Springer Science and Business Media LLC

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.

A case diagnosed to have the lesion of pachydermatocele type of Recklinghausen's disease in a 28-year-old female was studied mainly by means of fluorescence method (Falck and Hillarp). Histopathological examination revealed that the lesion was composed of Ota's nevus-like changes in the epidermis to the middermis and of proliferation of neurofibromatous tissues coexisting with melanin-producing cells in the lower dermis to the subcutaneous adipose tissue. Melanin-producing cells in the neurofibromatous lesion were shown by fluorescence method to have characteristics of nevus cells rather than of melanocytes. Innervation of monoaminergic and cholinergic nerves was not found to the arteries in neurofibromas. These findings are thought to suggest that the abnormalities of not only Schwannian cells and melanocytes of neural crest origin but also of nevus cells and autonomous nerves of neural crest origin are related with the pathogenesis of pachydermatocele type of Recklinghausen's disease.