| Abstract|| |
Background: The Andaman and Nicobar Islands are a group of islands to the east of the Indian mainland. The Nicobar district in its southern part includes the Nancowry group. Very little is known about the dermatoses in this remote region and hence, this study was carried out at a community medical camp held in Kamorta on November 12, 2014. Aims: To study the pattern of dermatoses in Nicobarese attending a community medical camp at Nancowry.Subjects and Methods: All Nicobarese, predominantly mongoloid, attending a multi-specialty community medical camp at Kamorta on November 12, 2014, were initially seen by a general practitioner. Persons with dermatologic complaints or the presence of skin lesions were then seen by a single dermatologist. Results: A total of 375 patients were seen. Out of these, 113 cases (30.13%) had a skin disorder. Females comprised 50.44% and males 49.56% of the cases. The mean age was 21.28 years. The most common dermatoses were infections and infestations comprising 53 cases (46.9%) of which fungal infections were seen in 25 cases (22.12%), pyodermas in 12 cases (10.62%), scabies in 9 cases (7.96%), warts in 4 cases (3.54%), 1 case each of molluscum contagiosum, herpes zoster, and pediculosis capitis (0.88%) followed by eczema in 20 cases (17.70%), acne in 13 cases (11.5%), papular urticaria in 9 cases (7.96%), and psoriasis in 3 cases (2.65%). Miscellaneous dermatoses made up the rest of the 15 cases (13.27%). Conclusion: The pattern of dermatoses seen among the Nicobarese is quite similar with respect to the prevalence of infections in other regions of India, especially humid regions such as Assam, coastal Karnataka, and Kolkata and much higher than arid regions such as the deserts of Rajasthan.
Keywords: Andaman and Nicobar, dermatoses, Nancowry, Nicobarese
|How to cite this article:|
Subramaniyan R. Pattern of dermatoses among nicobarese in a community health camp at Nancowry, Andaman and Nicobar Islands. Indian J Dermatol 2016;61:187-9
|How to cite this URL:|
Subramaniyan R. Pattern of dermatoses among nicobarese in a community health camp at Nancowry, Andaman and Nicobar Islands. Indian J Dermatol [serial online] 2016 [cited 2017 Apr 28];61:187-9. Available from: http://www.e-ijd.org/text.asp?2016/61/2/187/177766
What was known?
The pattern of dermatoses in various parts of the Indian mainland including deserts, coastal areas, and plains is well known. Little is known about the pattern of dermatoses in Andaman and Nicobar Islands, especially Nicobar district.
| Introduction|| |
The Andaman and Nicobar Islands are situated approximately one thousand kilometers to the east of the Indian mainland. The Nicobar district, an archipelago of islands in the southern part includes the Nancowry group, comprising five inhabitable islands Chowra, Teressa, Nancowry, Kamorta, and Katchal. Kamorta is the largest of the Nancowry group of islands and is its administrative headquarters. The entry to these islands is prohibited for outsiders who require a special permit to enter. Nicobarese belong to the mongoloid race are coast dwellers, in the vicinity of tropical forests. The primary occupation of the tribal population is agriculture, which is basically limited to coconut, areca nut, and banana plantations. They still maintain their traditional way of life though their lifestyle is in a state of rapid transition due to frequent exposure to modern amenities. Due to the requirement of trade, business, and infrastructure development in the region, a small percentage of other ethnic groups from the Indian mainland are also present. The climate is moist with heavy rainfall and extremely high relative humidity throughout the year, being responsible for many of the skin disorders in the region. Very little is known about the pattern of dermatoses in this remote region. Hence, the pattern of dermatoses in the population attending a multi-specialty community medical camp organized in Kamorta for the local populace and for those from neighboring islands was studied and is discussed in this article.
| Subjects and Methods|| |
This was a cross-sectional study. All natives of Nancowry group of islands, predominantly mongoloid reporting to a multi-specialty community medical camp held at the community health center, Kamorta, on November 12, 2014, were initially seen by a general practitioner. Any person with dermatologic complaints or presence of skin lesions even if asymptomatic was referred to the dermatologist for evaluation. All dermatologic cases were seen by a single dermatologist.
| Results|| |
A total of 375 patients were seen in the medical camp and out of these, 113 patients (30.13%) had a skin disorder and were seen by the dermatologist. Fifty-seven patients were females (50.44%) and 56 were males (49.56%). The patients seen ranged in age from 2 months to 60 years with a mean age of 21.28 years and a median age of 17 years. The most common dermatoses seen were infections and infestations comprising 53 cases (46.9%) out of which superficial fungal infections in 25 cases (22.12%) was the most common, followed by pyodermas in 12 cases (10.62%), scabies in 9 cases (7.96%), warts in 4 cases (3.54%), 1 case each of molluscum contagiosum, herpes zoster, and pediculosis capitis (0.88%). Eczema was seen in 20 cases (17.70%), acne in 13 cases (11.5%), papular urticaria in 9 cases and psoriasis in 3 cases (2.65%).
Superficial fungal infections included dermatophytosis in 15 cases (13.27%) and pityriasis versicolor in 10 cases (8.85%). Bacterial infections comprised impetigo in five cases (4.42%) and folliculitis in seven cases (6.19%). Miscellaneous dermatoses made up the rest of the 15 cases (13.27%). These included two cases each of miliaria rubra, polymorphic light eruption, urticaria, and palmoplantar keratoderma (1.77% each), one case each of alopecia areata, androgenetic alopecia, telogen effluvium, dermatosis papulosa nigra, callosities, achrochordon, and Schamberg's disease (0.88% each). The common dermatoses seen in this study are summarized in [Table 1].
| Discussion|| |
The most common group of dermatoses seen was infections and infestations comprising 53 cases (46.9%). The breakup of various infections in this study is given in [Table 2]. Studies in other populations showed the prevalence of infections to be 53.18% in Bundelkhand, 41.9% in the North Eastern state of Assam, 42.68% in Bantwal, a coastal area in Karnataka, 41.2% in Pune, 39.54% in Kolkata, 34.1% in the Kashmir valley, and 21.6% in the deserts of Rajasthan. The striking similarity of the incidence of infections in Nicobar islands, Assam, and coastal area of Karnataka could be attributed to the similar climatic conditions of high humidity and moderately high temperatures in all these regions. The predominant infection in this study was superficial fungal infections, comprising 22.12% of all dermatoses (nearly 50% of infections), very similar to the incidence of fungal infections in Assam, coastal area of Karnataka, Pune, and Kashmir.
Superficial fungal infections were the commonest infection in this study, seen in 22.12%. This incidence was similar to that observed in coastal Karnataka having similar climatic conditions (24.08%), a little higher than the incidence of fungal infections in Pune (15.1%), Kashmir (13.84%), and Kolkata (11.12%) and much higher than the incidence of fungal infections in Rajasthan (8.3%) which can be explained by the dry arid climatic conditions in the deserts in contrast to the warm, humid climate in Nicobar. In this study, bacterial infections were seen in 10.62%, which was a little higher than that observed in coastal Karnataka (7.25%) and Kolkata (7.7%) but much higher than in Pune (6.1%) and Rajasthan (4.6%), which can be explained by similar climatic conditions in Nicobar, coastal Karnataka and Kolkata as compared to the dry arid conditions in Rajasthan. Scabies was the most common infestation in this study, seen in 7.96% of the cases, again similar to the study in coastal Karnataka (9.44%), but much higher than the deserts of Rajasthan (1.7%) and lower than in Kolkata. The lower incidence of scabies in Rajasthan could be attributed to a sparse population in the deserts and no overcrowding.
Out of the noninfectious dermatoses, eczemas constituted the largest group and were seen in 17.7%. This was also the case in the study in deserts of Rajasthan (28.3%) and coastal area of Karnataka (33.93%) where eczemas were the most common noninfectious dermatoses, but the incidence of eczemas in these studies was higher than in the present study.
The next most common dermatosis was acne vulgaris seen in 11.5%, and its incidence was strikingly similar to that observed in other studies in Rajasthan (10.9%), Kashmir (10%), and Pune (8.7%).
There was no case of pigmentary disorder in this study, unlike the studies in Rajasthan (11.1%), Kashmir (14.18%) and Pune (13.4%). This striking difference could be attributed to the dense foliage in the region reducing sun exposure and the low mean age of the patients seen which was 21.28 years. There was not a single case of sexually transmitted infections (STIs) or leprosy. The low incidence of STIs could be attributed to the small sample size and relative isolation of the region from tourists and travelers due to regulations or an actual low incidence of STIs in Nicobar. The reasons for the low incidence of leprosy could again be the relative isolation of the region from the mainland or actual low prevalence rate of leprosy which is 0.59/10,000 population with 28 registered cases in the whole of Andaman and Nicobar Islands as per the National Leprosy Eradication Programme progress report in March 2015.
| Conclusion|| |
It is felt that the pattern of dermatoses seen among the Nicobarese in the community health camp at Nancowry is quite similar with respect to the prevalence of infections in other regions of India, especially humid regions such as Assam, coastal Karnataka, and Kolkata and much higher than arid regions such as the deserts of Rajasthan. The absence of pigmentary disorders, leprosy, and STIs in the study population could be due to reasons discussed above or the small sample size.
The limitations of the study are the small sample size, the fact that the study population was only the people reporting to the camp and not a house to
house survey which would have given a better picture of the prevalence of dermatoses and the fact that the pattern of dermatoses was assessed on a single day. Nevertheless, since there is a paucity of data on the prevalence of skin disease in Nicobar in literature, this cross-sectional study does give an idea of the pattern of dermatoses in the region. Future studies on a wider population base and pattern of dermatoses throughout the year could bring out more accurate results.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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What is new?
The pattern of dermatoses in Nicobarese at Nancowry, a remote group of islands in Andaman and Nicobar Islands, who are a predominantly mongoloid population was not known earlier and has now been ascertained in this cross-sectional study. The findings are similar to that seen in the humid regions of mainland India.
[Table 1], [Table 2]