Skip to main content

Advertisement

SpringerLink
Log in

Dermatologic conditions and risk factors in people experiencing homelessness (PEH): systematic review

  • REVIEW
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Limited data is present that characterizes dermatological conditions and their risk factors in people experiencing homelessness (PEH).We conducted a systematic review to investigate the types of dermatological conditions in PEH, their risk factors, and provide solutions when providing dermatological care to this patient population. We searched PubMed, EMBASE and Cochrane for articles written in English from 2012 to 2022. The last search was performed on December 27, 2022. Twelve studies met the inclusion criteria. Fifty-eight percent of the studies took place in the USA (n = 7) and 42% of studies took place in Canada (n = 5). Prevalent dermatological conditions included, skin cancer, cutaneous manifestations of malnutrition, cutaneous diphtheria, Group A Streptococcus infection (iGAS), lice, atopic dermatitis, acne, sexually transmitted infections (STIs), and Staphylococcus aureus infections. Risk factors included substance use disorder, skin trauma, not having access to sunscreen or hats, unstable housing, higher exposure to extreme weather, and higher mobility. Due to studies being conducted in the USA or Canada, results may not be generalizable. This systematic review strongly suggests that many dermatological conditions prevalent in PEH can be contributed to poor skin integrity. Better measures can significantly reduce certain dermatological conditions by improving access to dermatological care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

PEH:

People experiencing homelessness

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

TH:

Tanya Henry

AK:

Amor Khachemoune

iGAS:

Group A Streptococcus infection

AUD:

Alcohol use disorder

S. aureus :

Staphylococcus aureus

HCV:

Hepatitis C virus

WSI:

Wounds and skin infections

References

  1. Adly M, Woo TE, Traboulsi D, Klassen D, Hardin J (2021) Understanding dermatologic concerns among persons experiencing homelessness: a scoping review and discussion for improved delivery of care. J Cutan Med Surg 25(6):616–626. https://doi.org/10.1177/12034754211004558

    Article  PubMed  PubMed Central  Google Scholar 

  2. Fowler PJ, Hovmand PS, Marcal KE, Das S (2019) Solving homelessness from a complex systems perspective: insights for prevention responses. Annu Rev Public Health 40:465–486. https://doi.org/10.1146/annurev-publhealth-040617-013553

    Article  PubMed  PubMed Central  Google Scholar 

  3. Truong A, Laggis CW, Annis TD et al (2020) Factors associated with follow-up adherence in patients seen at a referral-based dermatology clinic for the homeless. J Am Acad Dermatol 83(2):629–631. https://doi.org/10.1016/j.jaad.2019.09.078

    Article  PubMed  Google Scholar 

  4. Zakaria A, Amerson EH, Kim-Lim P, Fox L, Chang AY (2022) Characterization of dermatological diagnoses among hospitalized patients experiencing homelessness. Clin Exp Dermatol 47(1):117–120. https://doi.org/10.1111/ced.14828

    Article  CAS  PubMed  Google Scholar 

  5. Leibler JH, Liebschutz JM, Keosaian J et al (2019) Homelessness, personal hygiene, and MRSA nasal colonization among persons who inject drugs. J Urban Health 96(5):734–740. https://doi.org/10.1007/s11524-019-00379-9

    Article  PubMed  PubMed Central  Google Scholar 

  6. Athey TBT, Teatero S, Sieswerda LE et al (2016) High incidence of invasive group A streptococcus disease caused by strains of uncommon emm types in Thunder Bay, Ontario. Canada J Clin Microbiol 54(1):83–92. https://doi.org/10.1128/JCM.02201-15

    Article  CAS  PubMed  Google Scholar 

  7. Dohoo C, Stuart R, Finkelstein M, Bradley K, Gournis E (2020) Risk factors associated with group A Streptococcus acquisition in a large, urban homeless shelter outbreak. Can J Public Health 111(1):117–124. https://doi.org/10.17269/s41997-019-00258-5

    Article  PubMed  Google Scholar 

  8. Pilon PA, Savard N, Aho J et al (2019) Invasive group A streptococcal infection outbreaks of typeemm118 in a long-term care facility, and of type emm74 in the homeless population, Montréal. Quebec Can Commun Dis Rep 45(1):26–31. https://doi.org/10.14745/ccdr.v45i01a03

    Article  CAS  PubMed  Google Scholar 

  9. To MJ, Brothers TD, Van Zoost C (2016) Foot conditions among homeless persons: a systematic review. PLoS One. 11(12):e0167463. https://doi.org/10.1371/journal.pone.0167463

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Valenciano SJ, Onukwube J, Spiller MW et al (2021) Invasive Group A streptococcal infections among people who inject drugs and people experiencing homelessness in the United States, 2010–2017. Clin Infect Dis 73(11):e3718–e3726. https://doi.org/10.1093/cid/ciaa787

    Article  PubMed  Google Scholar 

  11. Cahn BA, Bartholomew TS, Patel HP, Pastar I, Tookes HE, Lev-Tov H (2021) Correlates of injection-related wounds and skin infections amongst persons who inject drugs and use a syringe service programme: a single center study. Int Wound J 18(5):701–707. https://doi.org/10.1111/iwj.13572

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bonilla DL, Cole-Porse C, Kjemtrup A, Osikowicz L, Kosoy M (2014) Risk factors for human lice and bartonellosis among the homeless, San Francisco, California, USA. Emerg Infect Dis 20(10):1645–1651. https://doi.org/10.3201/eid2010.131655

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ungureanu L, Apostu AP, Vesa ȘC et al (2022) Impact of the COVID-19 pandemic on melanoma diagnosis in romania-data from two university centers. Int J Environ Res Public Health. 19(22):15129. https://doi.org/10.3390/ijerph192215129

    Article  PubMed  PubMed Central  Google Scholar 

  14. Oldenburg CE, Pinsky BA, Brogdon J, Chen C, Ruder K, Zhong L, Nyatigo F, Cook CA, Hinterwirth A, Lebas E, Redd T, Porco TC, Lietman TM, Arnold BF, Doan T (2021) Effect of oral azithromycin vs placebo on COVID-19 symptoms in outpatients with SARS-CoV-2 infection: a randomized clinical trial. JAMA 326(6):490–498. https://doi.org/10.1001/jama.2021.11517

    Article  CAS  PubMed  Google Scholar 

  15. Coates SJ, Amerson EH, Chang AY (2020) Dermatologic care of persons experiencing homelessness: key concepts in an era of housing instability. JAMA Dermatol 156(9):945–946. https://doi.org/10.1001/jamadermatol.2020.0902

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. College of Medicine, University of Illinois, 1853 W Polk St, Chicago, IL, 60612, USA

    Tanya Henry

  2. Veterans Affairs Medical Center, 800 Poly Pl, Brooklyn, NY, USA

    Amor Khachemoune

  3. Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA

    Amor Khachemoune

Authors
  1. Tanya Henry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amor Khachemoune
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TH and AK: wrote the main manuscript text. All authors reviewed the manuscript.

Corresponding author

Correspondence to Amor Khachemoune.

Ethics declarations

Conflict of interest

None declared.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Henry, T., Khachemoune, A. Dermatologic conditions and risk factors in people experiencing homelessness (PEH): systematic review. Arch Dermatol Res 315, 2795–2803 (2023). https://doi.org/10.1007/s00403-023-02722-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-023-02722-2

Keywords

Search

Navigation