Climate change, human migration, and skin disease: is there a link?

Abstract

Climate change, exemplified by higher average global temperatures resulting in more frequent extreme weather events, has the potential to significantly impact human migration patterns and health. The consequences of environmental catastrophes further destabilize regions with pre-existing states of conflict due to social, political, and/or economic unrest. Migrants may carry diseases from their place of origin to their destinations and once there may be susceptible to diseases in which they had not been previously exposed to. Skin diseases are among the most commonly observed health conditions observed in migrant populations. To improve awareness among dermatologists of the burden of skin diseases among migrants, the group searched the English language scientific literature to identify articles linking climate change, migration, and skin disease. Skin diseases associated with human migration fall into three major categories: (i) communicable diseases, (ii) noncommunicable diseases, and (iii) environmentally mediated diseases. Adopting comprehensive global strategies to improve the health of migrants requires urgent attention.

Figure 1

Conceptual framework of the impact of climate change on the skin diseases of migrants and displaced population

Figure 2

Lepromatous leprosy in a 13-year-old male who stayed in Australia for 6 years. He was treated for ichthyosis and atopic dermatitis. Biopsy of enlarged earlobe in the Philippines revealed Hansen’s disease, lepromatous (a). Borderline leprosy with neuritis in a 50-year-old male who worked and stayed in the Middle East for 7 years (b)

Figure 3

Tuberculosis verrucosa cutis on the finger of a 23-year-old health worker (a). Papulonecrotictuberculid in a 25-year-old female with concomitant pulmonary tuberculosis (b). Tender nodules of erythema induratum of Bazin in a 32-year-old female (c). Pruritic widespread flat topped papules of lichen scrofulosorum in a 67-year-old male with pulmonary tuberculosis (d)

Figure 4

Cutaneous leishmaniasis in a 32-year-old male overseas Filipino worker returning from Iraq who presented with “volcaniform” ulcerated nodules and plaques surrounded by small satellite erythematous papules (a). Round to oval basophillic structures (Leishman Donovan bodies) are present in the cytoplasm of macrophages, Giemsa stain ×400 (b)