Impact of environmental changes on Dermatology

Abstract

Urbanization, pollution and the modification of natural landscapes are characteristics of modern society, where the change in human relations with the environment and the impact on biodiversity are environmental determinants that affect the health-disease relationship. The skin is an organ that has a strong interface with the environment and, therefore, the prevalence patterns of dermatoses may reflect these environmental changes. In this article, aspects related to deforestation, fires, urbanization, large-scale agriculture, extensive livestock farming, pollution and climatic changes are discussed regarding their influence on the epidemiology of skin diseases. It is important that dermatologists be aware of their social responsibility in order to promote sustainable practices in their community, in addition to identifying the impacts of environmental imbalances on different dermatoses, which is essential for the prevention and treatment of these diseases.

Keywords: Climatic variations; Environment; Pollution; Radiation; Sustainability; Urbanization.

Figure 1

American cutaneous leishmaniasis. Facial ulcer, with an erythematous, infiltrated border and granular bottom; in a farmer from the Tietê river valley.

Figure 2

Fogo selvagem or endemic pemphigus foliaceus. Extensive exulcerations with hematic crusts on the back in a young resident of the Tietê river valley.

Figure 3

(A), Erythema chronicum migrans as the early manifestation of borreliosis-like illness. (B), Remission of clinical picture after treatment with doxycycline (Kindly provided by Prof. Sinésio Talhari).

Figure 4

Freshwater stingrays (Potamotrygon sp.) associated with severe accidents with bathers and fishermen at the Paraná River basin. Detail of the serrated stinger. Skin lesions due to stingray accidents: lower-limb ulcers on an extensive livedoid base (< 72 h) that develops into necrosis and eschar (> 7 days).

Figure 5

River resort (municipality of Adolfo-SP, 21°09'56"S, 49°43'03"W) at a reservoir area of the Tietê River. Accidents due to piranha attacks on bathers: punched-out ulcers in the foot. Details of the adult animal and the triangular teeth (Serrasalmus maculatus).

Figure 6

Chloracne. Farmer from the Tietê river valley with extensive papulopustular eruption with comedones. He reports unprotected handling of pesticides containing hexachlorobenzene (banned from use in Brazil in the 1980s). Three other family members were affected.

Figure 7

Non planned urbanization process in an indigenous village in the upper Solimões region, state of Amazonas (Kindly provided by Prof. Sinésio Talhari).

Figure 8

Pediculus humanus capitis. Causal agent of pediculosis of the scalp, endemic in large urban agglomerations.

Figure 9

Skin ulcer with necrotic eschar formation derived from an accident caused by a spider of the genus Loxosceles (>96 h). Example of an adult brown spider (Loxosceles sp.).

Figure 10

Temporal series (1960 to 2019) of monthly temperature averages (A and B) and relative humidity (C and D) in the municipalities of São Paulo-SP and São Simão-SP. (Source: INMET).

Figure 11

Cutaneous-lymphatic sporotrichosis, ulcer on the left hand dorsum, accompanied by ascending nodular lymphangitis in a young adult male who “adopted” an infected street animal. Picture detail showing the cat with an ulcer on the nose, a characteristic representation of feline sporotrichosis.