After a trip: the souvenirs in the skin

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Dermatoses are one of the most common reason for medical consultation after returning from a trip. The first consideration to take into account is that the spectrum of skin diseases that affect immigrants, long term travelers and expatriates may be different than those suffering from other travelers.

According to two large scale international studies performed by the GeoSentinel Surveillance Network involved 17,353 and 25,500 ill returned traveler encounters respectively at globally dispersed travel or tropical medicine clinics, between 1996 and 2006, the dermatosis were the third reason for consultation in frequency, after fever and diarrhoeal illness, and represented 17-18% of all diagnoses.

Independently of these studies and other series, dermatoses are likely to have higher incidence because they often resolve spontaneously or sometimes the patients require medical assistance outside the Travel medicine or Tropical disease units which have conducted the most research on these topics.

In assessing dermatoses in travelers, it is important to consider some factors such as the geographical destination visited,places visited en route, length of stay, purpose of travel and activities.

Dermatoses can be noninfectious and infectious/infestation, which can be cosmopolitan or from tropical origin.

The most common diagnoses are cutaneous larva migrans, soft tissue bacterial infection, arthropod bite, allergic reaction, myiasis, cutaneous leishmaniasis and tungiasis.

It is important to remember that skin lesions may be manifestations of systemic infectious diseases such as dengue rash, Chicungunya viruses, rickettsial infection, or non-infectious diseases such as those related to previous medical history, drug allergies, climate or sea related dermatoses.

Appropriate investigations and consultation with tropical or tavel medicine experts may be needed in order to make the correct diagnosis and provide correct management of these diseases. It is also necessary to emphasize preventive measures related to skin diseases in pre-travel advice.