7

10.69.60.8

5.6

2.3

2.4

1.0

0.3

3.4

12.7

. . .9.1

1.4

3,03.0

2.7

2.0

E. . .9.8

4.64,6

0.8

0.8

1.4

3.0

. . .120.1

83.374.1

2.1

0.2

8.7

3.25.5

2.72.7

6.86.8

1.5

2.3

2.4

1.0

0.3

3.4

7.7

39

Table 10. Prevalence rates for skin conditions of concern (complaints], all types and the most frequently reported types, among males l-74years, byageandpart of bodyaffected: United States, 1971.1974—Con.

Condition and NYU cede]

Skin conditions of concern, total..., .... .. .. .. ..... ... .. .. .... .... ..5kin conditions of concern with site and type specified..

Diseases of sebaceous glands .... .. .. .. ..... .. ... ..... .. .. ... .... ... ...7l4l.7l49Aone vulgaris .. ...... .. .. .. .... .... .. .. .... .. .. .. .. .. ..... ... .. ... .. ..... .. ...7l4l5OCystic 8cne ...... .. .. ... ... .... .. .. ... ... .. .. .. .. .. .. .. .. .. ... .. .. ... .. .. .. ....7l4lSOAcne scars ... .. .... ... ... .... ... .... ... .. ... .... ... .. ..... .. ... .. .. ... .. .. .. ...7l4l9OXerOsis . .. ..... ... .. .. .... ... ... .. .... .... .. ..... .. .... ..... .. ... .. ... .. ... .. ....7l493O

Dermatophvtoses ... .. .... .. .. ... ..... .. .. .. ..... ... .. .. ... ..... .. .. .. .. ... ... .. .. ... ..l3lTines pfidis . ... .. .. .. .... .... .. .. ... .... ... .. .. ..... .. ... ..... ..! . ... .... .. ... .. ...l3loTines unguium ... .. .. .. .... .. .. .. .. .... .... .. .. .. ...... .. .. .. .... .... .. .. .. .....l3l2Tineaversicolor .. ... .. .. .. ... .... ... .. .. ..... ... .. .. ... .... ... .. .. ... .... ...13191 OTines cruris ... .. .. .... .. .. .... .... .. .. .. ...... .. .. .. .... .... .. .. ... .... ... .. .. ..l3l3l

Tumors2 .. .. .. .... .. .. .. .... .. .. .. .. .. .... .. .. .. ... ... .... .. .. ... ..l9X.22X.23X.23YMalignant ... ... .. .. .. .... .... .. .. .. ...... .. .. .. ..... .. ... ...... .... .. .. .. ... .... ....91 X

Basal<ell epithelioma..,...,,., . .. ... .... ... .. ... .. ..... .. .. ... ..... ...l9Xl13enignz .. .. .. ... ..... .. .. .. .... .. .. .. .... .... .. .. ... .. ..... .. .. ...... .. .. .. .. ..... ...22x

Lipoma ... .. .. .. .. .. .... .. .. .... . ... .. .. .. .... .... .. .. .. .... .... .. .. .... ..22X959Precancerous and not specified.,..,., .... .. .. .. .... . ... .. .. .... .. 23 X,23Y

Actinic keratosis ..... .. ... .. ... .. ..... ... .. .. .. ... .... ..... ... .... ...23XOSl

Seborrheic dermatitis ... ..... .. .. .... .... .. .. ... .... ... .. .. .... .... .. .. ... ..... .. .. ..7OOSeborrht?ic dermatitis, type not indicated ...... .. .. .. ... ..... ..7OOOlO

Atopic dermatitis, eczema ... .... .. .. .. ....701 ,708300,7083 10,70S320Atopic dermatitis ..... .. .. .. .. .... .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. ..... ....70831 OLichen simplex chronicu$ .. .. ...... .. .. .... .... .. .. ... .. ..... .. ... .. ...7O832OHand eczema.. . .. .. ... .. .. .. .... .. .. .. ... ..... .. .. .. .. ... ... .. .. ...... .. .. ...7oloooNummular eczema ..... .. .. ... ... .... .. ... .. ..... .. .. ..... ... .. .. .. .... ....701 OlODyshidrotic eczema ...... .. .. .. .... .... .. .. ... ..... .. .... ...... .. .. ... ....701 O3O

Contact dematiris . .... .... .. .. .. ...... .. .. .. .... .... .. .. .. ..... ... .. .. .. .. .... .. .. ...7O3

Ichthyosis, keratosis .. .. .. .. .... .. .. .. .. .. ...... .. .. .. .. .. .. .. .. ..71 O130.71 Ol5O

Verruca vulgaris .. .. ... ..... .. .. .. ..... ... .. .. ... ..... .. .. ... ..... .. .. .. .... .... ..696O3O

Folllculitis .... .. .. ... .... ..... .. ..... ... .... ... ..... .. .. ... .... ... .. ... .. .. .. ... .. ..7l39O8

Psoriasis.... .. .. .. .... .. .. .. .... .... .. .. .. ... ..... .. .. ... ..... .. .. ... .. ..... .. .. ... ...7 O6O9O

Seborrheic keratosis . .. .. .. ...... .. .. .. ...... .. .. .. ... ..... .. .. .. .... .... .....22X44X

Vitiligo .. .. .. ... .... ... .. .. ... .. .. ... .. ... ... .... .. .. ..... .. ... .. .. .. . ... .. .. .. ... ....7l62lO

Urticaria (hives, etc. ) .... .. .. .. .. .. .. . ..... .. .. .. .... .... .. .. .... .. .. .. .. .. ...242.243

Hwpc+$ simplex .... .... .. .. ... ... .. .. .. .. ... ..... .. .. .. ..... ... .. .. ..... ... .. .. ... ......O96

All other skin conditions .. ..... .. ..... ... .... ..... .. ... .. ... .. ... .. .. ... .... ... .. .. ... ..

See footnotes at end of table

Male

18-24 years

EnIz159.0151.3

76.667.6

8.S

25.57.23.44.2

10.6

2.1

2.1

1.11.1

743,0

4.5

13.1

1.0

6.2

2.4

1.9

0.4

13.6

. . .13.0

2.71.5

1.3

7.6

1.0

1.7

:Oot

. . .21,7

10.77.23.4

3.2

3,2

1.6

6.2

25.34 years 35.44 years

Other Total Hand Foot Other Total Hand I Foot


. . .116.6

76.667.6

S.8

14.s

4.210.6

2.1

2.1

1.11.1

1.51.5

3.9

6.2

2.4

1.9

0.4

5.7

148.8151.4

36,o25.1

9,1

49,423.4

S.96.4

10.7

1,2

1.2

S.38.3

16.45,52.83.1

2.8

4,8

0.8

4,2

7.3

0.8

22.2

. . .16.4

4.81.7

3.1

3.5

3.7

4.4

. . .3s.1

25.723.4

2.3

0.50.5

4.50.90.8

2,8

7.4

. . .96.9

38.025.1

9.1

23.7

6.66.4

10.7

1.2

1.2

7.87.8

7.12.92.0

1.3

0,s

4.2

3,6

0.8

10.4

146.556.5

17.411.0

4.7

70.940.8

4.24.8

11,1

3.1

3.10.5

3.33.3

8,1

0.60.86.6

6,0

1.7

9.5

1.8

I),g

33.s

. . .16,8

S.7

2.1

5.2

0.60.83.7

2.9

. . .49.5

0.3

0.3

40.636,9

2.1

2.9

2.9

1.6

4.1

)ther

. . .90.2

17.111.04.4

21,63,9

4.811.1

3,1

3.10.5

3.33.3

4.4

1.7

9.5

1,8

0,9

26.8

40

Table 10. Prevalence rates forskin conditions of concern (complaints), all Wpesand themost frequently repotied tvPes, among males l-74years, byageandpan of bodyaffected: United States, 1971-1974-Con.


Skin conditions of concern, total . .. ..... ... .. .. .. .. .... .. .... .. .. .. .Skin conditions of concern with site and type specified..

Diseases of sebaceous glands ... .. ... .. .. ... .. .. ... .. .. .. ... .... ... ....7l4l.7l49Acne vulgaris .. .... .... .. .. .. .... .. .. .. .. .. .. .... .... .. .. .. ... ... .. .. .. .. ...t.7l4l5OCystic acne ... .. ..... ... .. .. ... .. .... .. ... .. .. ..... .. ... .. .. ... .. .. .. ... .. .. ...714180Acne scars ..... .. .. .. .... .. .. .. .. .. .. .... .. .... .. .. .. .... .... .. .. .. .. .... .. .. ..7l4l9OXerosis ... .. .... .... .... .. .. ... .. .... ... .. .. .. ... .... .. ... .. .. ... .... ... .. .. .. ...7l493O

Dermatophvtoses ... .... .. .. .. ... ..... .. .. .. .. ... .. ..... .. .. .. ... .... .. ... .. .. .. ... ....l3lTines pedis . .. .. ... .. ... .. .. ... .... .. ... .. .. .. ... .... ... .. .. .. ... .... ... .. .. .. .. ... 1310Tinea unguium .. .. .. .... .... .. .. .. .. ... ..... .. .. .. ... .. ..... . ... .. ... .. ... ... ..1312Tines versicolor . .. ... ..... .. .. .. .. ... ... .... .. .. .. .. ... ..... . ... .. .. ... .. ... 131910Tines cruris ..... .. .. .. .... .. .. .. .. .. .. ... ..... .. .. .. .. .. .. .... .. .. .. .. ... .... .. .13131

Tumom2 ... .. .. .. ... ... .. .. .. ... ..... .. .. .. .. .... ... ... .. .. .. ... ...l9X.22X23X.23YMalignant ... .... ... .. .. ... .... ... .. .. .. ... .... .. ... .. .. ... .. .. .. ... .... .. ... .. .. ....l9x

Basal.cell epithelioma .... .... .. .. .. .. ... .. ... .. .. .. .. ... ..... . ... .. .. .. 19X1Benignz .... .. ... .. .. .. .. ... .... ... .. .. ... .. .... ... .. .. .. ... .... .. ... .. .... ... .. .... .. 22x

Lipoma ... .. ... ... .... .. .. .. .. ...... .. .. .. .. .. ... .... ... .. .. ... .. .... .. ... 22X959Precancerous and not specif ied .... .. .. .. .. .. .. .... .. .... .. .. .. .. . 23 X,23y

Actinic keratosis ... .... ... .. .. ... ... ... .. .. ... .. .. .... ... ... .. .. .. ... 23X081

Seborrheic dermatitis ..... .. .. .. ... .. ..... .. .. .. .. ... ... ... ... .. .. .. ... ... .... .. .. ...7OOSeborrheic dermatitis, type not indiciated .. .. .. .. .. .. .... .....7OOOl O

Atopic dwrnatitis, aczema .. .... .. .... .. ...701 ,70B300,70831 0,708320Atopic dermatitis . ... ..... .. .... ... .. .. ... .. .. .. .. .... ... .. ... .... ..... .. ..7 0831 OLichan simplex chronicus ... ... .. .... .. ... .. .. ... .. .. .. .... . .. ... .. .. ..7O832OHand eczema .. .. .. .. .... .... .. .... .. .... .... .. ..<.<. ... .... ... .. .. .. ... .. ....7oloooNummular eczema ... .. .. .. .... .... .. .. .. ... .... ... .. .. .. .. .. .. .. .... .. .. ..701 OlODyshidrotic eczema ..... .. ... .. .. ... .... .. ... .. . .... .. .. .. ... .. .. .. ... ....7olo3o

Contact dermatitis ... .. .. .. .... .. .. .. .. .. ... .... .. ... .. .. ... ... .... .. .. .. .. .... .. .....7O3

Ichthyosis, keratosis .. .. .. .. ... ..... .. .. .. .. ... ..... .. .. .. .. .... ..71 Ol3o.7lol5o

Verruca vulgaris .. .. .. ... .... ... .. .. .. .. ... .. .. ... .. .. .. ... .. .. ... .. .. .. ... ... ....696O3O

Folliculitis .. .. ... .... ... .. .. ... .. .. .. ... .... ... .. .. .. ... .... ... .. .. .. ... .... ... .. .. .713908

Psoriasis .. ... .. .. .. .. ...... .. .. .. .. .. .... ... ... .. .. .. .. .... . ... .. .. .. .. ..... ... .. .. ...7WfflO

Seborrheic keratosis . ... .. .. ... .. .. ... .. .. .. ... .. .. ... .. .. .. ... ..... .. .. .... .. 22X44X

VitiligO ... .. .. .... .... .. .. .. .. ... ..... .. .. .. ... .. ..... . ... .. .. ... ..... . ... .. .. .. .... ..7l62lO

Urticaria [hives, etc.) .. .... .... .. .. .. ... . .. .. .. .. .. .. .. .. ... .... ... .. .. .. .....242.243

Herpes simplex ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .... .. .. .. .. ... ..... .. .... .. ... ..... ..W6

All other skin conditions ... ... .. .. .. ... .... .. ... .. .. ... . ..... ... .. .... .. .... .... .. .. .. ..

45-54 years

Total Hand Foot Other

184.5185.8

3.41.5

1.9

86.448.416.7

6.15.2

22.99.99.85.0

8.08.0

16.516.5

9.21.32.62.71.2

6.9

0.4

6.8

2.7

28.6—

. . .19.5

4.41.6

2.4

2.42.4

1.91.8

4.0

2.7

2.7

4.1

. . .66.0

66.047.816.7

. . .100.3

3.41.5

1.9

16.0

6.15.2

20.59.99.95.0

5.65.6

14.614.6

5.21.32.6

1.2

4.2

0.4

8.8

2.7

24.5

Male


Total Hand Foot Other Total Hand Foot


130.5128.1

7.30.3

1.8

36.010.512.8

3.48.7

20.65.35.30.80.4

14.514.5

2,72.7

11.0

6.32.32.4

10.3

1.1

7.6

0.4

31.1

. . .21.7

0.6

0.4

0.40.4

4.7

2.32.4

5.0

2.6

8.4

. . .28.5

18.510.5

8.0

2.42.42.4

1.5

1.5

6.1

. . .77.9

7.30.3

1.8

16.9

4.83.48.7

17.82.92.90.80.4

14.114.1

2.72.7

4.8

4.8

5.3

1.1

6.0

0.4

16.6

155.B152.3

2.70.5

1.3

28.817.5

6.80.91.8

42.410.2

7.54.72.2

27.525.1

6.96.8

11.50.7

10.6

6.4

1.6

6.2

2.5

5.5

1.3

36.5

. . .6.4

0.7

0.2

2.9

2.92.9

0.2

1.3

1.3

. . .22.4

0.2

0.2

19.717.5

2.2

1.1

1.4

Other

. . .123.5

2.50.5

1.1

8.4

4.40.91.8

39.510.2

7.54.72.2

24.622.2

6.86.9

11.30.7

10.6

6.4

1.6

6.2

2.5

.3.1

1.3

33.8

lSee r~ference 8.2Excludes seborrheic keratosis (22 X44 X) which is listed with benign tumors inthe NYUcla.ssification.

41

Table 11. Prevalence rates for skin conditions of concern (complaints), alltypes andthemost frequently reporfed wpes, among females l-74years, byageandpartofbodyaffected: United States, 1971-1974

Female

1-5 yews I 6.11 years I 12-17 vear5

Total II Hand

47.941.0

3.4

1.4

1.3

3.9

3.9

5.15.1

15.711.6

1,4

3.0

0.7

1.0

6.9

. . .0.2

0.2

,Fmx Other Total Hand Foot Other Total Hand Foot Other


. . .2.2

1.1

1.1

1.10.4

. . .38.6

3,4

1.4

1.3

2.8

2.8

5.15.1

14,411.2

1.4

3.0

0.7

1.0

6.9

41.037.2

2.61.6

0.7

1,9

0.3

1.9

1,9

6.64.2

1.3

2.4

2.1

9.7

10.4

6.3

6.3

. . .4.1

1.80.7

0.7

1.6

. . .26.8

2.61.6

0.7

1.9

0.3

1.9

1.9

4.83.5

1,3

2.4

2.1

2.7

8.4

157.3144.4

89.684.7

0.21.9

3.0

3.0

9.2

9,2

1.11.1

6.31.62.6

1.2

5.4

4.3

3.7

4.4

3.8

0.4

13.2

. . .7.5

1.41.4

1.7

1.7

0.8

2.6

1.0

. . .2.9

1.7

1,7

1.1

0.1

. . .134.0

88.283.3

0.21.9

3.0

3.0

5.8

5.8

1.11.1

5.51.62.6

1.2

5.4

4.3

4.4

3.8

0.4

12.1

42

Table 11, Prevalence rates forskin conditions ofconcern [comtiaintsl, all Wpesand themost frequently reported types, among females l.74years, by W?andpartofhdyaffected: United States, 1971-1974-Con.


Win conditions of concern, total ... .. .. ..... .. ... .... ... .... .. ... .. .Skin conditions of concern with site and type specified..

Diseases of sebaceous glands ... .. .. .... .... .. .. .. ... ... ... ... .... ... ..7l4l.7l49Acne vuIgaris .. .... .... .. .. .. .. .... .... .. .. ... .... . .... .. .. ... .... ... .. .... ...7l4l5OCystic acne .. .. .. .. .. .. .... .... .. .. .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. .... .... ..7l4l8OAcne scars . ...... .. .. .. .... .... .. .. .. .... .... .. .. .. .. ... ... .. .. .. .. .. .. .. .. ....7l4l9OXerosls .... .... .. .... .. .. .... .... .. .. .. .. .. .. .... .. .. .. ... ... .... .. .. .. ... .. . ....7l493O

Dermatophytoses ..... .... .. .... .. ..... ... .. .. .. .. .. ... ... .. .. ... .... .. ..... .. ... .. .. ..l3lTines pedis ... .. .... ... ... .. .. .. ..... ... .. .... .. .... .... .. .. .. ... .... ... .. .. .. ... ..1310Tines unguium .. ... .... .. .. .. ..... ... .. .. .. ... .... ... .. .. .. ... .... ... .. .. .. ... ..l3l2Tines v.wsicolor . .. .. ... ..... .. .. .. .... ... ... .. .. .. .... .... .. .. .. .. .... .... ..131910Tines cruris ... .... .. .. .... .... .. .. .. .. .. .. .... .. .. .. .... .. .. .. .. .. .. .... .. .... ..l3l3l

Tumors2. .... .. .. .... .... .. .. .. .. ... ... .. .. .. ... .... ... .. .. ... .. ...l9XZ2X.23XZ3YMalignant .. .. .. .... .. .. .. ...... .. .. .. .... .. .... .. .. .. .. ... ..... .. .. .. .. .. . .... ... .. . 19X

Basal@ll epithelioma .... .. .. .. .. .. .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. .. 19X1BeniSn2 ..... ...<.n. ...<.... ..a. .. ..... ... .. .. .. .. ... ..... .. .. .. .. .... .... .. .... ... ...22x

Lipoma ..... ... .. .. .. .. .... .. .. .. ... .. ..... .. .... .. ... ..... .. .. .. ... ... ... 22X959Precancerous and not specified ..... .. ... .. .. ... .. ... .. .. .. .. ... ..23 X.23Y

Actinic keratosis ... .. .. ... ... .. .. .. .. .. ... .... ... .. .. ... .... ... .. .. ..23XWl

Seborrhelc dermatitis ..... .. .. .. .... .... .. .. .. .. .... .. .. .. .. .. .. ... .... ... .... .. .....7OOSeborrheic dermatitis, type not indicated .. .... .. .. .. .. .. ......70001 O

Atopic dermatitis, eczema .. .... .. .. .. .. ...701 ,70S300,708310,708320Atopic dermatitis ..... .. .. .. .. .... .... .. .. .. .. ... ..... .... .. ... .... ... .. ...70S31 OLichen simplex chronicus ...... ... .. .. .. ... .... ... .. .. .. ..... .. ... .. ...7O832OHand eczema .. ... .. .. .. .... .. .. .. .. .. ... .... .. ... .. .. ... .... ... .. .. .. .. .... ..7olwoNummular eczema .. .. .. .. .. ... ..... .. .. .. .. ... .. ..... .. .. .. .... ... ... .. ...7 OlOlODyshidrotic eczema ... ..... ... .. .. ... ..... .. .... .. .. ...... .. .. .. .. ... ... ..701030

Contect dermatitis .. .. .. .. .. .... .... .. .. .. ... .... ... .. .. .. ... .. .. .. ... .. ... ..<... ... ..7o3

Ichthyosis, keratosis ...... .. .. .. .. ... ... .. .. .. .. .. .... .... .. .. .. ..71 Ol3O.7lOl5O

Verruca vulgaris ... .. .. .. ...... .. .. .. ... .... .. ... .. ... .. ..... .. .... ... .... ... .. ...696O3O

Folllculitis .... .. .... .... .... .. .. .. .. ..... ... .. .. ... .. .... ... .. .. ... .. .. ... .. .... ....7l39OS

Pmriasis .. .. .... .... .. .. .. ...... .. .. .. ... ... .... .. .. .. ...... .. .. .. .. .... .... .. .. .. .. ..7O6O9O

Seborrheic keratosis . ... .. .. .. ...... .. .. .. .. .... .... .. .. .. .. .... . ... .. .. .. .. .. 22X44X

Vltiligo . .. .. ... ... .. .. .. .. .. .... .. .. .. .... .. .. .. .. .. .... .... .. .. .. ... ..... .. .. .. .. ....71621 O

Urticaria (hives, etc.] .. .. .. .... .... .. .. .. .. .... ... ... .. .. .. ... .... ... .. .. ....242.243

Herpes $Implox ... .. .... .... .. .. .. ..... ... .. .. .. .. ..... ... .. .. .. .. ... .. ... .. .. ... .... ...O96

All other skin conditions .. ... .. .. .. ..... ... .. .. .. ... .... ... .... .. .... .... .. .. .. ... .. ....

Sce footnotes at end of table

Female

18-24 years I 25-34 years I 35-44 years

Total Hand Foot Other Total Hand FootI

Other Total Hand Foot


141.5131.2

66.660.6

1.01.70.4

6.30.21.93.6

6.3

4.7

1.50.7

4.44.4

6.06.00.3

0.61.3

4.7

1.2

1.0

3.1

3.8

2.1

2.8

3.1

17.8

. . .5.4

0.5

0.2

0.2

1.90.70.2

1.2

1.8

1.0

. . .5.2

1.2

1.2

0.8

0.6

0.20.2

0.1

0.1

2.9

. . .120.6

66.660.5

1.01.70.4

4.60.20.73.6

5.3

4.5

0.70.7

4.44.4

5.85.10.1

0.6

2.8

1.2

3.1

3.8

2.1

2.6

3.1

14.9

120.5112.5

34.631,5

0<31.60.6

7.95.20.61.60.1

1.7

1.7

11,511.5

16.55.11.34.90.82.7

6.4

0.2

0.3

0.6

1.4

2.4

0.6

0.9

25.3

. . .16.0

02

0.2

0.2

10.00.70.64.9

2.7

3.7

02

1.7

. . .7.7

0.10.1

5.15.1

0.6

1.4

0.5

. . .88.8

34.731,4

0.31.60.6

2.60.10.61.80.1

1.5

1.5

11.511.5

5.94,40.7

0.6

3.3

0.2

0.1

0.6

1.4

2.4

0.6

0.9

23.1

116.0107.5

17.914,3

1.00.20.9

11.32.36.02.20.4

4.10.40.43.4

0,3

8.38.3

10.21.15.31.8

0.5

14.2

0.7

1.3

1.8

1.9

2.4

2.4

31,0

. . .13.9

1.6

1.2

2.8

1.8

0.5

6.3

0.7

2.5

. . .14.7

0.80,8

7.12.34.8

6.8

Dther

. . .

76.9

17,113.6

1.00.20.9

2.6

2.20.4

4.10.40.43.4

0.3

8.36.3

7.41.15.3

7.9

1.3

1.8

1.9

2.4

2.4

21.7

43

Table 11. PrevalmIca rates forskln condltionsof concern (complaints), all Wpesand tll@most frequently reported types, among f#males l-74years, byageand part of, bodyaffected: United States, 1971 -1974 -Ccm.

Condition and NYu $~de~

Skin wnditicm$ of concern, total . .. .. .. .. .. .... .. .. .... .. .. .. .. .. .. .Skin conditions of concern with site and typo specified,.

Dismses of sebaceous glands ... .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .....7l4l.7l49Acne vulgaris .. ..... .... ... .. .. ... .. ... .. .. ... ..... .. .. .. ...... .. .. .. .... .....7l4l5OCVstlcacne ... ... .. .. .. .. ...... .. .. .. .... .... .. .. ... .. .. ... .. .. .... .. .. .. .. ....7t41 SOAcne scars. ... .. .. .. .. .. .. .. .. .. .... .. ..!.. !.. ... ... .. ....<. .. .. .. .. ... ..... ...7l4l9oXerosis .. .. .. .. .... .. .. .. .. .... .. .... ...... .. .. .. ... .. ... .. .. ... .... ... .. .. .. ... .714930

Dermptgphyto~ . ...... .. .. .... .... .. .. ... ..... .... ... .... ... .. .. .... .... .. .. .. .. ... ..l3lTines pedls. ... .. .. .. ...... .. ...#.. .. .... .. .. .. .... .. .. .. ...... .. .. .. .... .. .. .. .. ..l3loTines ungulum .. ...... .. .. .. ...... .. .. .. .... .... .. .. .. ...... .. .. .. ...... .. .. .. ..l3l2~n8averslc010r .. ..... .... .... .... .. .. ... ..... .. .. .... .... .. .. .. ..... .. ... ..l3l9lOTines cruris !. .. .. .. ...! .. .. .. .. .. .. ...... .. .. .. .... ....#. .. .... .. .. .. .. .. .. .. ...l3l3l

Tumors2 . .. ...... .. .. .. .. .... .. .. .... .... .. .. .... .. .. .. .. .. .. .... ..l9X.22X.23X23YMalignant ..... .. .. ... .... ... .... .... .... .. .. ... ..... .. .. .. ..... ... .. .. ..... ... .. .. .. 19X

6asal-call eplthelioma .. .... .. .. .... .... .. .. .. ......! . .. .. ...... .. .. ...!l9xl6enlgn2 .. .. .. .. .. .... .... .. .. ... ..... .. .. .. ...... .. .. .. .... .... .. .. .. .. .... .. .. .. ....22X

Lkmma ,. .... .. .. ..... ... .. .. .... .... .. .. ... .... ... .. .. .. .... .. .. .. .... ...22X969Precancerous and not $peclf lad .. .. ... ... .. .... .. .. .... .. .. .. ..... 23 X,23Y

,Actinlc knratosis . .. ... ... .. .. ... .. ... .. .. ... .... ... .. .. ..... ... .. .. ..23XO8l

Sebarrheic dermatitis . .. .... .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .... .. .. .. ...... .. ...7OO.Seborrheic dermatitis, type nor indicated .... .. .. ... ..... .. .. ..70001 O

Atoplo dermatitis, eczema ...,..,. ,.......,701,708300,7083 10,70S320Atopic dermatiti$ ,!,.,.. ,. .. .. ....!... ...1......,..,...,,., . .. .. ..... .. ... .70s310

Lichen simplex chmnicus ... .. .. .. ...... .. .. .. .... .. .. .. .. .. .... .. .. ...7O832OHand emema .. .... .... .. .. ... ..... .. .. .. ...... .... .. .... .... .. .. ...... . ... ...7OlWO

Nummular eczema .. ..... .. .. .... .... .. .. ... .... ..... .. ..... ... .. .. ... .. ...7OlOlODyshidrotic aczema ... .. .. .. ...<.. .. .. ... .....<. .. ... . .... .. .. .. ... ..... ..7olo3o

Contsct dermatitis . .. .. .. .... .... .. .. ... .... ... ...... . ... .. ..,!, !...,.....,...,., . ... .703

Ichthyosis, keratosi$ ... .. .. .. .. .. .. .. .. ... .... ... .. .. .... .... .. ...710130.71 Ol5O

Verruua vulgaris . .. .. .. .. .... ...!.... .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .696030

Folliculitls . .. .... .. .. .... .... .. .. ... ..... .. .. .. ...... .... .. ..... ... .. .. .... .. .. .. ...7l39O6

PsOriUls .. .. .... ... ... .. .. .. .... .... .. .. .... .... .. .. .. . .... ... .. .. .. .. .. .. .. .. ...... ..7WO9O

Seborrheic ker?to$is .. .. .. ..! . .. ..... ... .. .. .... .... .. .. .. .......i .. .. ..... ... 22X44X

VitlligO ... ... .. .. .... ... ... .. .... .... . ... .. ...... .. .. .. ..... ... .. .. .... .... .. .. ... .. ..71 S21 O

Urtlcaria (hives, etc.) .. .. .. .. .. .... .. .. ..... ... .. .. ... ..... .. .. .. .. .... .. .. ...242.243

Hwpesslmplex . .. .. .. ..... ... ..... .... ..... ... .. .. ... ..... .. .. .. ...... .. .. ... .. ... .. ..W6

All other skin conditions .. .. .. .. .... .. .. .. .. ..... ... .. .. .... .... .. .. .. ...... .. .. .. .... ..

Female

45-64 y’clars 55.64 years 6s.74 years

Totpl Hand Foot Other Total Hand Foot Other Total Hand Foot Other

100.992.4

2.5

2.5

15.73.79.31.90.8

7.0

5!35,3

1.71.7

8.66.6

8.91,33,40.s0.23.1

2.0

1,1

12.0

1.7

S.6

3.0

24.4

. . .8.1

0.20.2

3.7

0.8

2.9

1.9

1.7

0.6

. . .14.8

11.43.57.9

0.6

0.3

0.2

2.8

. .69.5

2.5

2.5

4.1

1,41.90.6

7.05,35.3

1.71.7

8.6

8.6

4,6

1.33,1

0,2

0.1

1.1

10.3

1.7

5.5

3.0

21.0


115.4102.1

3.7

0.7

11.01.74.24.70.4

18.6

5.22,41.9

11.58.7

5.85.9

6.93.42,61.0

5.0

1,9

2.8

7.0

2.2

4.6

4.7

27.8

. . .9.1

0..4

0.4

2,4

Z.i2.4

2.51,5

1.0

2.1

0.3

1.4

. . .8.8

0.7

o.;

2.61.70.9

5.5

.. . 122.284.2 121.0

3.0 2.6

1.9

8.0 16.46.0

2.9 9.14.7 .0.4 .

16.2 28,6

5.2 7.32.4 5.11.9 2,7

0,29.1 18.66.3 16,8

:: z

4.4 9,9

1.9 1,62.6 0,7

1,84.4

2.9 5,3

1.9 1.4

2.8 -

7.0 4.0

2.2 6.3

4.3 1.6

4.7 1.5

20.9 35.2

. . .12.2

0.3

0.3

3.41.1

0,1

2.22.2

2,2

1,8

3.0

0,1

3.2—

. . .21.6

0.4

0.;

13.76.07,7

0.8

0.80.1

0.8

1.1

0.1

4,9

. . .87.0

1.9

,-

1.2

2.7

1.4

24.46.25.11.80,1

16.414.6

6.26.2

6,91.60.7

4,4

2.3

1.4

2.9

S.3

1.4

1.5

27.1

lSee reference 8,2~xc,u~88 $eb~~~h~i~ ker~t~$is (22X44X) which is listed with benign tumors in the NYu classification.

44

Table 12. Prevalence of skin conditions of concern (complaints] among persons l-74 years, by r~currence, duration, handicap, disfigurement and discomfort fromcondition. wa and sex of persons affectad, showing rates, selected standard errors, and number of persons affected: United States, 1971-1974

—

Handi-cap to

employ.ment orhouse-work

Pm.eludes

pre-Social

ferredhandi-

emplOy-Cap

ment

ActiveRecur- in

rent pastyear

Presentless

than2 years

Somedis-

figure-ment

Some

pain or Someburn- itching

ing

Some

motionlimita-tion

Someoveral I

Limitsactiv-

iw

Age and sexdiscom

fort


10.2—

0.61.26,9

16.516.811.9

9.114.912.6

9.9

1.12.42.6

23.314.5

8.810.915.311.2

10.4

1.5_

1.00.72.20.73.00.21.81.62.2

1.3

35.1_

3.07.4

68.862.544.235.325.227.122.0

32.6

1,6

6.158.559.343.838.228.677.420.1

37.4

71.4_

19.521.399.693.48&979.073.380.766.6

74.7

15.721.887.192.482.890.295.491.699.8

68.4

59.2—

20.025.771.064.869.471.377.355.270.2

66.0

12.933.970.9

Both sexes, 1-74 years ... ... .. .. ... . . 62.8_

14.620.977.876.588.774.870.456.068.0

68.6

10.425.574.762.097.888.369.767.183.0

56.3

77.1_

22.026.3

100.497.1

100.485.983.276.669.8

83.9

10.6_

2.95.5

12.414.411.812.3

8.214.111.6

9.6

22.6_

10.26.9

19.728.732.926.427.022.626.4

25.9

7.27.8

22.834.834.727.039.230.925.6

19.5

46.7_

20.023.041.936.660.056.372.151.855.4

55,0

5.6_

2.12.74.98.28.06.43.15.3

11.4

6.1

12.3_

9.011.625.517.410.5

7.78.38.48.0

12.6

6.59.5

25.117.512.0

4.215.99.35.8

12.1

1-5 years . ... ... .... .. .. ... .. .... ... ..... .. .. .... ... .. ..... ..6.11 years .. .. .. ..... ... .. .. .... .. ... ... .. .. .. .. .... .. .. .. ..12-17 years .. ... .... .. ... .. .. ... .... .. ... .. .. .. ... .... .. ...18-24 vears .. .. ..... ... .. .. .. .. ... . .. .. .. .. .. .. .. ... .. ... ..25-34 years .. .. .... .... .. .. .... .. ... ... .. .. .. .. ... ..... .. ..3544 years .. .. .. .... .... .... ... .... ... .. .. .. .. .. ... ..... ..45-54 years .. .. .... ... ... .. ... .. .... ... .. .. ... .. .. .... .. ...55.84 years ..... .. .. .. ... ..... .. .. ... .. ... .... .. ..c.. . ... ..65-74 vears ..... .... .. .... .... .. .. .. .... .. .. .. .. .. .. .. .. ...

Male, 1-74 years .. .... ... ... .. .. ... ... . ..... ..

2.56.37.6

14.47.0

15.68.8

18.17.8

11.1

0.21.13.0

3.71.13.6

1.7

13.931,s40.939.171.273.1

100.660.461.1

39.0

1-5 years ..... .... .. .. .. ... ..... .. .. .. .... .. .... .. .. .. .. ... ..6.11 years . .... ... .. .. .. .... .... .. .. .. .. ... ... .. .. .. .. .. ... .12-17 years .. ... .... ... .. .. ... ... .. .. .. .. .. ... .. .... ... .. ..18-24 years ... .. .. .. .. .. .. .... .. .. .. .. .... .... .. .. .. .. ... ..25-34 years .. .. ..... ... .. .. .. .. ...... .. .. .. ... .. ..... .. .. ..3544 yaars .. .. ... .. .. ... .. .. ... .... ... .. .. .. .... ... ... .. ..45-54 yEas .. ... .. .. ... ..... .. .. .. .. ... ... .... .. .... .. ... ..55.64 years ... .. .. .. ...... . ... .. .. ... .... ... .. .. .. .. .... . ..65-74 years ... .. .. .. ..... .. ... .. .. ... .... ... .. .. .. .. .. ... ..

Female, 1.74 years., . .. .... . ... .. .. .. .. .... .

15.733.584.1

102.7107.5102.0108.1

60.8104.9

70.7

1.92.81.9

10.19.38.85.26.69.8

5.2

65.679.783.0

103.564.171.3

52.7

l.5years . .. .. .. .. .. .. .. .. .... .. .. .. .. ...... .. .. .. .. .. .. ... . .6-11 years .. .. ... ..... .. .. .. ... .. ..... .. .. .. ... ... ... ... .. ..12-17 yeafi ... .. .. .. .. .... .... .. .. .. .... .. .. .. .. .. .. .... .. .18-24 years ... .. .. .. .... .. .... .. .. ... ... .... .. .. .. .. ..... . .25-34 years ... .. .. .. .... .... .. .. .. ... .... ... .. .. .. .. .... .. .35-44 yearn .. ... .. .. .... ... ... .. .. .... ... ... .. .. .. .. .... ...45-54 yaars .. ... ..... .. .. .. ... .. .. ... .. .. .. .... . .... .. ... ..55-64 yean .. .. ... .... ... .. .. ... ..... .. .. .. .. .. .... ... ... ..55-74 yaars .. ..<.. .. .. ... .. .. ..c.. .. .. ... .. .... .. ... .... ...

19.016.280.971.460.562.552.649.856.7

28.619.0

116.191.698.572.164.577.577.6

11.613.825.917.3

9.110.9

1.47.59.6

3.44.7

17.514.416.2

9.27.6

10.614.5

0.2

11.510.219.014.8

7.414.513.6

1.90.21.31.45.70.3

2.11.2

4.5B.7

79.565.644.532,724.035.823.4

23.320.7

112.684.379.268.753.171.060.5

13.36.1

16.522.931.225.815.915.127.0

26.214.342.934.249.840.845.944.052.8

2.42.58.16.46.84.31.34.2

12.7

27.317.271.164.060.060.553.247.369.4


8oth saxes, 1-74 years .. .. ... .. .. ... . 6.22 7.30 1.70 2.06 2.04 0.45 3.95 6.65 2.61 4.02 0.70 5.80

7.11 8.41 2.25 1.63 2.04 0.50 3.30 7.63 3.69 5.61 0.93 6.816.63 7.49 1.63 2.62 2.26 0.51 5.65 6.63 2.20 3.41 0.95 5.92

Numbar of persons in thousands

Male, 1-74 years ... .. .. .. ... .. .... ... .. .. ... ... .. .... .. .Femda, 1-74 yaars ... .. .. .. .. ... ... .. .... .. ..... ... .. .

12,174 13,569 2,072 2,031 1,876 280 6,809 13.657 4,360 9,G65 1,086 11.475

6,551 7,153 962 919 936 124 3,071 7,033 2,435 5,174 573 6,2175,623 6,416 1,110 1,112 1,040 166 3,736 6,624 1345 3,881 523 5,256

8oth :exec, l-74years ... .. ... ..... ..

Male, 1-74 yearn ... .. ... ... ... ... .... ... .. .. .. ... .. .. .. .Female, 1-74 years .. .. .. .. ... .. .. .. ... .... ... .. .. .. .. .

45

Table 13. Type of care sought and adequacy of treatment for skin conditions of concern (complaints) among persons 1-74 Years, by age

and sex, showing rates, selected standard errors, and number of persons affected: United States, 1971.1974

All con.Some

Care for skin complaint sought fromNot Could be ciitions

con-NOW ditions

undernow improved could

EzIIzlE. ‘~~ ‘:” ?r ‘:* ‘?? ‘:?

Age and sex


27.4 21.5 82,0Both sexes, 1-74 years.. 5.9 79.5 5.9 6,218.4 20.7

1.63.8

30,426.725.017.617.918.617.3

21.7

1.60.2

13.1

9.17.54.66.83.43.1

7.0

3.59.8

18.529.729.019.426.025.520.4

19.3—,

1.413.9

7.3

29.826.814.732,226.220.0

22.0

17.114.517,622,228.143.940.5

31.633.2

27.2

10.910.724.420.624.825.126.922.727.5

19.3

22.828.5108.9110.296.189.795.076.298.7

93.0

20.328,5110.0104.393.386.487,375.598.9

90.5

16.134,9109,7111.3113.4109.2118.179,9114.0

69.1

24,521.8110.497,775.165.559.071.887.5

4.90.54.68.97.0

‘10.46.93.95.7

6.2

4.90.54.68.97.0

10.49.03.95.8

6.4

3.90.66,99,86.212.37.83,46.3

$.9

1-5 years .. .. .. .. .. .. .. .. .. .. .. .. .. .. . ... .. .. .. .

6-11 years ... .. .. .... .. .. .. .. .. .. .. .. .. .... .. ..12-17 years ... .. .. .. .. .. ...... .. .. .. .. .. .... ..18-24 years .. .. .. .. .. .. .. .... .. .. .... .. .. .. ...

25-34 years ... .. .. .. .... .. .. .. .. .. .. .. .. . . ....35-44 years .... .. .. .... .. .. .. .. .. .. .... .. .. ...45-54 years .. .... .. .. .... .. .. ... . .. .. .... .. .. .

55-64 years ... .... .. .. .... .. .. .... .. .. .. .. .. ..65-74 years .. .. .... .. .. .... .. .. .... . ... .... .. .

Male, 1-74 years .. ..... . ... .. .. ..

1.03.8

31.527.431.826.824.622.319.2

15.3

1.3

15.88,66.65.411.36.63.1

4.9

13.616.514.118.226.046.750.630.432.9

27.6

7.97.813.723.718.419.937.321.427.3

23.6

18.735.1

108.0113.4116,9111,5125.6

83.8

116.3

71.7

3.9

::;9,86.212,35.73.46.3

5.7

1-5years . .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. ....6-11 years . ..... .. .. .... .. ...... .. .. .... .. . ....12-17years .... .. .. .... .. .. .. .. .. .. .. .... . . ...18-24 years .. .... .. .. .... .. .. .... ... . .... . ... .25-34 years . .. .. .. .. .. .... .. .. .... .. .. .... .. ..35-44 years .. .. .... . . .. .. .. .. .. .... .. .. .... .. .45-54 years .. .. .... .. ... ... ... . .... .. .... .. ...

55-64 years ... .. .... .. .. ..... .. .. ... .. ... .... .65-74 years .. .. .. .. .. .. .. ..... . .. .... .. . .. ....

Female, 1-74 years .. .. .... .. .. .

5.90.42.27.97.68.610.14,45.5

1-5years ... .. .. .. .. .. .. .... .. .. .. .... ...... . ...6-11 years .. .. .. .... .. ..... . .. .. ..... . . ..... .. .12-17 years .. .. ...... .. . ... .. .. ...... .. .. .. ...18-24 years . .. . . .... .. .. ...... .. .. .. .. .... ... .25-34 years .... .. .. .... .. .. .... .. .. ... ... . ....35-44 years ... .. .. .. .. .. .. .. .. .. .. .. .... .. .. ..45-54 years .. .. .. .. .. .... .. .. .. .. .. .. .... .. .. .55-64 years ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..65-74 years .. .. .. .. .. .. .... .. .. .... .. .. .... .. .

2<23.929.326.018.99.211.715.315.9

1.80.310.39.58.43.92.60.63.1

5.65.7

30.229.630.923.720.224.920.7

20.712,421.325.930.141.331.432.733.4

14.1

13.7

35.617.7

30.629.817.323.927.6

27.121.8

109,7107.2

77.269.686.969.485.4

5.90.42.27.97.68.68.04.45.3


8oth sexes, 1-74years.. 2.87 1.68 1.75

3.79 2.16 2.302.98 1.65 2.14

2.60 I 2.36 i 7.68 i 7.29 i 1.30 I 1.39

2.96 I 2.81 9.72 I 9,30 1,71 I 1,713.16 3.09 7.39 7,19 1.19 1.37

Male, 1-74 years.., ... .. .. .... .. .. .. .. .. .. ..Female, 1-74 years ... .. .. .. .. .. .. .... .. .. .

Number of persons in thousands

4,179 I 15,914 1, 15.419 I 1,147 I 1,1971

Both sexes, 1-74 years..

1,819 I 8,753 8,525 583 I 6062,361 7,161 6,894 565 592

Male, 1-74 years ... .. .. ...... .. .. .... .. .....Female, 1-74 years ... .. ... . ... ..... . .. ....

46

APPENDIXES

CONTENTS

I. Statisticzd Notes ................................................. ............................................................................The Smey Desi@ .........................................................ti..................................................... .....Nonresponse ....................... ......................................................................................................Mksing Data ..............................................................................................................................Small Numbers ........................................................ ............. ........................................... ..........SampIing and Measurement Error ............ .................................................................................Tests of Significance ................................. ................................................................................Examiner Variabtity .................................................................................................................

4848495151515252

U. ~eDematolo~ Extinction Fom ............................................... .............................................. 60

III. Stin Patiolo~~assification mdGIoss~of Selected Terns .................................. ..................... 67Cl=sification ............................................................................................................................. 67GIOSSW ....................................................................................................................................69

LIST OF APPENDIX TABLES

I. United States civilhn nonirrstitutiontilzed population, by age, sex, and color, November 1,1972 .................. ............... ..................... ................ ...................................................................... 50

11. Percent distribution of nonresponse adjustment factors: Health and Nutrition Examination Sur-vey, stands 01-65, 1971.1974 ............... ...... .................................................................. ............... 51

III. Total number of exasninecs and those not given the derrnatological component, by age and sex:Health and Nutrition Examination Survey, United States, 1971-1974 ........ ................................. 51

IV. Range, mean, median, and quartiles in the distribution of dermatologist examiners, by the age-sexadjusted proportion of examinccs with significant skin pathology, skin conditions of concern(complaints), and their ratio: Health and Nutrition Examination Survey, 1971 -1974 ................. 53

V. Number of exarninees and age-sex adjusted proportion of exarninees with skin pathology, skinconditions of concern (complaints), and their ratio, by dermatologist examiner and scx ofcxarnince: Health and Nutrition Examination Survey, 1971-1974 ............................................... 54

47

APPENDIX I

STATISTICAL NOTES

The Survey Design

The sampling plan for the first 65 stands ofthe Health and Nutrition Examination Survey(HANES) followed a stratified multistage proba-bility design in which a sample of the civiliannoninstitutionalized population of the coter-minous United States, 1-74 years of age, wasselected. Excluded from the selection were per-sons residing in Alaska and Hawaii and thosewithin the coterminous United States confinedto institutions or residing on reservation lands ofAmerican Indians. Successive elements dealtwith in the process of sampling were the primarysampling unit (PSU), census enumeration district(ED), segment (a cluster of households), house-hold, eligible persons, and finally sample per-sons.

The starting points in the first stage of thisdesign were the 1960 Decennial Census lists ofaddresses and the nearly 100 PSU’S into whichthe entire United States was divided. Each PSUis either a standard metropolitan statistical area(SMSA), a single county, or two or three contig-uous counties. The PSU’S were grouped into 357strata for use in the Health Interview Survey andsubsequently collapsed into 40 superstrata foruse in Cycles II and III of the Health Examina-tion Survey and HANES.

Fifteen of the 40 superstrata contained asingle large metropolitan area of more than2,000,000 population. These 15 large metropolit-an areas were selected for the sample with cer-tainty. The 25 noncertainty strata were classi-fied into four broad geographic regions ofapproximately equal population and cross-classified into four broad population densitygroups in each region. Then a modified Good-man-Kish controlled selection technique was

used to select two PSU’S from each of the 25noncertainty superstrata with the probability ofselection of a PSU proportionate to its 1960population so that proportionate representationof specified State groups and rate of populationchange classes was maintained in the sample. Inthis manner a total first-stage sample of 65PSU’S was selected. These 65 sample PSU’S orstands are the areas within which a sample ofpersons would be selected for examination overa 3-year survey period.

Although the 1970 Census data were used asthe frame for selecting the sample with PSU’Swhen they became available, the calendar ofoperations required that 1960 Census data beused for the 44 of the 65 stands in the sample ofHANES. Census enumeration districts (ED’s) ineach PSU were divided into segments of anexpected six housing units each. In urban ED’sthe segments were clusters of six addresses fromthe 1960 Census Listing Books. For ED’s nothaving usable addresses, area sampling wasemployed and, consequentIyj some variation inthe segment size occurred. To make the samplerepresentative of the current population of theUnited States, the address or list segments weresupplemented by a sample of housing units thathad been constructed since 1960.

Within each PSU a systematic sample of seg-ments was selected. The ED’s that fell into thesample were coded into one of two economicclasses. The first class, identified as the “povertystratum, ” was composed of “current povertyareas” that had been identified by the U.S.Bureau of the Census in 1970 (pre-1970Census), plus other ED’s in the PSU with a meanincome of less than $3,000 in 1959 (based on1960 Census). The second economic class, the

48

“nonpovert y stratum, ” includes all ED’s notdesignated as belonging to the poverty stratum.

All sample segments classified as being in thepoverty stratum were retained in the sample.For those sample segments in nonpoverty stra-tum ED ‘s, the selected segments were dividedinto eight random subgroups and one of the sub-groups was chosen to remain in the HANESsample. This procedure permits a separate analy-sis with adequate reliability of those classified asbeing below the poverty level and those classi-fied as being above the poverty level.

After identification of the sample segments,a list of all current addresses within the segmentboundaries was made, and a person in each ofthe households was interviewed to determine theage and sex of each household member, as wellas other demographic and socioeconomic infor-mation required for the survey.

To select the persons in sample segments tobe examined in HANES, all household membersage 1-74 in each segment were listed on a sampleselection worksheet with each household in thesegment listed serially. The number of house-hold members in each of the six age-sex groupsshown below were listed on the worksheet underthe appropriate age-sex-group column. Thesample selection worksheets were then put insegment number order and a systematic randomsample of persons in each age-sex group wasselected to be examined using the following sam-pling rates.

Age Rate

1-5 years 1/2

6-19 years %2044 years male 1A2044 years female ?/?45-64 years %65-74 years 1

The persons selected in the 65-stand sampleof HANES make up a representative sample ofthe target population and include 28,043 samplepersons 1-74 years of age of whom 20,749 or74.0 percent were examined. When adjustmentsare made for differential sampling for high riskgroups, the response rate becomes 75.2 percent.

All data presented in this report are based on“weighted” observations. That is, data recorded

for each sample person are inflated to character-ize the subuniverse from which that sample per-son was drawn. The weight for each examinedperson is a product of the reciprocal of the prob-ability of selecting the person, an adjustment fornonresponse cases (i.e., persons not examined)$and a poststratified ratio adjustment that in-creases precision by makiig the final sample esti-mates of the population agree approximatelywith independent controls prepared by the U.S.Bureau of the Census for the noninstitutional-ized population of the United States as ofNovember 1, 1972 (approximate midsurveypoint), by color, sex, and age shown in table I.Population estimates are included in some of thetables in greater detail than that used for weight-ing. These population figures, while not precisecensus estimates in this degree of age detail, areincluded to give a rough idea of the number inthe population at risk.

A more detailed description of the surveydesign and selection technique can be found inthe “Plan and operation of the Health and Nu-trition Examination Survey, United States,1971 -1973,” Vital and Health Statistics, Seriesl-No. 10a.7

Nonresponse

In any heaIth examination survey, after thesample is identified and the sample persons arerequested to participate in the examination, thesurvey meets one of its more severe problems.Usually a sizable number of sample persons willnot participate in the examination. Whether ornot an individual participates is determined bymany factors, some of them uncontrollable and,therefore, may be reasonably treated as an out-come of a random event with a particular proba-bility of occurrence. If these probabilities of par-ticipation were known and greater than zero forall persons, then the examined persons wouldconstitute a probability sample from whichunbiased estimates of the target populationcould be derived. In this situation, the effect ofnonparticipation would only be to reduce thesample size, thereby increasing the sampling

NOTE: A list of references follows the text.

49

Table 1, Unit6d States civilian nonin~titutional ized populdtioh, by age, $@x,and oolor, November 1, 19721. ~

Age in yearsSex and color Total

1-5 6-19 2044 45.64 65-74

Total ............................................ 193,976,447 17,282,843 55,434,127 66,307,351 42,344,237 12,607,889

Male ..............t ................ .............................. 94,151,059 8)8 18,156 28,014,291 31,757,861 20,090,701 5,469,960

White ........ ...... ........................................ 82,652,067 7,407,500 23,911,243 28,195,112 18,19C),f48 4,948,064All other ................... ......................... ..... 11,498,992 1,410,656 4,103,048 3,562,749 1,900,643 521,896

Femak ........................... .............................. 99,825,388 8,464,687 27,419,836 34,549)490 22,253,446 7,137,929

White ...................................................... g6,932,196 7,070,629 23,261,515 30,102,612 20,011,119 6,4%6,421All other ....................................... .......... 12,843,192 1,394,158 4,158,321 4,446,87g 2,242,327 651,508

Source: Unpublished estimates of September 27, 1974, from the U.S. Bureau of the Census.

errors of examination findings. In practice, how-evert a potefitial for bias due to nonresponseexists because the exact probabilities are neverknown. A further potential for bias exists if: (1)a sizable proportion of sample persons have azero probability of participation, that is, theywould nevet agree to participate in an examina-tion survey of the same procedures and induce-ments, and also (2) these persons differ fromother sample persons with respect to character-istics under examination. It is for these reasonsthat intensive efforts are made in HANES todevelop and implement procedures and induce-ments that would reduce the number of non-respondents and thereby reduce the potential ofbias due to nonresponse, These procedures andinducements are discussed in the “Plan and oper-ation of the Health and Nutrition ExaminationSurvey, United States, 1971 -1973,” Series l-No.10a.7

Despite these intensive efforts, 24.8 percentof the sample persons from the 65 stands werenot examined. Consequently, the potential for asizable bias does exist in the estimates in thispublication, From what we know about the non-responderits and the nature of nonresponse, webelieve that the likelihood of sizable bias issmall, For instance, orIly a small proportion ofpersons gave reasons for nonparticipation whichwould lead to the belief that they would neveragree to participate in examination surveys andthat they may differ from examined personswith respect to the characteristic under examina-tion. Only 15 percent of the nonrespondents

gave as their reasons for nonparticipation per-sonal illness, physically unable, pregnant, anti-doctor, or fear of finding something wrong.Typical among the reasons given by the othernonre,spondents were: unable because of $vork,school, or household duties; suspicious or slfepti-cal of the program; just not interested in p~rtici-pating; and private medical care sufficient o}rjustvisited doctor.

An analysis of medical history data obtainedfor most nonexaminees as well as examinee$ alsosupports the belief that the likelihood of sizablebias due to nonresponse is small. No large differ-ences were found between the examined groupand nonexamined group for the statistics com-pared. For example, 11 percent of personsexamined reported having an illness or conditionthat interferes with their eating as compared to9 percent of persons not examined but who hadcompleted a medical history. The percent of per-sons examined reporting ever being told ~by adoctor that they had arthritis was 20 percent;the percent for high blood pressure was 1? per-cent and for diabetes, 4 percent. The corre-sponding percents for nonexamined personswere: arthritis, 17 percent; high blood pressurej21 percent; and diabetes, 4 percent.

As was mentioned earlier, the data in thisreport are based on weighted ob servation$, andone of the components of the weight assigqed toan examined person was an adjustment for non-response. Because the probabilities of participa-tion are not known for sample persons inHANES, a procedure was adopted that rnulti-

50

plies the reciprocal of the probability of selec-tion of sample persons by a factor that bringsestimates based on examined persons only up toa level that would have been achieved if allsample persons had been examined. This nonre-sponse adjustment factor is the ratio of the sumof sampling weights for all sample personswithin a relatively homogeneous class defined byage, sex, and five income groups (under $3,000;$3,000-$6,999; $7,000-$9,999; $1o,ooo-

$14,999; and $15,000 and over) within each

stand, to the sum of sampling weights for all re-sponding sample persons within the same homo-geneous class for the same stand. To the degreethat homogeneous groups can be defined whichare also homogeneous with respect to the charac-teristics under study, the procedure can be effec-tive in reducing the potential bias from nonra-

table II. Percent distribution of non response adjustment fac-

tors: Health and Nutrition Examination Survey, stands01-65, 1971-1974

Number Percent

Size of factor of distri -cells bution

Total .. . .... . . ..... .. .. .... .. .... .. .. .... .. . .....

l. 00.1.24 .. .. .. .... .. .. ... ... .. .... .. . ... .. .. .... .. .. ....

l.25.1.49 .. .. .. .... . .. .... .. .. ... ... .. ... .. .. ... ... .. ... .l.50.1.74 . . ... .... .. . ..... . ... ... ... . .... . .. .... . ... .....l.75.1.99 . . .... .. ... . .... . .... ... ... . .... . .. .... .. .. .... .2.00-2.49 ... .. ... .. .. ..... . .... .. .. . ..... .. . .... .. .. .... .2.50-2.99 . .... . ... .. .. .... .. ... ... .. .. .... . ... .. ... . .... .3.00-3.03 ............................ .... ............ ....

325

106125

5924

91

1

100.0

32.638.418.2

7.42.80.3

0.3

sponse. For the 65-stand sample of HANES, thepercent distribution of the nonresponse adjust-ment factors used for the 325 income group-stand celk is shown in table H.

Missing Data

Examination surveys are subject to the lossof information not only through the failure toexamine all sample persons, but ako from thefailure to obtain and record all items of informa-tion for examined persons. The dermatologyexamination was not obtained for 111 or 0.54percent of the 20,749 examinees in this HANESI program. The age-sex distribution of these non-examined persons is shown in table III. In thedetailed tables and fiidings of this report, noestimate has been made for what skin findingsthey might have had. Rather it has been assumedthat they had normal skin.

Small Numbers

In some tables, magnitudes are shown forcells for which the sample size is so small thatthe sampling error may be several times as greatas the statistic itself. Obviously in such instancesthe numbers, if shown, have been included toconvey an impression of the overall story of thetable.

Sampling and MeasurementError

In the present report, reference has beenmade to efforts to minimize bias and variability

Table I I 1. Total number of exam inees and those not given the dermatological component, by age and sex: Health and NutritionExamination Surveyr United States, 1971-1974

AgeBoth

Malesexes

Female

I Total number examined

Ail ages, 1-74 years . . .. .... . ... .... .. . ...4. .. ... ... . ..... . . .... . ... ... .. .. .... .. .... .. ... ... .

1-5 years .. . ... .. .. .. .. .... . .. ... .... .... .. .. .... . . .... .. .. ..... . .. ... . .... .. .. .. .... . ... .. ... .. ... .. ... ... . . .... ..

6-11 years ... .. .... . .. .... .. .. .. .. .. ...... .. .... .. .. ... ... .. ... . .. .... .. .. .. ... . .... .. .. ... .. .. .... . .. .... .. .. .. ..12-17 years . .... .. .. .... .. . .... . ... ... .. .. .... .. .. .. .... . ... .. .. .... .. .. ... .. .. .... . ... .. .. ... ... .. . .... .. .. ... ..

18-24 years . .... ... . .... . .. .... ... . .... .. .. ... . .. .... .. .. ..... . .. ... . ... ... .. .. .... . .. ... .. .. .... .. .. ... . .. .... ..25-34 years . . .... .. . ..... .. .. ... ... .... .. .. .... . ... .. .. .. .... .. . ..... .. . ... .. .. .... . ... ... . .. ... ... . ..... . .. ... ..3544 years .. .... .. ..... . .. .... .. .. .... .. .. ... . .. .... .... .... .. . .... .. .. .... .. . .... . .. ... ... .. .... . .. ... . .. .... ..

45-54 years .. . ... ... . .... .. .. ... ... ..... . .. .... . ... ... .. . ..... . . .. .. . ... ... .. .. .... . .. .... . .. ... ... .. ... .. . ... .. .55-64 years .. ... .. .. .... .. .. .... .. .. ....<. .... .. .. .... .. . .....<. .... . ... .... .. . .... . .. .... .. . .... ... .....4.. ... . .

65-74 years ... ... .. .. .... .. .. .. .... .... .. . ..... . .. .... ... .... . .. .... .. ... ... .. . ... .. ... ... . ... ... .. .. ... .. . .... . .r20,749

2,9532,0192,1322,2972,6942,3271,5991,262

3,466

8,819 t 11,930

1,502 1,4511,001 1,0181,068 1,064

770 1,527

799 1,895

666 1,661

767 832591 671

1,655 1,811

II I

111

88

1117

1415

1211

15 I39 72

2 64 44 77 104 102 135 75 66 9

51

of measurement techniques. The potential ofresidual bias due to the high nonresponse ratehas also been discussed.

The probability design of the survey makespossible the calculation of sampling errors. Tra-ditionally, the role of the sampling error hasbeen the determination of how imprecise thesurvey results may be because they come from asample rather than from the measurement of allelements in the universe.

The estimation of sampling errors for astudy of the type of the Health and NutritionExamination Survey is difficult for at least threereasons: (1) measurement error and “pure” sam-pling error are confounded in the data–it is noteasy to find a procedure that will either com-pletely include both or treat one or the otherseparately, (2) the survey design and estimationprocedure we complex and, accordingly, requirecomputationally involved techniques for the cal-culation of variances, and (3) hundreds of sta-tistics are presented in the tables in this report,many for subclasses of the population for whichthere are a small number of sample cases. Esti-mates of sampling error are obtained from thesample data and are themselves subject to sam-pling error when the number of cases in a cell issmall or, even occasionally, when the number ofcases is substantial.

Estimates of the standard errors for selectedstatistics used in this report are presented inmost of the tables in this report. These estimateshave been prepared by a replication techniquethat yields overall variability through observa-tion of variability among random subsamples ofthe total sample.1 8)19 Again, readers arereminded that these estimated sampling errorsdo not reflect any residual bias that might stillbe present after the attempted correction fornonresponse. The standard error is primarily ameasure of sampling variability, that is, the vari-ations that might occur by chance because onlya sample of the population is surveyed. As calcu-lated for this report, the standard error alsoreflects part of the variation that arises in themeasurement process. It does not include esti-mates of any biases that might lie in the data.The chances are about 68 out of 100 that anestimate from the sample would differ from acomplete census by less than the standard error.

The chances are about 95 out of 100 that thedifferences would be less than twice the stand-ard error and about 99 out of 100 that it wouldbe less than 2% times as large.

Tests of Significance

The procedure used in this report for testingthe significance of the difference between thetwo means consisted of dividing the differencebetween the two means by the standard error ofthe difference; that is, a z statistic was com-puted. An approximation of the standard errorof a difference d = x - y of the two statistics xand y is given by the formula

Sd = (s; + s; p

where SX and SY are the sampling errors, respec-tively, of x and y. Of course, where the twogroups or measures are positively or negativelycorrelated, this will give an overestimate orunderestimate, respectively, of the actual stand-ard error.

Examiner Variability

The Data Collection Unit of the Committeeon Planning for the NationaI Academy of Der-matology (NAD), under chairman Dr. Wu.-ie-Louise T. Johnson, was responsible for planningthe content of the dermatology examination andfor recruiting and training the 101 dermatologistexaminers employed at the 65 examination loca-tions in the Health and Nutrition ExaminationSurvey of 1971-1974.

Advance training in the dermatology examin-ation protocol was given each dermatologistbefore the survey examinations were started. Inaddition, members of the NAD Data CollectionUnit periodically reviewed the methods used andthe recording of findings by the dermatologistsduring the survey. After completion of the sur-vey, Dr. Johnson thoroughly reviewed the20,637 recorded examinations to ensure consist-ency with the standard examination protocol,including the selection of the significant diag-noses, and resolved the diagnoses of skin cancerand dermatophytoses on the basis of subsequentfindings from the biopsy and fungal laboratorydeterminations, respectively.

52

The number of examinees per dermatologistranged from 4 to 638, with 27 percent examin-ing fewer than 100 persons, 28 percent 100-199persons, 26 percent 200-299 persons, and 20percent 300 persons or more.

Variation would be expected among theexaminers in the proportion of their examineesfound to have significant skin pathology and inthe proportion with skin complaints because ofdifferences in the age-sex distribution amongthem in the groups examined, regional differ-ences, and the extent or type of environmentalexposure that may affect the prevalence of vari-ous types of skin pathology and other factors.To assess the extent of examiner variability andthe effect that it may have had on the findingsfrom this dermatology examination, the effectof age-sex differences in the groups examined byeach dermatologist have been controlled througha direct adjustment method. In this the age-sex-specific rates for each examiner have beenapplied against the number of persons in thatage-sex group for the total population and theage-sex-adjusted rate recomputed.

Among persons examined, the age-sex-adjusted proportions found to have significantskin pathoIogy range from O to 90.4 percentper examiner, with one-fourth of the dermatolo-gists finding 13.7 percent or less of theirexaminees to have such pathology, one-half find-ing between 13.7 and 46.1 percent, and theremaining one-fourth finding 46.1 percent ormore with significant skin pathology (tables IVand V). The range in such findings amongexaminers is negligibly greater among females (Oto 90.0 percent) than among males (O to 88.2percent).

Examiner variability in the proportion oftheir examinees with skin complaints, when theeffect of age-sex differences among the groupsare removed by direct adjustment is somewhatless than that for significant pathology becauseof the lower rates in general for the complaints.The range in the age-sex-adjusted rates of skin

Table IV. Range, mean, median, and quartiles in the distribu-tion of dermatologist examiners, by the age-sex adjustedproportion of examinees with significant skin pathology,skin conditions of concern (complaints), and their ratio:Health and Nutrition Examination Survey, 1971-1974

Measure and sex

Both sexes

Range .. . .. . ... .. . . .... . .. ... .. .. ..Mean ... .. .. ... .. .. .... . . ..... .. .. .Median ... .. .... . . .... . ... ... .. .. .

’25 ““””-”””””-”-”””””””””””””””””””P75 ““””””””””””””””””””””””’”””””””

Male

Range . ... .. .. .... .. .. .. .. .. .... .. .Mean . .... .. .. .... . .. ... ... .. ... .. .Median ... .. .. .... .. .. .. .. .. .... ..

’25 ““”””-””””’”””--””””””””””””””””P75 ““”””””””””””””””””””””””””””’””

Female

Range . .... .. .. .... . ... .. .. .. ... .. .Mean .. ... .. .. .. .. . ... . . .. .. .. .. .. .Median .. ... . ..... . .. ... .. .. .... ..

’25 ““””””-”””””””””””””-””-”””-””””P 75 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..-

Signifi-Ratio–

Skin100 X skin

cant conditioncomplaint/

skin of con-pathol-

significanttern to

Ogyskin

examineepathology

1 1


0-903.9312.4265.4136.7461.1

0-882.5339.8279.7149.2508.3

0-900.2286.6241.0122.8429.5

0-707.8113.6

88.627.3

198.0

0-805.6127.7118.8

30.0261.5

0-627.4100.3

90.625.8

204.9

10-428.936.443.5

8.584.8

10-617.637.643.5

9.999.0

104,424.635.047.584.092.8

lExclude~ examiner finding of no simsificant DatholoW but

with examinee having conditions of c;ncern (~4.2 pe;;ent).

complaints is from O to 70.8 percent perexaminer, with one-fourth of the examinersrecording 2.7 percent or less, one-half of theexaminers between 2.7 and 19.8 percent, andthe remainder 19.8 percent or more of theirexaminees with skin complaints.

The ratio of skin compktints to significantskin pathology per examiner ranges from O to4.29, with one-fourth of the examiners showing0.08 or less, one-half from 0.08 to 0.85, and theremainder 0.85 or more.

53

Table V. Number of examinees and age-sex adjusted proportion of examinees with skin pathology, skin conditions of concern(complaints), and their ratio, by dermatologist examiner ancl sex of exam inee: Health and Nutrition Examination Survey, 1971-1974

Examiner number

All examiners . .. .... ... .. .... . .. .... ... . ..... . . .... ... .. .... .. .. .... .. .. ... ... . ..... .. . .... .. .. .... ... .. .

Signifi- SkinRatio–

100 X corn.cant com - Nultiberskin plaints

plaints/sig-nificant

ofpathol- by the

skinexaminees

09Y examineepathology

312.4

94.5206.0403.9

47.0

184.4

170.099.4

281.3367.2487.8

26.2377.9427’.7198,6

249.1116.1188,6134.4217.0362.4

53.796.0

436.8106.2456.0380.1581.6244.8614.8198.3364.2

89.258.7

314.5230.7227,6

244,7107.4164.0256.8

500.3275.6670.5250.7221.7715.9853.7466.2

791.4

Rate per 1,000 persons

113.6

141.088.0

400.5

38.7203.0

146.643.4

234.6156.0205.5

14.4390.8190.6204.7

48.5142.0

95.074.4

129.0361.1

60.90.0

352.19.70.0

10.6236.7

12.50.1

196.5128.8

18.30,0

196.227.6

72.244.8

29.4107.5

90.440.0

153.693.757.444.633.228.210.8

2.6

36.4

149.242.7

99.282.3

110.1

86.243.6

83.442.542.155.0

103.444.6

103.1

19.4122.3

50.355.359.499.6

113.40.0

80.69.10.02.7

40.75.10.0

99.135.420.5

0.062.411.531.7

18.727.465.535.2

7.955.714.022.9

20.14.9

3.32.30.6

20.638

274438

9131

221

303174312183629218119217216370

98638216266552

181160116247229603427417

7543

241258241404328277

41284251234176

89500217215481139166

54

Table V. Number of examinees and age-sex adjusted proportion of examinees with skin pathology, skin conditions of concern(complaints), and their ratio, by dermatologist examiner and sex of examinee: Health and Nutrition Examination Survey, 1971-1974–Con.

52 . .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .... .. .... .. .. .... .. .. .. .. .. .... .. .... .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. ... . .. .. .. .. ......

53 . .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... .. .. .. .. .. .... .. .. .... .. .... .. .. .. .. .. .. ... . .... .. .... .. . ... .. .. .. .. .. .... . . ......54 ... .... .. .. .... .. .. .... .. .. .. .. .. .... .. .. .. .. .. .. .. .. ... . .. .. .. .. .. .... .. .. .. . ... .. .. .. .... .. .... .. .. .. .. .. ... . .. ... .. . ......

56 .. .... .. .. .... .. .. .... .. .. ... . .. . ... .. .. ... . .. .... . . ... .. ... ... .. . .... . . .... . .. ... . .. .... .. .. ... . .. .... . . .... . .. .... . . .......57 .. .... .. .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... . . .. .. .. .. ... . .. .... .. .... . ... .. .. .. .... . . .... .. . .... . .. .... .. .... .. . ......58 .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .... .. .. .. .. .. .. .. .. . ... .. .. .. .. .. .... .. .... .. .......59 .. .... .. .. .... .. .. .... .. .. ... ... .. .. .. .. .... . . .... .. .. .. .. .. .... . . ... .. . .... . .. .... . .. .. . .. .. ... . .. ... .. .. ... . .. ... . .. .......

60 .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .... .. .... .. .... .. .. .. .. .. .... .. .... . . .. .. .. . ... ... . ... .. . .... .. . ..... .. .... .. .......61 ... .... . ..... ... ... ... . .... .. .. .... .. . .... . .. .... . . .... .. .. .. .. .. .... .. .. .. .. .. .. .. ... .. ... . ... .. .. .. .. .. .... .. .... .. ........62 ...... .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ... . .. .... .. .. .. .. .. .... .. .... .. .... . . .. .. .. .. .. .. .. .... .. .... .. .. ... . .. .......63 .... .. .. .. .. .. .. ... ... .. .. .. . . .... .. .. ... . .. .... .. .. .. .. .. ... ... . .... . .. ... . .. ... .. ... .. ... . ... . .. ... .. . .... .. . ... .. . ........64 .. .. .. . . .. .. .. .. .... .. .. .... .. .... .. .. .... .. .... .. . .... . .. .... .. .. ... . .. .... .. .... .... .. .. .. .. .. .. .... . . .... .. .. .. .. .. .......65 .. .. .. .. .... .. .. .... .. .. .. .. .. .... .. .. .. ... . .... .. .... .. .. ... .. .. ... .. .. .... . . .... . .. ... .. .. ... . .. .... . .. ... . ... .. .. .. .. ... . .66 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. . ... .. . ... .. .. .....4.... .. .. .. .. .. .... . . .... .. .. .. .. .. .......67 ... .. .. .... .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. ... . .. .... .. .. .. .. .. .... .. .... .. .. .. .. .. ......68 .. .. .. .. .. .. .. .. .. .. .. .... .. .... .. .. .. . . .. .. .. .. .. .... .. .... .. .. .. .... .... . . .. .... .. .... . ... .. .. .. .... . . .... . . .. .. . ... .......69 .... .. .. .... .. .. .. .. ... ... .. . .... . .. .... .. .. .. ... . .... . . .... . ... .. .... . ... .. . .... .. . ... ... .. .. .. .. .... . .. .... . .. ... . . ........70 .. .. .. .. .... .. .. .. .. .. .... .. .. .... .. .. .. .. . .... .. .. ... . .. ... . ... .. .... . ... . .. .... .. . .... . .. .. .... . .... . .. ... .. .. .. .. .. .......71 .. .. .. .. .. .. .. .. .. .. .. .... .. . ... .. .. .... .. .. .. .. .. .... .. . ... . ... .. .. .. .... .. .... .. .. .. .. .. .... .. .. .. .. .. .... .. .. ... . .. .. .....72 .... ... .. ... .. .. .... .. .... .. . . .... .. .. .. .. .. .... .. . ... .. . ... .. .. ... ... .. .. . .. .... . .. ... .. ... .. .. . ..... . .. .... . .. ... . .. .......73 .... .. . .... . .. .. .. .. .. .... .. . ..... .. .. .. .. .. .. .. . . .... .. .. .. . ... ... ... .... .. . .... . .. ... . . .... ... . ..... .. .... . . .... .. .. ... .. . .

74 .. .. .. .. .. .. . ... .. .. .... .. .. .... .. .... .. .. .... .. .. .. .. .. .... .. .... .. .. .. .. .. .... . .. .... . . .... .. . .... .. .. ... .. . .... . .. ........75 .. .. .. .....e.. .. .. .. ..... . .... .. .. . ..... .. .. .. .. .. .. .. .. .... .... .. ... . .. .. .. .... .. .. ... . .. .... . . .... .. .. .... .. .... .. .. .. .....76 .. ... . .. .... .. .. ... .. .. ... .. .. .... . ... .. .. .. ... .. . .... . .. .... . .. .. ... .. ... . .. .... . . .... .. .. ... .. . ... .. . .... . ... .... .. ........77 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. . ... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .......78 .. .. .. .... .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... .. .. .... .... .. .. . ... .. .. .... .. .... .. .. .......

.... .. .. .... .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .... .. .... .. .... .. .. .. .. .. .... .. .. ... . . .... ... .. .. .. . .... . .. ... . .. .... .. . ... .. . ..

: .. .. .. .. .... .. .. .. .. .. .... .. .... .. .. ... . .. . ... .. .. .. ... . .... . . .. .. .. .. .... .. .... .. .. .. .. .. .... .. . ... .. .. ... .. . .... . . .. .......81 ... .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .... .. .. .. ..o. .. .. .. .. .. .. .. ... . .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... .. .... .. .. .. .. .. .. .. ....82 ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .... .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. ......83 . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. ......84 ... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . ..... .. .... .... . ... .. .. .. .. .... .... .. .. .. .... .. .... .. .. .... .. ... . .. ..

86 ... .. .. .... .. .. .... .. .. .. .. .. .... . . .. .. .. .. .... .. .... .. .. .. .. .. ... .. .. ... .. .. .. .. .. .... .. .... .. . .... ... .... . .. ..... .. ........87 ... .. .. .. .. .. .. .... .. .. .. .. .. ....e. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... . ... .. .. . ... .. .. .... .. .. .. .. .. .. .. ....88 ..... .. .. .. .. .. .... .. .. .. .. .. .... .. .. .. .. .. .... .. . ... .. .. ... . ... ... ... ... .. .. .. .. .. .... .... .. .. .. ... .. . .... .. .... .. .. .. ......

89 ... .. .. .... .. .. ... . .... .. .. .. ... .. . .... .. .. .. .. .. ... ... . ... .. .. .... .. .... .. .. .... .. .. .. . . .. .. .. . ... ... . .... .. .... . . .... ......

91 . .... .. .. ... . .... .. .. . ..... .. .... .. . ... . ... .. .... . ... .. . .... . .. .... .. . ... ... . ... .. . .... . ... ... .. . ... .. . ..... .. ... . .. .... . .. ..92 ... .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .... .. .... .. .. .... ... ... .. .... .. .. .... . . .... .. .. .. .. .. .. .... .... . . .... .. . .........

93 . .. .. .. .. .. .. .. .... .... .. .. .. .... .. .... .. .. .. .... ... ... .... .. . .... . .. .. .. .. .. ... . .. .... . ... .. .. .. .. .. .. .... .. .. .. .. .... .. .. ..

94 ... .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. ... .. .... . . .... . .. .... .. .. .. .. .. .... .. .. .. .. .. .... .. .... .. . ... .. .. ... . .. ..

95 ... .. .. ..... . .. .... .. .. ... . .. .... . .. ... .. ... .. .. .. ...` . . .... . .. ... .. .. .. ... . .... .. . .... . ... .. ... . ... .. .. ... . .. ... .. . .... .....96 ..... .. .. .... .. .. .. .... .... .. . ... . ... .. .. .. .... .. . ... . .. .... . .. ... .. .. . .. .. . .... .. . ... .. ... .. .. .. .... .. . ... ... ..... .. ........97 ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .... .... .. .. .. .. .. .. .... .. .. .. .... .... .. .... .. .. .. .. .. .. ......99 ..... .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. . .... . .. .... ... ... .. .. .. .. .. ... ... .. .. . ... .. .. .. .... .. .. .. .. . ..... ... .......loo .. .. .. .... .. .... ... . .... .. .. ... .. . .. .. .. .. .. ... . ... .. . .... . .. ... .. .. ... .. . .... .. . ... .. ... .. .. . .... .. .. ... .. . .... . . .... . ....101 ... .. .. .. .. .. .. .. ...e.. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .... .. .. .. .. .. .. .. .. .... .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. ..

102 ... .. .... .. .. .... .. .. .... .. .... .. .. .. .. .. .... .. .. .. .. .. .. . ... . ... .. .. .. .. .. .. .. .. .... .. .... . ... .. .... .. .. .. .... .. .. .. .. .. ..lw .... .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .... .. .... .. .. .. .... . ... .. .... .. .. .. .. .. ... . .. .... .. .. ... .. . .... .. .... .....lo5 ... .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .... .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .... .. .... .. .. .. .. .. .... ....

Signifi-cantskin

09Y

70.3

592.6261.4243.7

45.9

135.4764.9162.9728.1601.0171.3514.3431.9137.9903.9501.3396.9272.7128.4

68.2256.4436.3322.1239.4636.3378.4358.5104.7

554.2108.2

523.8106.9445.8

547.3641.4288.8

63.3402.0

340.3200.8489.0

48.1

135.5436.2

269.5292.2207.0600.6

38.8518.0490.3

SkinRatio–

100 X comcom - Number

plaintsplaints/sig-

Ofby the

nificant

skinexaminees

examineepathology

Rate per 1,000 persons

0.0592.6

13.3127.6

35.2250.0

5.219.1

143.1357.4

82.0233.4445.2

591.430.837.4

131.7144.5

89.350.8

234.84.5

7.2195.2162.7

99.6156.1

0.0

18.716.9

623.8182.9

22.211.4

62.531.9

259.2241.7179.4265.8

199.577.6

397.4390.5707.8124.5

27.071.272.0

443.9

0.0100.0

5.152.376.7

184.60.7

11.619.659.447.845.4

103.1428.9

3.47.4

33.253.070.074.591.2

1.0

2.281.525.626.343.5

0.0

3.415.6

100.0171.1

5.02.1

21.6

50.464.5

0.052.7

132.440.8

161.3

91.1145.0242.2

60.14.5

183.513.994.6

678093

102116

39131140226

407955

1739

209326253136129280143

580212384157194110362

61562289

1136168

3159423

157125

104

197261108

504

76210

23451

166

55

Table V. Number of examinees and age-sex adjusted proportion of examinees with skin pathology, skin conditions of’ concern

(complaints), and thair ratio, by dermatologist examiner and sex of examinee: Health and Nutrition Examination Survev, 1971-1974–Con.

Examiner number

Signifi- SkinRatio–

100 X comcant com - Numberskin plaints

plaints/sig-n if icant of

pathol- by the exam ineesOgy

skinexaminee

pathology


339.8

137.8250.2

505.829.2

240.0210.7

76.7299,1

395.3

523.210.6

511.8496.7301.5266.2

68.3255.4

156.3231.6390.8

51.2149.4506.8101.8551.6401.3664.0293.0

653,0

130,4431,1129.4

64.2357.0246.0256.7

281.4139.5191.0282.4575.6314.2

708.8224.0170.9692.4865.3556.0845.6

127.7

234.4113.0505.8149.8254.8168.6

16.8248.6

154.6

218.33.6

501.8253.9301.6

10.998.7

111.0

92,5126,5390.8

26.80,0

394.411.5

0.017.0

278.316.0

0,0

380,7111.8

21.80.0

221.2

17.2103,1

331,837.9

118.0

119.022.8

23’6.4

98.243.946.127.844.5

1.00.4

37.6

170.145.2

100.0513.0106.2

60.021.983.1

39.147,734.098.051.1

100.04.1

144.543.5

59.254.6

100.052.3

0.077.811.3

0.04.2

41.95.50.0

291.925.916.8

0.062.0

7.040.2

117,927.261.842.1

4.074.913,919.627.0

4.0

5.10.20.0

8,780

121189

441592

12379

137

90

26884499286

15642

253

91101245

826752

115

91259182185

40

17

96102113163145121

14123108

977243

205

8392

2195671

152

56

Table V. Number of examinees and age-sex adjusted proportion of examinees with skin pathology, skin conditions of concern(comcdaints), and their ratio, by dermatologist examiner and sex of exam inee: Health and Nutrition Examination Survey, 1971-1974~Con.

Examiner number

52 .................................. ...........................................................................................53 ............. ...... .. ............ ...... .... ............ .................. .................... ...... .................... ......

55 ........ ........ ........ ...... .................... ................ ...... .................. .. ...... .................... .......56 ................ .............. ........ ............ .. .............. ...... ............ .. .... ........ ...... ...... ........ .......57 .........." .... ........ ...... .................... .. .... .. .................... .................... .................... .......58 ...... .. ...... .. ...... ........ ........ ...... ...... .. .... ................ .......... .. .. ...... .................. ...............59 ................ ........ ........ .... .. ...... ............ ............................ .........................................60 ........ ...... .......... ...... ........ .............. .............. ...... .................. ........ .................. .. .......61 ...................... .........o...... ............ ...........................................................................62 ........................ ...... ................................... ............................................................63 ................................................................. ............................................................64 .................................................. ...... .............. ........................................................65 ...................................... .......................................................................................66 .................................................. .......................... .................................................67 ....... ...................................................................... ................................................68 .............................................................................................................................69 ............................................................................................................. ................70 ...................... ...... ................ .......................... ............ ...................... .............. .......71 ............................................................................. .............. .................. ................72 .................................. ...........................................................................................73 ...................... ............ .................................................................... ........ ...... .........74 ...................... ......u..... ..............e............................................................................75 .............................. .............. .................................................................................76 ...................... ....................................................................................... ........ ........77 ................................... ........ ...... ............ .............. ................................. ......... .......78 .............................. .............. ................................ .......................................... .......79 .................................. .......... ...... .......................... .......................................... .......80 ............................................ ................................................ ................. ................81 .............. .................................... ...........................................................................82 .............................................................................................................................83 ........ .................... ...... ...................... .............. ...... .............. .. ............ ........ .............84 ............ ........ ........ ........ .............. ...... ........ ............ ............................ ........ .... .. .......

86... !........o. ........ ...............o....................!................................o.....o...........................87 ................ ........ ...... ...... .. ............ ....0..!.................. ............................ ........ .............88 ................ ................ .................. .................... ............................ ............ ...............

90 ................................ .................. ..........................4... ............ .................... ...........0.91 .... ...... .. ...... ...... .............. ............................ ...........................................................

93 .................. ................................................ ................................ ...........................94 .. .......................................... .............. ........ ........ ...... .............................................95 .... ...... .. ...... ...... ...................... ........ ...... ............ ...... .. ...... ...... ...... .................... .......

97 ...... ...... ...... .. .. .................. ...... ...... .. ...... ...... ...... .......................... .. .............. ...........99 .. .. ...... .. ............ .. ....n. .............. .............. ...... ...... .. ............ ............ .............. ...... .. .....100 ....... .. .................... .. ...... ............ .............. ...... ........ .................... ........ ..................101 .......... ...... .. ............ .. ...... .....!.... .......... .................................................................lo2 .................... .... .. ...... ......! .....o..... .............. ........ ............ .......................... ............ .104 ......... ............................ ...... ...................... ................................ ..........................lo5 .......... ...... .......... ........................ ........ ...... ...... .......... .... ........ ........ .... ...... .. .... .. .....

ISignifi- Skin

cant com-skin plaints

pathol- by theOgy examinee

355.6213.8368.2

19.9149.0730.0200.6705.4486.9

97.2548.2518.3136.0882.5538.9509.8279.7

94.859.3

230.7449.6417.9216.2648.3514.6416.7142.6519.3199.6235.3

51.0473.7528.2685.6266.3

41.6455.1

336,8224.9”412,7

75,8175.0525.1110.5194.4180.4666.0

58.2213.0453.0

Ratio–IOOX complaints/sig-

nificantskin

pathology


94.4684.3

11.6172.6?22.9422.6119.634.1

132.5530.4

30.3286.6583.8690.8

37.445.9

154.3175.960.053.9

193.96.60.0

130.8138.461.895.7

0.00.0

48.0728.444.211.518.6

59.929.7

339.0449.6103.4314.0390.5

98.8

533.2307.9805.6268.2

33.485.3

392.2414.8

..-192.4

5.446.9

617.6283.6

16.417.018.8

108.931.252.3

112.6507.9

4.28.5

30.362.963.390.984.0

1.50.0

60.521.312.023.0

0,00.0

24.0309.6

88.72.43.5

22.571.474.5-..

30.7139.684.6

130,3

101.5278.6414.4148.7

5.0146.6164.191.6

Numberof

exam inees

2832354252174755

10517392769

580

164112

5947

11562

23390

171698140

1502425

73782462828

13240

862554360

1194423

23589

1062177

57

Table V. Number of exam inees and age-sex adjusted proportion of exam inees with skin pathology, skin conditions of concern

(complaints), and their ratio, by dermatologist examiner and sex of examinee: Health and Nutrition Examination Survey, 1971-1974–Con.

Examiner number

All examiners .. .... .. .. .. .. .. .. .. .. .. .... .. .. .. .... ..... . .. .. .. .. .. .. .. .. .. .. . .. .. .. .. .. .... .. .. .. .. .. ..

Sign ifi- SkinRatio–

100 X comcant com -

plaints/sig-Number

skin plaintsn if icant

ofpathol - by the

skinexam inees

09Y examineepathology

I I I

Rate per 1,000 females

286.6

65.4156.9214.0

51.2129.2120.1

98.6246.4327.6443,6

35.5236.0376.3103.0241.0125.6135.1125.6188.5304.4

47.0

68.1359.9111.8366.9363.7502,9196,4

571.6212.6315,6

69.155.9

276.4

288.8222.8

173.4221.9

80.4114.3230.8460.6

218.4

636.6258.6245.2829.2467.9736.3

100.3

62.263.5

210.4224.4146.3110.7

57.9192.0

156,4200.8

19.5268.3166.8113.1

83.3148.4

80.847.9

124.6302.4

91.30.0

401.04,40.03.6

199.814.0

0.0220.1

94.515.5

0.0163.8

37.530,1

119.025.484.688.3

54.4

64.190.6

55.039.040.3

8.0i6,7

4.8

35.0

95.140.598.3

438.3113.2

92.258.777.947.745.354.9

113.744.3

109.834.6

118.259.838.166.199.3

194.30.0

111.43.90.01.0

39.77.10,0

103.529,922.4

0.059.3

13.013.568.611 “.4

105.277.323.613.941.5

8.615.116.4

1.03.60.7

11,858

153249

4716

129180

95175

93361134

70125128

214

56385125165307

999364

132138344245232

3526

145156128241

183156

27161143137

10446

295

134123262

8395

205

58

Table V. Number of examinees and age-sex adjusted proportion of examinees with skin pathO109Y, skin conditions Of concern(complaints), and their ratio, by dermatologist examiner and sex of examinee: Health and Nutrition Examination Survey, 1971-1974–Con.

Examiner number

52 ....... ........................ ........ ................ ............ .......... .......................... .. ....................53 ....................... .......... .......................................... ...... .. .......................... .. ..............54 ....................... ................................................................................ ......................55 ........................................ .............. ............ ........ .................... ........ ...... .................56 ...................... .. ........ ........ ...... .................... ........ .................................... ...... .........57 ............ .................................................................................. .. .................... .........58 .... .........................................................................................................................59 .............. ...... ................ .. ............................ ...........................................................60 ................ ...... .. ...... ........ .. ...... .................................... ..........................C......... .......61 .............. ............................... ................................................................................62 ............ ................................ .................................................................................63 .................................................... ........ .............. ...................................................64 .............................................................................................................................65 .................. ............................ ...............................................................................66 .............................................................................................................................67 ...........s...... ...........................................................................................................68 .......................%................. ....................................................................................69 ............................................................. ................................................................70 ....... ................ ......................................................................................................71 .....................................!..................................................................t ....................72 .............................................................................................................................73 ....................................... ......................................................................................74 ......... ........ ........ .............................. .............. .. .... .. ...... ...... ........ ............................75 .................................................................... .. .......................................................76 ......................................... . ..................................................................................77 ................................. ........W........................ .. .............. ........ ..................................78 ....................... ..................A.................. .............. ...... ...................... ...... ................79 ....... ................ ................ .............. ...... .............. ....................................................80 ............................................................ .................................................................81 .............................. ...............................................................................................82 .............................................................................................................................83 .............. .................................... ................ ................................................ ......4....84 ........................ .............. .......................................................................................85 .............................................................................................................................86 ............................ ........................................................... ......................................87 ............. .............................. .............................................!...... ..............................

............. ...................................... ........ ............ ........ ........ ...... ................................; ....... ........s............. .......................................... ........................................... ...........90# ...................!... o.........o..s...... ...................................... ..... ......................................9192:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::93 ................................... ..........................................................................................94 ,!!,.............,, ,,, .,.0.!,............................................... ................ .................................95 ...........!.... ................................,.,....,,,,..,., .............................................................96 ................................................,.., ... ..!,,.... ............ .................................... .............97 ... ., !.......................................................... .............................................................99 ............................................................................ .................................................100 ......................................................................................... ..................................101 .#........ ...... ...... ..?................................... .............. ...... [email protected] .................s.........................................................................................................lw ....................o!..o.m.......... ......................................................................................105 .......................................................... .................................................................

Signifi-cantskin

pathol-ogy

Skincom-

plaintsby the

examinee

Ratio–100X complaints/sig-

nificantskin

pathology

Numberof

examinees

173.6587.4262.8

88.953.9

153.9699.3138.1751.0619.6272.5416.6396.8

18.7900.2447.3218.7295.3139.380.1

230.4411.7229.6245.2628.1269.6347.4

98.8655.7

64.2563.3111.3442.4541.4504.5222.2

84.2293.2

344:1195.6512.8

12.471.6

450.8364.7222.5248.0541.3

37.5625.1539.0

Rate per 1,000 famales

0.0587.5

18.157.236.8

313.06.9

11.3151.5253.6189.4209.0371.2827.4

21.826.1

111.1139.898.252.6

241.22.7

14.3229.8196.9130.9214.2

0.028.4

0.0563.3260.4

32.6

122.8109.734,5

233.0440.4246.2258.4

88.344.1

384.5490,5777.5195.6

22.135.5

181.1476.7

0.0100.0

6.964.368.3

203.41.08.2

20.240.969.550.293.5

4,424.62.45.8

50.847.370.565.7

104.70.76.29.4

31.348.661.7

0.05.10.0

100.0234.0

7.4

24.349.441,079.5

71.5132.1

17.23.6

85.3134.5349.4

78.94.1

84.729.088.4

3948586064228485

121234028

1044

129162141

7782

16581

347122223

88113

70212

37311552

113673340

1835415957061

1171426427

241

1211283089

...,.,,?=.

59

APPENDIX II

THE DERMATOLOGY EXAMINATION FORM

r > . .

HE AL THAN DNu TRIT I ON EXAMINATIONS URVEYDE RMATO LO GY EXAM IN AT ION

151Deck No.(USE RED PENCIL TO FILL FORM)

NAME (Last, First, Middle) “SAMPZENUMBER EXAMINER NO.

I

STATE OR FOREIGN COUNTRY OF LONGESTRESIDENCE

——. —— __ mOCCUPATIONAL EXPOSURE la Yes

m——=2R No EX=URE TO LIGHT

IF YES: (CHECK ALL THAT APPLY) ~ (by history)

~ In Chemicalq f.me$or vapors ~ lU Immersion (hands or feet)~ In Oils ~ la Other(SPECIFY)

In Unimpressive

~ 10 Insecticides

2D Moderate

3Q Considerable

SIGNIFICANTDESMATOLOGICAL DIAGNOSIS FROM THIS EXAMINATIONClinical Impression Code Biopsy

1.~ Cm 1 Done l~Refusesl—.-— ——— Not done+ 2mn

2.~ ;U Done ~ 10 Ref.sed

2U Not done+ 2mOther reason

3.ma 10 Done mla Refused—-—— —— 2m Not done+ 2n Other reason

FINDINGS RELATING TO NUTRITION

.,, ,SIGNIFICANT DERMATOLOGICAL DIAGNOSIS MADE PKEVIOUSL~ PHOTOGRAPHY OF SKIN: Frame No.NOW SUPPRESSED OR IN REMISSION Lesion diagnosis code ~

Code Certain~

Probable Doubtful

1. a ~=.—.—. — !lQL ~ 1 J 2 3n

:.~d----GENERAL APPEARANCE (1 - 3)

~Age at firstgraying years--1. Jipircolor (Natural)

(CHECK 1 BOX)

m%’ ::; 4:: ~

- ,. ..

03cj04/g05Q06D07008D09010U----

Whi~e - I

Medium to ii~h~ ~r~;__ _ _ _Chestnut or auburnRed (titian, carro~,-e;c~)- --Dark blonde

---- .

Light blond; -------- -

Previous HairColor if Grayor Whi

Black ---- --- ---- __ 04mDark b;o-m. ----- ___ 05m

n ,--- 06C]07C1- —-08c]

----- -— p~~

----- -——~ vu

te

---- ----- ----- _____ ____ ___ - -- -.CHECK “YES OR ‘NO“ FOR EACH

Dyed, tinted or bleached? ~ llZ Yes2C] No---------------------------------------

Flag signs?~-irJ.y:;-.--.-.

2r] No

2. Eye Color -(CHECK 1 BOX)

la Dark brown SD Dark blue20 Light brown 6D Light blue3D Gray,green, 7U Mismatch

hazel 8a Other(SPECIF$40 Speckled

---- ____ ____ ____ ____ ____ _

Nevus of Iris - (CHECK 1 Box)

m ;~ M;:t

3n Both

m 2 “-12’(?age 1)7-W

.Iumllii-l I 2rl I 3U,

3. Skin TextureSurface 10 NO FINDINGS

~ ~U Coarse 2U Fine~ ~D-5ii~------ZB-E;:5 miE;EG5”-E;EG--”~ ~u-i;:sE--..------...--. ---------------

---------------------------------,--------.

m Dry 1n Senile 20 Winter30 Both Lo Atopic Ury

Complexion

Skin ColorCodeAbdomen ~ _ _

Foream ~,---------

~-i~-iiorid 2~-~;Iz~&’ ------—----- --—

-----------------------------------------------~ la Erythematous

2U Sallow

Form Approvedo .M.B. NO. 68-R1184

60

4. PIGMENT ABERRATIONSItems 4-6+ ~ 10 NO FINDINGS (GO TO ITEM 7)

1vpe I Impression

DE51m

ma

la Melanin general-hyper

I

-------------- -----.-- -------------.---=---

la Melanin ~eneral-hypo------.------- -------- ---------------------

In Melanin general-cosmetically disfiguring

---------- ---------------- . ------- ------------ I IMelanin localized

In Facela Bodyla Extremities-- ------------------------------------.......

~o Melanin localized - hyper

I?E~U--fi;i&::-i:& ii;;:d-:-&p; ----------------lU--fi; i;:l;-i:::ii;;~-:6;~;1;;iij-~1 ;Zifi;1

~~ Sen~lg-dgp-ig~egt~tion_. ---- -— --- ---- -—.Icterus‘--------:EZZXE-------------------”-----------------------------------

Q --;~n Tatoo - arlu--?i;;;-:-i;aumatic20 Tatoo - traumatic - cosmetically disfig.

In Addison’s disease-------------------------------------------.-

In Albinism - Total2n Albinism - Partial--------------------------------.----.-------

:D Pella~oid pigmentation------ ------- --------------------------In Vitiligo - Total~U Vitili&o - Partial------: ----------------------------------~u Peat Inflammatory------,.--------- ~F$Fzij----------------Iu Chronically illiU-W&:-W%c~FYj-------------------------

Significant Trau- Surgi- *oth HerbieScars matic cal ZosterHypertrophic lU 2U 3U 4UAtrophic lU 2U 3U 4UKeloids ll_J 21.._l 31-I 4U

Senile Lentigenes ~ 10 Many (10+)------------ -------------------------- ---------- -.----

EphiIidee ~ ~ 10 Many (10+)

6. Vascular

—VASCULAR CHANGSS OTHRR TNAN NBVI (7 - 10)ITEMs 7-10-+@ I&l NO FINDINGS @-Tc)~T&KL~ ~--g-..----.---..-.-------.---..------....--.....--.L---

---‘-‘~~~~1 ~-~~fiM%Oti- -------7. . VASCUL4R CHANGES OTNSR THAN NSVI

Source (CHSCK ONE) Location (CHECK ONE)~ 10 Observed UIQ 11=1 Hands

~ 10 Furpura-senile ~ :U Coldness---------Other purpura(CHECK ONE) ~ ~B Qanosis

2D BY history 20 Feet ~ In Traumatic-. ------

~ In Sdema3~ Both 3U Both 21=1 Med. induced

-------------

DurationSdema, chronic

3D Dis. related ~ lU Persistent

—— years f+m Idiopathic 20 RecurrentSD Etiology obscure ~ lD-~;;~;-----

mermorstaHSM 425-12 (Page 2)7-72

Form ApprovedO.M.B. No. 68-R1184

61

9. ACTINIC DAMAGE j

Minimal

! ~

Moderate Severe

Overall impression 123 In 2 3Fine telangiectasia 124 In 2 3r-Senile Elaetoais 125 lU ~ 3q-1Actinic keratoses .126 lU 2 3

10. OTHER TELANGIECTASIA

Location

Face ~ lr~ ExtremitiesScalp and neckFace, scalp,and neck

Weber Osler RondouPeat irradiationSclerodactyly

2[3 Trunk3D Trunk and

extremities

~ in Idiopathicfamilial

~ 10 Poikiloderrnavasculareatrophicans

~ ID Other(SP13CI-

lQ_—._.——

Family history

~ la Mother 20 Father 30 Both~ 10 Paternal 2m Paternal 3D Both

male female~ In Maternal 2U Maternal 3m Both

male female

12. NEOPLASTIC CWANGE~ lm NO FINDINGS (GO TO ITEM 13)

‘- mSuperficial BCE--------Squamous Ce11 Carcinoma- - 6

l!=%

Bowen’s disease__ _ _ - - 67 IILymphoma, leukemia_ _ _ _ . 70 1U1Metastatic__ _ _ _ _ . 73 1[

L MISCELLANEOUS LESIONS OF COLOR AND TEXTO’RE~ 10 NO FINDINGS(GO TO Few Many

ITEM 12) d5 5+

Clams (feet) ---------------- ~ In inSeborrheic keratoses

Face and scalp 141 In 2n---------------Back and cheat---.----------- 142 la znNasolabial or otherbody folda 143 10-------------------Papuloaa nigra---------------- 144 10 gEpithelial tags--------------- 145 lUNeurofibromata --------------- 146 IU [1Dermatofibromata 147 1u-------------- +Epidermal Levi----------------K lrl _Warts-hands ------------------.% m 2Warts-feet--------------------150 lrl 2[

Warts-genital---------------m-351 In !2

Warta-other(SPECIFY) 152 1[-J 2n

Tophi------------------------- 153 lUXanthomta -------------------- 154 lu _ –+Acanthosis nigracanS---------- 155 lULichen atriatus 156 lU 21-1

I

—1I

~

II

I

II

(LrLipoma----- m—_Ganglioma-..~Sebaceoua

—

Size of lirgeat‘-->9, codeto 9)

——cm.cm.

ademoma___ ~ cm.Benign neo-plasm ofaweat glandsand ducts cm.Other fib;;:

j mt..--_-.~ cm.

ECTODERML APPENDAGES13. Ectodermal glands ~ ~ lU NO FINDINGS (GO TO ITEM 14)

EccrineLocati“,x

Activity Forehead I Hands IFeet

Marked ---- la

Minimal- --k .7, !

-----------

Dishydrotic. I /\ U, r-l W,rl I--- 1/ -4 .L , I *A4J

1[_l AnhydrotidApocrine (Poat pubertal)Mammary gland developmen~ Fox Fordyce diseasela Absent !3D Marked ~1~ Axillary m la2a Deficient ~ 10 Para-areolarSebaceous glands:Sebum production ~ 1 n Increaaedi;:iG:i:;-:;;EG-7i::~ -i-U-Z-L--------? -D-:5 -?---

Genital

La;gest ~ cm. (9 or > code to 9)Location of cysts :~ ~ lU Chest ~ 10 Face

mm In Back lD Other(SPECIFY)+

HSM 425-12 (Page 3)7-72

Form ApprovedO.M,B. No. 68-R1184

62

14. NAILS - ~ ~ 1D NO FINDINGS (GO TO ITEM 15)

Fingernails (TOTAL NIJMBSR) ~ _ _

Abnormsliti.es(RECORD NUMBER OF NAILS INVOLVED. IF LESS THAN ~ PRECEDE

Color m— — whit’; ~ ye;::: m91_Quality — — soft;Contour

——~~ Raised; ~ ~~dd

Surface — — Ridged; .—Other ~] Thickened; ~ Clubbed

Complete absence of nails, not traumatic ~ 10B●nds White,cross;~~ pigmented 10ng—.

NUMBER WITH ())

_ Green, brown or black

Clinical impression of abnormalities noted above:

~ 1U Fungus ~ In Trauma @ lU Alopecia areata

~ la Lichen plan.a ~ la Nevus ~~ 1U Psoriasis

~ In Other (SpECIFY)-----------------------------------------------------------------------------------------------------------

Toenails

Abnormalities~ In Thickened ~ la Discolored ~ la Pigmented bands

Clinical impression of abnormalities noted above:

~ lU Fungus ~ 10 Psoriasis ~ 1[~ Nevw7~ 1U Trauma ~ la Other (SPECIFY)

15. HAIR —> ~ la NO FINDINGS

~: Alopecia Min. Mod . SevereMalePattern--- m lrl 2n 30

>Localized m lrl 2n 30

Diffuse-- m lrl 21-I 3n

Impressionof etiology

~ 1n Areata ~ 10 Infection

H la Anti meta- ~ 10 Traumabolites

~ 10 POstcli- ~ la Familialmacteric

Texture:~ lC]Fj.ne 2CI COarseUZZl lUDry staring Za Easily plucked 30 Both

,Eyebrows:~ lnSparse 2U Absent

Evelashes:~ laSParse 20 Absent

Facial Hair (post pubertal)

Males~ luSparse 2U Absent

Females >

~ l~cessive 1

~ 10 Alopecia @ In GeneticallyAreata determined

~ In Post infec- ~ la Post traumation

~ la Endocrine ~ 1n Other(SPECI-FY)

Axillar~~ lnsparae 2H Absent

Pubic~ l[~Sparse 2~ Absent (not shaved)

Body Weir

m 10 Inappropriate -xutch-n

Location ‘None Minimal Marked Excessive

Anterior ThoraxPosterior Thora~~ 262 1Arms

..........

H;M7$?5-12 (Page 4) Form Approved. O.M.B. No. 68-R1184

63

REGIONAL EXAMINATION

16. H?L4DAND NECK

m la NO FINDINGS (GO TO ITEM 17)

‘% Scalin$. .ZQ-.EEY!L%E---?-Q--!?!!. 7 --------- --

-Impressions:—l.@ la Seborrheic dermatitis~ In TraumaLLu j In Psoriasis~ 10 Other

Q-=@-lz:=:d !.:~=t!!kt,!w?&Family Histor

EarsDeform~~ 10 Acquired 2a Congenital@ la Chondodermatitia helicis nod.laris

Nose

Deform~~ la Acquired Zu Congenital (saddle, etc.)

Mouth BuccaObserv= LiPs lf.ucos Gingiv Tongue

Fissuring-------Pigmented les. 30Leukoplakia ‘------Lichen PlanusTumor---Angularscars -,Cheilosis------- 132011r

L?!2.8w (-t’,. ) General ma-wzlossiaMal developed generally~ In Forked ~ la Partial atrophy 20 Fu11 atrophyPapillae

~ 10 AtrOphic ~ 10 Geographic 30 PyramidalZn Black hairy 4n Scrotal

Palate~ In Smok=s 2~Glandular hypertrophy ~ ;~ .kr;h~d

(non-smokers)----------

Color30 Bc}th

= lU Beefy red Za MagentaOther findings:~81 In Serrations 2U Swelling(marginal 3[Z Bc,th

(marginal bilateral) bilateral)

18. THIGHS AND BUTTOCKS~1 la NO FINDINGS (Go To ITEM 19)

[~ ~D Veno.a stars~ l~-F1i;il~;i-Zj; i;:d’li~i:-------

20 Pilonidal cysts-drainage3D Pilonidal cysts-no drainageAU Pilonidal cysts-repaired

~ l~-~~~~~i-~~~~; i;---------------Za Rectal fissure and ulceration~a Both

~ lU-Y;;;;:Gi:E:Si-E:; ::i:---’-----

l& G~o

E3?a 10203U

~ lU

I 3ii Both4U Uncertain

2(?. EXTREMITIES~] la NO FINDINGS(W TO ITEM 21)

NO FINDINGS (GO TO ITEM 20)Chancre

IRedness and scaling due to:

Other VD ~ l~PosriasisBoth 2a Seborrheic derma-

titisUlcers CQiKl itg-&&~:a:----A----

1 2D Parasites

ClubbingacquiredClubbing------familial------Deformity,acquired------Deformity,familial------

----------------’.---- ‘----------------------- k-----

Varicoaities bin. jMod. ISeverRight 13581 1C112CI 30Left-~z4 13591I lrllzcl I 3LI

----------------------------------- -------- --------N3 color Peri-’foll.

Follicular hyperkeratosis change redness

Upper-outer arm 36~ 1n 2CI---------

Rest of upper extrem. m m 2D---

Entire arm m In 2rl-------.------

Upper-outer legs m 1c1 2Kl--------

Rest of lower extrem---- m ~ 20

Entire leg m 1n 20--------------

Upper back ---- ------ =~ la 2L

Abdotnen_ -- _ ..- -,--- .m . la 2U

Buttocks----- - ._.- _ -- .= 13.CI 2m-:,

,17, THORAX AND ABDOMEN —m la NO FINDINGS(GO% ITEM 18)Supernumerary areolaeL.= number with glandular tissue

lJ.31J number yithout glandular tissueGynecomastia:----------~=Minimal

F

Etiolo2~Marked 10 Medication

2~ Liver dysfunction3m Both

Striae:- --.------------~ lEI purple ~ 1n White~ In Draining fistulae or other lesions

= lD Pigmented

m Congenital malformationsHSM 425-12 (Page 5) Form Approved7-72 O.M.’B.No. 6B-R1184

64

DISEASE ORIENTE D EXAMINATION

[3691 1[ 1 NO DISEASE [(ITE?JB21-31) SKIP TO EVALUATION ON NEXT PAGE-]

21. ACNE VULGARIS 26. cent.’d Cause of Urticaria (CIDICKALL TK4T APPLY)

~ lU Inactive

b~’

Min. I Mod. ISever =~~U-F~od ~n Inhalant

20 Active.:.--:---

711 11 JI 2EI 3 m 1~ fi~dzcat.on m lD-56;:G;:-:;-: EF:;-------------------------- ---------------------------------

A.-o ..Vct.(SPECIFY)

--s-tlx! 2 UL.%’2’LL’L?----------------------IQ Plt scarrln~------ ------------IQ ~stic scarring-------- --- ------------ ----------------------------

Extent of acne

.=~ 1 -Face

II!27. CONTACT DERMATITIS (CHSCK ALL THAT APPLY)~ la Plant ~ In Rubber~ 10 Medication ~ la Leather~ la Chemical ~ In Cosmetics~ 10 Metal ~ 10 Obscure

in Fabrics.-

22. SECONDARY ACNE (CHECK ONE)~ lD Steriod

11----30 Anovulatory p]

2U Halogen tions .--------

4Cl Oil------------------------------------------------------ Feet

L

~---------ACNE ROSACSAla Minimal 30 Severe Hands 1’0 2CI11[ 1

Irepara+

w

SEBORRHEIC DERMATITIS (CHBCK ALL THAT APPLY)

Culture taken for Candida? ~ la Yes 2UN0 Feet: ~~ ;= ~jj------~-u--Gii;Ei-;Eifi24. PSORIASIS

4[--~--=-----------

~ lU Inactive

—--:--r.-::------:.

2D Active ~F---------------------- --------------------------------11=

~ Combination

Severnanas: WJ LQ Nal L crimi---------

IL]I 22~ Glabrous skin

m -~ Groin

Il@ 1 -m;----------------------------------------Location

~ 10 Scalp only ~~ 10 Trunk2U Extremities only 2r2 SebOrrheic 11— .–

Viral Vesi/12’.‘lM:lNFE::~@xcE~wARTs)

: Diagnostic Impression

3a Both areas only W 11-J H. Simplex 3U M. Contagiosum

3~ Both 2D H. Zoster 4D Primary Varicella------------------------------------------------------. --------------------------------- ---------------

Tzanck smear

-II Description/Severity I

Family History Furuncles ~

~ la Parent 20 Sibs 30Parents and sibs Min. Ii-l In

~ i~-~~~~-;;l;~~;; ;--------------------------- Mod . 20 2n------------------------------------------------------- Severe >1 J 5( II SI J15

Did joint problem precede psoriasis? Folliculitis M mlwy

~ lU Yes 2U No Min. la lm ‘m ‘Mod.

25. ATOPIC DERMATITIS20 2nl .q

Severe r “- ‘ --Severity Impetigo

~ la Minimal 2Q Moderate 3U Severe Min. 1r] InDistribution

Mod. 20 20

H la Flex.ral areas only TBC2U Flexural areas and other(SPECIFY) Min.

3U GeneralizedMod . 2Severe 31 1 I-1,

Family History Hansen’s rh-1[ml

EEH ElAto~ Disease Min. lrl 11--I

.-=.----‘~;~icarla and?~~-~;~~;------------ Mod . 2m 2m,-4-----------------------------------------Severe 3 31--I 31_J JI

Personal History Swim. Pool

~ la Urticaria and/or asthma Gran. Min. 1Mod . 2

26. URTICARIA (CHRCK ALL THAT APPLY)

Joint Involved~ ~D Fi.~ers 2U Toes

~ in Positive 2D Negative 3n Not done30 Both~ ~n.~;in:---------------------------- on BACTERIAL INFECTIONS

m Ln-6iR6i-I:IiE7EFEEiH j---------------------------------- --------------------------

~ ~U Cholin&gic ~ lnAn@o-ne”roticede !=@19~nczi;;--- ‘--- IIEEmiCl&.lZ---------------mt3E3lnb;~ifi;;~-;;;icaria----------------- --------------------------------------

IlD Yes

ARTKROPOD AND PROTOZOAN INFECTIONS~ l~%rimmer ‘a itch

~ lCIMites~ la Leiahmaniaais

] la Pedic.losis capitis ~] 10 Pediculosis pubis ~

Q la Pediculosis corporis ~. _

IJ= 1~ _ __.._.——–Creeping eruption IRSM 425-12 (Page 6)7-72

Form ApprovedCJ.M.B. No. 68-R1184

65

EVALUATIONOFD ERMATOLOGICAL COMPLAINT

w 10 NO CONDITIONS (END OF EKAM)

LOCATIONI

-—I OTHER(SPECIFY

EvALuATION HAND FOOT

filO~’-l

EVALUATION148.sl

32. Diagnostic Code— ———-— —- —-- - .——. -

Recurrent? 4L9Ql ruul 11 D Yes 1 D Yes 1 mYe2DN0 2 m No 2 No

IF YES-Monthsactive in past 12months

.— ._ ~s X

m TOTALSKIN

Years duration--.--.- .—— —— —— COMPLAINTw] XL2.1

Percent limitationof activity----------

33. Handicap to Gain-ful Employment orHousework w wTotal 10----------- In

Part-severe Zn 2[7----- / 2rl !21-J

Part-minimal 3r] 30----- 30 3~

None 4n----------------------------------

Precludes prefeoccupation

‘--”’+

lUYes

34. Handicap to SocialRelations

UIJ u MSevere Ir] 1rl---------- in In

Minimal Zr--l Zn--------- 2[~ z~

None 3U 3-rl------------ or] 3J-1

35. Care So”~htiCHECKALL THAT APPLY)

m11 I

Pharmacy---------

M.D.-------------

Fodiatrist ------

Osteopath--------

Dermatologist----

36. Presently UnderCurrent Best Care

-----------------IF NO:With expertarea. Woulcicondition

be improved?--------- -----------

b. Would conditionpermit Full Gain-

7.

3.

?..

b.

Disfigurement(examiner eval.)

Hand m

Foot m

Other m

SEVERITY

‘w

lr-1 21--J 3r-J 41-1

lr) Zrl 3n 4CI

In 2rl 3n L

Discomfort(Patient evaluation )

Fain orBurning-

Hand

Foot

Other

Itching

Hand

Foot

Other

c. Limitation ofMotion-

Hand

Foot

Other

d. overallDiscomfort

Hand

Foot

Other

9. OBSTACLE TO IMPROVEMENT OF CONDITION (CHECK ALL

TH4T APPLY)

= lo NO medical advice sowht~D Inadequate medical ad;ice.- -----..-.-7----------------l~Pattent cooperation1E

- - ‘iiiEiGGi-??ii-iiZZEii-GGi;”--------- ~------- ----.------- ~~ Availablllty of transportation~u-FIi:&;----------------------lrY-6E&---------- ”-----”--”-----

Emp. or W In in !------ 1[1 IPart. Emp. or I-W Zn Zn 1 2nNo change 3r-1 i 3n 3n I

I-------

HSM 425 12 (Page 7)

?-72Form ApprovedO.M.B. NO. 68-R1184

66

APPENDIX Ill

SKIN PATHOLOGY CLASSIFICATION

AND GLOSSARY OF SELECTED TERMS

Classification

Inclusions in the groupings of conditionsfrom the Code of Skin Diseases of the Depart-ment of Dermatology, New York UniversitySchool of Medicine (February 1968 edition)8as used in this report are as follows:

NYUCodes

020-029

030-039050-059

070-074

080-096

096

100-108

120-130

131

Condition

Syphilis-Congenital, Early, Late,Latent, and Unqualified

Other Venereal DiseasesBacterial Diseases–Scarlet Fever,

Erysipelas, Diphtheria, Meningo-coccal Infection, Plague, Tula-remia

Spriochetal Diseases (excludingsyphilis)

Diseases due to Viruses-SmalI-pox, Rubeola, Rubella, ChickenPox, VariceIla, Herpes Zoster,Trachoma, Herpes Simplex, Footand Mouth Disease, etc.

Herpes Simplex, Foot and MouthDisease, etc.

Rickettsial Diseases – Typhus,Rocky Mountain Spotted Fever,Q Fever, etc.

Leishmaniasis and other ParasiticDiseases–including Trypanoso-miasis, Toxoplasinosis, Trichino-sis, Pin Worm, etc.

Dermatophytoses–including Ath-lete’s Foot, Tinea Pedis, TineaManuum, Tinea Capitis, TlneaBarbae, Tinea Unguium, Onycho-

NOTE: A list of references follows the text.

13100-

1312--

13131-

131910

132-134

135-137

138

19X19X0

19X1

19X14X

mycosis, Paronychia, Tinea Cru-ris, Tinea Corporis, Favus, Tri-chophytids, Tines Versicolor,Tinea Nigra Palmaria, etc. (ex-chding Monilial)

Dermatophytoses of Foot, Ath-lete’s Foot, Tinea Pedis (ex-cluding Nails)

Dermatophytoses of Nails, TineaUnguium, Onychia due to Der-matophytes, Onychomycosis, Par-onychia (excluding Bacterial andMonilial)

Dermatophytoses-Crura.I, TineaCruris (excluding Monilial andErythrasma)

Tinea Versicolor, Pityriasis Versi-color

Deep Fungus Infections-Actino-mycosis, Coccidioidomycosis,Blastomycosis, Paracoccidiomy-cosis, Histoplasmosis, Cryptococ-cosis, Nocardiosis, Moniliasis,(Candidiasis), etc.

Zoonoses – including Scabies,Mites, Pedictdosis, Chiggers, TickBites, etc.

Sarcoidosis and other Infectiveand Parasitic Diseases

MaIignant TumorsMalignant Tumors–Bowen’s Dis-

ease, Erythroplasia, Paget’s Dis-ease (Breast and Extra-Mam-mary)

Malignant Tumors–FibroepithelialTumor, Basal-Ceil Epithelioma

Malignant Tumors–Basal-Ceil Epi-thelioma, Nodtdo-Ulcerative orSolid

67

19X18X

19X2

19X6

19X8

19X9

19XX

20X22x

22X44X22X95923X

23X08123Y242-243

244

245

Malignant Tumors–Basal-Cell Epi-thelioma, NOS

Malignant Tumors – Base-Squa-mous Epithelioma, Base-Squa-mous Carcinoma, IntermediaryMetatypical Epitheliorna or Car-cinoma, Mixed Metatypical Epi-thelioma or Carcinoma, Prickle-Cell Epithelioma and Basal-CellEpithelioma, and IntraepidermalEpithelioma

Malignant Tumors–Malignant M,el-anoma, Lentigomaligna

Malignant Tumors–Squamous-CellCarcinoma

Malignant Tumors–Adenocantho-ma, Adenocarcinoma, CutaneousMetastasis, Fibrosarcoma, Neuro-sarcoma, etc.

Malignant Tumors–on Skin NOSor NEC

Lymphomas and LeukemiasBenign Tumors–including Nevus:,

Hemangioma, Cafe au Lait Spot,,etc. (excludes 22X44X–Seborrheic Keratosis )

Seborrheic Keratosis, NOS or NECBenign Tumors–LipomaPrecancels–including Actinic Ker-

atosis, Burn (X-ray), Senile Kera.tosis, etc.

Actinic KeratosisTumor–Malignancy not statedUrticaria-including Angioneurotic

Edema, Nettle Rash, LichenUrticatus, Telangiectasia Macu-Iaris Eruptiva Perstans, Masto-cystosis, Hives

Allergic Eczema or Dermatitis dueto extermd agent–Eczema, Aller-gic Eczema, Drug Eruption,,“Auto-immune Syndrome,” Der-matitis Medicamentosa

Other Allergic Disorders–AllergicConjunctivitis, Allergic Disordersof Skin

—NOTE: NOS = not otherwise specified; NEC = not

elsewhere classi~lable.

250-254

260270-277

280-286

288-289

290-293

294-299

320-324

360-369

370-389

390-398

400-402

450-456

460-466

467468

Diseases of Thyroid Gland–Thy-rotoxicosis, Myxedema, Cretin-ism

Diabetes MellitusOther Endocrine Disorders–Pan-

creatic Disorders, Acromegaly,Gigantism, Hyperthyroidism,Dwarfism, Addison’s Disease,Cushing’s Syndrome, etc.

Avitaminosis and Nutritional De-ficiency States–including Beri-beri, Pellagra, Scurvy, Rickets,Alopecia, Vitamin Deficiencies,etc.

Lipoidoses and Other MetabolicDiseases–including Gout, Xan-thelasma, etc.

Anemias-including Pernicious,Iron-Deficiency, SickIe-Cell, etc.

Other Blood Dyscrasias–iricludingPolycythemia, Hemophilia, Pur- ,pura, etc.

Psychophysiologic, Mental Psycho-Neurotic, and Personality Dis-orders

Diseases of Nerve-including Bell’sPalsy, Erythredema Polyneurot-ica, Meralgia Paresthetic,

Diseases of Eye–including Con-junctivitis (nonallergic), Blephari-,tis, Sty(e), Chalazion, E@ropion,Entropion, Ptosis, etc.

Disease of Ear–includir~g OtitisExterna, Chondrodermatitis Nod-ularis Chronica Helicus

Rheumatic Fever–with or’ withoutHeart Involvement

Diseases of Arteries and Connec-tive Tissue—including Gangrene,Arterial Embolism, ArterialThrombosis, Lupus Erythemato-sus, Vasculitis, etc.

Diseases of Veins–includihg StatisUlcer or Dermatitis, VaricoseVeins, Hemorrhoids, Phlebitis,etc.

Other Diseases of Circula~ory Sys-tem–including Osler-Weber’s Dis-ease, Telangiectasis (h&editaryor NEC), Lymphedema, etc.

68

530-587

600-637

690-698

696030

700700010

701701000701010701030703

704

705

706

706090707

708708300708310

708320

709710

Diseases of the Digestive System–Buccal Cavity, Salivary GIands,Lips, Anus, Pancreas

Diseases of the Breast and Genito-Urinary System

Infections of the Skin and Subcu-taneous Tissue–including Boils,Carbuncles, Cellulitis, Impetigo,Infectious Warts, and other localinfections

Infectious Warts-Verruca Vulgaris(includes Periungua.1)

Seborrheic DermatitisSeborrheic Dermatitis, NOS or

NECEczemaHand Eczema or DermatitisNummular EczemaDyshidrotic EczemaOther Dermatitides – including

Contact Dermatitis due to Plants,Oils and Grease, Solvents, Drugs,other Chemicals, Radiation, Cos-metic, other Agents (such asDyes, Furs, C1othes, Dress, WOOI,Clothing Finishes, Shoes, Leather,Rubber), DDT, Pyrethrum, Paint,Varnish, Cement, PhotographicAgents, Wood, etc.

Pemphigus, Erythema PerstansGroup, Dermatitis Herpetiforrnis

Erythemas–including Toxic Ery-thema, Erythema Simplex, AcneRosacea, Rhinophyma, etc.

Psoriasis including Parapsoriasisand other and unspecified typesof Pityriasis

Psoriasis (all types, NOS or NEC)Lichen Planus and some other

Lichenoid DermatosesPruritus and related conditionsInfantile Atopic DermatitisNeurodermatitis Disseminate and

Atopic Dermatitis, NOS or NECLichen Simplex Chronicus, Cir-

cumscribed NeurodermatitisCorns and CallositiesOther Hypertrophic and Atrophic

Conditions of the Skin-includingScleroderma, Elastosis Seni.lis,etc.

710130710150712

713

713908714

7141-7149

714150714180714190714930715716

716210740-744

751-759766-780

781-795

850-999

Glossary

IchthyosisKeratosis PilarisDiseases of Nails-including In-

growing Nail, Hangnails, Discolor-ations, etc.

Diseasesof Hair and Hair Follicles–including Alopecia, Folliculitis,Dull Hair, etc.

FolliculitisDiseases of Sweat

Sebaceous GlandsDiseases invohing

GlandsAcne VulgarisAcne. Cvstic

Glands and

Sebaceous

Acne: S&rs or NOS or NECXerosisChronic Ulcers of SkinDiseases of Skin, NEC–including

Acne Scaring, Chickenpox Scar-ring, Smallpox Scarring, Cicatrix,Tattoo, Freckle, etc.

Vitiligo, Albinism, PiebaldismDiseases of Bones and Organs of

Movement–including Bunion,Tenosynovitis, Dupuytren’s Con-tracture

Congenital MalformationCertain Diseases of Early Infancy–

including Ritter’s Disease, Sclero-derma Neonatorum, ImpetigoNeonatorum, etc.

Symptoms, Senility and Ill-DefinedConditions

hjuries and Adverse Effects ofChemical and Other ExternalCauses

For those who are not familiar with the der-matological terminology in the tables and ex-amination form a glossary is included to identifyand explain certain clinical observations. Forfi.u-therclarification and discussion, the reader isreferred to a standard text of dermatology;three are cited:

MoscheIla, S. L., Pillsbury, D. M., and Hurley,H. J., Jr.: Dermatology, Vol. 2. Philadelphia.W. B. Saunders, Nov. 1975.

69

Fitzpatrick, T. B., et al.: Dermatology in Gerz-eral Medicine, New York. McGraw-Hill, 1971.

Rook, A., Wilkinson, D. S., and Ebling, F. J. G.:Textbook of Dermatology, 2d ed. Oxford andEdinburgh. BlackweU Scientific Publications,1968.

A canthosis niqicans. —A warty velvetychange in the skin of the axillae, groin, andabout the neck that can be associated withobesity, endocrine disturbances, and in adultswith visceral malignancy.

A ctinic keratosis. –Adherent yellow to brownscale on a red-tinged base associated with solar

da*age) a Pre*~iwancY of the epiderfis.Addison’s disease. *Primary adrenal cortical

insufficiency. It can have secondary hyper-pigmentation in the skin from an outpouring ofpituitary hormones responding to the adrenalcortical failure,

Albinism. –The result of an inherited failureof the melanocyte to produce normal amountsof pigment in the skin, or eye, or both. Partialalbinism (piebaldism), an autosomal dominanttrait, involves only the skin and hair. All formsof albinism are present from birth.

Apocrine glands. –Developmentally associ-ated with hair and sebaceous glands, theyatrophy during fetal Iife but persist in the axillaeand genital area to secrete at puberty an oily,colorless, odorless substance that undergoesbacterial decomposition to produce body odor.

A topic dermatitis. –An inflammatory con-dition of the skin characterized by itching, red-ness, and occasionally vesiculation and weeping,that is found in individuals with the inheriteddiathesis called atopy. The patient may presentone or several manifestations of the atopic statesuch as hay fever, allergic rhinitis, asthma, andurticaria or hives.

Basal-cell epithelioma. –An epithelial car-cinoma arising in the basal cells of the surfaceepidermis. It may be further characterized assuperficial eryth,ematous or nodular, and may bepigmented or not.

Bowen’s disease. -A precancerous dermatosispresenting as a defined brownish-red plaquewithout eIevated border single or multiple,which may have an historical association witharsenic ingestion.

Callus. –Hyperkeratosis of the epidermis ad-jacent to thinner skin and the apparent rdspcmseto constant rubbing or pressure. A corn is similarbut has a sharply demarcated translucetit core.Neither lesion is vascularized.

Candida. –A yeast genus of which the speciesAlbicans is the most common pathogen for man.It infects the mucous membranes of mouth andvagina most commonly but also body foIds andcan be widespread in the immune deficientpatient.

Dermatofibromata. –Firm circumscribed .papules of a half centimeter or so, in the skin,usually on legs and often hyperpigmented. Theymay represent a cellular reaction to injury.

Dermatophytosis. –Infection of the skinwith fungus.

Eccrine glands. –Sweat glands that produceand transport to the skin surface a hypotonic,clear, odor-free solution (eccrine sweat) in re-sponse to heat or psychological factors.

Eczema.–See eczematous dermatitis, ~Eczematotis dermatitis. -Not a condition but

an inflammatory resptmse of the skin to a num-ber of stimuli from within and without, ~Poisonivy can produce a characteristic weeping derma-titis that is eczematous, so too can surdight incertain sensitive individuals, Ingested dtiugs, aswell as the patient’s own host response to asuperficial infection as with fungus, can evokea similar eruption. Because atopic dermatitisin children is often eczematous, it has been com-monly called “eczema” with consequent cowfusion of the reaction pattern with the disease.“Atopic dermatitis. “ “ is the term to be preferredand shouId designate the active atopic conditionwhether in adults or children.

Ephelides. –Freckles, those circumscribedtan-brown macules scattered over Iight-qxposedskin.

Epithelial tags, –Hyperplasia of the skin re-sulting in soft polypoid lesions less than a cen-timeter in diameter that are skin colored andmultiple around neck, upper chest, and innersurface of the arms.

Herpes simplex. –A virus that inddces aninfection characterized by small vesicles on a redbase (fever blisters or “cold sores”) anld recur-rence. It can occur on head or neck, in the gen-ital area, over the buttocks, and more rarely onthe extremities.

70

Ich.thyosis. –Accumulation of polygomd scalethat gives a fishlike appearance to the skin. Itmay be congenital or acquired and in its suddenappearance can be associated with occult malig-nancy.

Lichen planus. –A papuIosquamous eruptionof violaceous polygonal lesions and character-istic histology that is often pruritic, can last 1 to2 years, and is of obscure etiology.

Lichen striatus. –A self-limiting Iinear derma-titis of unknown etiology that appears inflam-matory and occurs more often in children.

Moniliasis. –Infection with Candida.Mycosis fungoides. –A chronic fatal disease,

a T-cell Iymphoma of the reticuloendothelialsystem, initially invoIving the skin, with a namedescriptive of the large fungating lesions that canoccur and should not impIy fungal infection.The disease can be limited to the skin, but mayalso involve lymph nodes and viscera.

Neurofibromata. –An overgrowth ofSchwann cells and endoneuria that resuIts in asmooth soft to firm skin-colored papule that canbe inva~nated. In size they can range from a fewmillimeters to several centimeters in diameter.These lesions are found in large numbers inneurofibromatosis (Von Recklinghausen’s dis-ease).

Nevus. –The Latin for birthmark, is usedmost commonly for the clinical evidence ofaggregates of normal melanocytes or pigmentcells in the skin. In color they range from tan,brown to black, in size from millimeters to anentire trunk (giant hairy nevus). By histologicallevel of mektnocytes, they are divided into (1) ajunctional nevus that histologically has aII themelanocytes above the basement membrane,(2) a dermal nevus with all melanocytes in thedermis, and (3) a compound nevus with melano-cytes in the dermis and epidermis.

Onychomycosis. –A fungous infection of thenails.

Papulosa nigra. –The hyperpigmented sebor-rheic keratoses of the more pigmented racesoccurring usually on the face.

Pityriasis versicolor. –See tinea versicolor.Psort”asis.–An inherited disease of the skin

characterized by circumscribed red scalingpatches with silvery scale that may be few innumber or may extend to involve the skintotalI y. It can be associated with arthritis.

Seborrheic dermatitis. –A persistent erythe-matous, scaling dermatitis, more greasy thandry, that involves the scaJp, eyebrows, anteriorchest, and the areas about the nose and behindthe ears. It can be extremeIy bard as in miIddandruff or proceed to generalized redness andscaIing.

Seborrheic keratoses. –Raised, greasy, wartylesions that appear tacked on, vary in pigmentcontent from pale yellow to black, and in sizefrom a millimeter to centimeters in diameter.They are found mostIy on the trunk or face butmay appear on the extremities.

Senile keratosis. –See actinic keratosis.Squamous-cell carcinoma. –A tumor of the

epidermis which in its invasive form has all thecharacteristics of malignancy including theability to metastasize, but which usually has amore beni~ course when arising on sun-exposedskin.

Sweat glands. –hlay be eccrine or apocrine(see both).

Telangz”ectasia. –Dilated superficial vesselsthat appear as coarse or fine vascular threadson the skin. They can be a response to solardamage and are characteristic of the lesions ofcertain dermatological diagnoses.

Tinea. –A superficial infection with fungus.The term is usually further modified by ana-tomical site: T. capitis, of the scalp; T. corporis,of the body; T. pedis, of the foot; T. manuum,of the hand; T. umguium, of the nail; T. cruris,of the groin.

Tines nigra palmart”a. -A superficial fungousinfection of the palms leaving residual pig-mented macules seen largely in tropical climates.

Tinea versicolor. –A superficial fungous in-fection of the skin with Malassezia furfur.

Tophi. –Subcutaneous, firm to hard nodulesof a salmon-pink color that occur most com-monly on the helix of the ear, over the bursaeof the elbow, and about the digits of the handsand feet. They consist of urate deposits fromelevated uric acid levels of the blood and areseen in gout.

Trichoph ytids. –A generalized or Iocalizedskin reaction in individuals allergic to the fun-gus, Trz”chophyton.

Tumors. –Cellular aggregates that are clin-ically apparent in the skin.

Urticarib. -Hives or wheals.

Verruca. –Warts are epidermal responses tothe human papilloma virus that appear on theskin as circumscribe ed elevated, rough-surfacedpapules (verruca vulgaris or common warts);as threadlike polypoid growths (verruca fili.-formis, the filiform or digitate wart); as ia

smooth flat or slightly elevated skin-coloredor gray-yellow papule (verruca plana, the plane

wart); on the sole of the foot as a horny papule,

(verruca plantaris or plantar wart); in the genitaIarea as the venereally transmitted pink, elong-ated, occasionally filiform or peduncuIated

warts (cond ylomata acuminata or acuminatewarts).

Vitiligo. –A spontaneous loss of pigmentwith disappearance of the melanin-producingcells of the hair bulbs, skin, and mucous mem-branes but not other parts of the me~anocytesystem such as those in the eyes and brain.It is probably an inherited defect and is morecommonly found in those with diseasq associ-ated with autoimmune mechanisms, perniciousanemia, hyperth yroidism, Addison’s disease, andidiopathic hypoparathyroidism.

Xanthomata. –Erythematous papules with ayellow cast that appear singly or diffusely andare associated with abnormal concentrations orcomposition of pIasma lipids.

Xerosk -Dry skin.

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Series 1.

Series 2.

Series 3.

Sem”es4.

Series 10.

Series 11.

VITAL AND HEALTH STATISTICS Series

Programs and Collection Pro cedures. –Reports which describe the general programs of the NationalCenter for Health Statistics and its offices and divisions and data collection methods used and includedefinitions and other material necessary for understanding the data.

Data Evaluation and Methods Research. –Studies of new statistical methodology including experi-mental tests of new survey methods, studies of vital statistics collection methods, new analyticaltechniques, objective evaluations of reliability of collected data, and contributions to statistical theory.

Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and healthstatistics, carrying the analysis further than the expository types of reports in the other series.

Documents and Committee Reports. –Final reports of major committees concerned with vital andhealth statistics and documents such as recommended model vital registration laws and revised birthand death certificates.

Data Fro m the Health Interview Suroey. –Statistics on illness, accidental injuries, disability, use ofhospital, medical, dental, and other services, and other health-related topics, all based on data collectedin a continuing national household interview survey.

Data From the Health Examination Survey and the Health and Nutrition Examination Survey. –Datafrom direct examination, testing, and measurement of national samples of the civilian noninstitu-tionalized population provide the basis for two types of reports: (1) estimates of the medically definedprevalence of specific diseases in the United States and the distributions of the population with respectto physical, physiological, and psychological characteristics and (2) analysis of relationships among the. .various measurements without reference to an explicit finite universe of persons.

Series 12. Data From the Institutionalized Population Surveys. –Discontinued effective 1975. Future reports fromthese surveys will be in Series 13.

Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilitiesproviding long-term care, ambulatory care, hospital care, and family planning services.

Series 14. Data on Health Resources: Manpower and Facilities. –Statistics on the numbers, geographic distri-bution, and characteristics of health resources including physicians, dentists, nurses, other healthoccupations, hospitals, nursing homes, and outpatient facilities.

Series 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthlyreports. Specizd analyses by cause of death, age, and other demographic variables; geographic and timeseries analyses; and statistics on characteristics of deaths not available from the vital records based onsample surveys of those records.

Series 21. Data on Natality, Marriage, and Divorce. –Various statistics on natality, marriage, and divorce otherthan as included in regular annual or monthly reports. Special analyses by demographic variables;geographic and time series analyses; studies of fertility; and statistics on characteristics of births notavailable from the vital records based on sample surveys of those records.

Series 22. Data From the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reportsfrom these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Series 23. Data From the National Survey of Family Growth. –Statistics on fertility, family formation and dis-solution, family planning, and related maternal and infant health topics derived from a biennial surveyof a nationwide probability sample of ever-married women 15-44 years of age.

For a list of titles of reports published in these series, write to: Scientific and Technical Information BranchNational Center for Health StatisticsPublic Health ServiceHyattsville, Md. 20782