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Abstract

Background

Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress.

Objectives and project description

The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:

To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.

To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.

To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth.

Future impact

With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.

Keywords

sex gender dermatology incidence skin condition

Introduction

Sex and gender have been increasingly recognized as significant risk factors for many diseases, including dermatological conditions. Sex represents the biological differences between males and females and includes anatomical, physiological, endocrine, genetic, and morphological traits.¹ On the other hand, gender (short for gender norms, gender roles, and gender expression) encompasses the sociocultural, psychological, and behavioral differences between men and women, such as self-representation, roles, habits, and activities that are perceived as either masculine or feminine according to society, culture, and/or religion.^1
-3 Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, this creates bias in research data and clinical care as both have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and psychological distress.²

Through gene expression, epigenetic modifications, hormone levels, immune system functioning, and variations in skin anatomy, sex can exert effects on cutaneous disease onset, etiology, and progression in a multitude of ways. Likewise, through variations in lifestyle, diet, stress, environmental/occupational exposures, and socio-cultural behaviors, gender can exert its effects on disease risk, clinical presentation, healthcare access, and treatment compliance. Thus, sex and gender can interplay to mediate substantial effects on patients’ disease at all stages. Sex and Gender Medicine must therefore be recognized as a critical step in improving patient-centered care,² for individuals identifying as transgender, gender fluid, and/or non-binary as well as cisgender individuals.

The specific objectives of this paper are to 1) review the biological differences relevant to dermatology between males and females (sex), as well as the sociocultural differences between men and women (gender); 2) describe and discuss important sex- and gender-related epidemiological and clinical disparities for various skin conditions; and 3) discuss skin diseases in the transgender community.

Terminology

For the purpose of this article, the terms male and female refer to individuals with XY and XX sex chromosomes, respectively, and the terms men and women refer to one’s gender identity, which is defined as the internal experience and knowledge of oneself as a man, woman, non-binary, or as another form of gender identification.^4,5 The terms men and women are also used to discuss gender, which includes sociocultural norms and learnt gender behaviors.^4,5

Part 1 – Underlying Concepts

Sex: Biological Differences

Multiple biological and physiological differences between males and females account for the observed sexual dimorphism in skin diseases. Genetics along with epigenomic modifiers are crucial for XX vs. XY genotype, influencing the hormone milieu and immune function. In Part 1, we will review basic concepts in genetics, hormones, immune system, skin anatomy and function that contribute to these observed differences (Figure 1).

Figure 1

Summary of biological (sex) and sociocultural (gender) factors that differ between men/males andwomen/females

Genetics and epigenetics

The XY or XX chromosomes are functional in all cell types.⁶ The presence of Y chromosome determines male gonadal differentiation and hormone expression, whereas its absence underlies female gonadal differentiation and hormonal milieu. The X chromosome contains many additional autosomal-like genes that contribute to phenotypic differences notably through modulation of immunity and epigenetics.^2,6
-8

The gene expression of sex chromosomes is also modulated by lyonization, imprinting and additional epigenetic modifications explaining heritability concepts beyond the genotype.⁷ Lyonization (i.e., X chromosome inactivation in females) leads to mosaicism and increased genetic heterogeneity in females.^2,6,7,9 This mosaicism becomes visible to dermatologists in female patients heterozygous for an X-linked disease, where the disease phenotype is milder in females compared to males and/or follows a mosaic or patchy distribution (e.g., Incontinentia Pigmenti and Goltz syndromes) ^10,11. Genomic imprinting further influences expression or inactivation of genes depending on which parent it was inherited from.^7,12 Histone modification, noncoding RNAs, and DNA methylation are additional mechanisms behind silencing or activation of sex and autosomal genes’ transcription.¹³ While epigenetic modifications are complex and far from being fully understood, they are influenced by both biological factors (e.g., immunity and hormones) and external influences, which include sociocultural and gender-related factors, whereby sex and gender concepts closely interact with each other.¹³

Hormones

The effect of sex hormones in general health and disease is discussed elsewhere.¹³ Briefly, their influence starts in the embryo affecting morphogenesis and continues throughout life affecting multiple genes, receptors, and the neurochemical axis. The importance of sex hormones during embryogenesis and its clinical implications are summarized in the Supplemental Material.¹³ In dermatology, sex hormones affect both skin homeostasis and immune responses, as receptors for estrogen, progesterone, androgens, and prolactin are generally present on numerous cells of the epidermis, dermis, and innate and adaptive immune systems.^2,6,7,13,14 In particular, estrogens are believed to be activators of the immune response, whereas androgens and progesterone are suppressors. This leads to an overall stronger immune response in females compared to males, as well as a predilection for autoimmunity in females.²

Estrogens prolong the anagen phase of hair growth through increased cell proliferation, increase skin thickness and collagen content, maintain skin moisture, increase sebum production, promote wound healing, and have antioxidant properties.^14

-17 Progesterone exhibits mainly androgen-like effects on the pilosebaceous unit explaining acne flare-ups perimenstrual or with external progesterone contraceptives.^18
-20 Androgens are crucial in the development and maintenance of the pilosebaceous unit, regulation of hair growth, secretion and production of sebum, wound healing, and skin barrier formation.^14,16,21 Local or systemic androgen overproduction may clinically translate into seborrhea, acne/hidradenitis suppurativa, hirsutism, and androgenetic alopecia.^6
-8,21,22 Prolactin promotes keratinocyte proliferation and regulates keratin expression and sebum production. It has inhibitory effects on hair growth, and plays a role in osmoregulation and thermoregulation.²³ Hormonally influenced life events such as puberty, menopause/andropause, and pregnancy or external hormonal replacement therapies influence skin homeostasis and alter the risk of various skin diseases. Further information concerning the effects of estrogen, progesterone and androgens on the immune system is summarized in Supplemental Tables 1-3. Hormonal variation during life events (e.g., puberty, pregnancy, post-partum period, menopause, andropause) and their impact on skin homeostasis is summarized in Supplemental Table 4.

Immune System

In general, the innate, cellular, and humoral immune responses are all heightened in females as discussed above.^6,24 Many pro-inflammatory genes are present on X chromosomes, and therefore have a higher level of expression in females. Antigen presentation and phagocytic activity of innate immune cells are more efficient in females than in males.⁸ There are no differences in total lymphocyte counts between sexes; however, the proportion of T cells and the CD4:CD8 ratio is lower in males.^6,7 Females generate stronger humoral and cellular immune responses to antigens.⁷ Notably, females have higher IgM levels at all ages and produce higher levels of circulating antibodies in response to an antigen or a vaccine.^6,7,25 T-cell differential is also different across sexes. Females have an increased tendency to develop a Th1 response and generate more inflammatory cytokines.²⁶ On the other hand, males produce a stronger Th17 response (which may correlate with more severe psoriasis seen in males, see Part 2) and, over the years, immunosenescence with Th2 skewing is more pronounced in males than in females.^6,27,28 Females’ heightened immunity contributes to their lower risk of infection/cancer, which is hypothesized to provide a survival advantage during the reproductive years but predisposes them to autoimmunity (discussed in Part 2). It has been hypothesized that inactivation of genes involved in immunity by lyonization contributes to this predisposition.^29,30

Skin Anatomy and Function

The epidermis has the same thickness, and the stratum corneum has the same mass, thickness, hydration, and adhesion in both sexes.^8,14 Males carry more organisms on the skin, and there is conflicting evidence with regards to sex differences in total epidermal water loss and skin pH.^8,14,26 Dermal collagen is denser and as a result the dermis is thicker in males; however, whether this translates into clinical importance is unknown.^8,14 Males and females both demonstrate gradual dermal thinning starting in the second and fifth decade, respectively.⁸ The subcutaneous fat is thicker in females.⁸

Males have higher sebum content, especially on the face, as well as overall higher sweat rates than females, which predisposes males to diseases involving sebaceous glands, including seborrheic dermatitis and acne.^8,14,31,32 In terms of cutaneous microvasculature, females have decreased basal blood flow and demonstrate vasodilation in response to local heat at lower temperatures than males do, possibly leading to a lower sweat response in females.¹⁴

Pharmacokinetics

There exists a multitude of ways in which sex may affect an individual’s response to therapeutics.³³ Drug absorption can vary by sex through differences in gastric pH (more acidic in males), varying levels of expression of gastric and intestinal enzymes, and shorter gastrointestinal transit time in males (44.8 hr vs. 91.7 hr) ³³. Drug distribution is influenced by a variety of parameters including plasma volume, body mass index, average organ blood flow, total body water, free plasma protein concentration, and cardiac output which are generally higher in males, as well as body fat, which is higher in females. The larger volume of adipose tissue results in an increased distribution of lipophilic drugs in females.³⁴ There also exists established sex-related differences in drug metabolism as females have higher activity of certain CYP450 enzymes (CYP3A4 and 2D6). Drug elimination can vary by sex as renal blood flow and pulmonary function are increased in males.³³ These parameters are also influenced by age and hormonal life events (e.g., pregnancy and menopause) ^33,35. For topical medications, owing to increased dermal thickness, absorption is decreased in males whereas it is increased in pregnant females due to increased dermal hydration and blood flow.³³

Gender: Sociocultural Differences

At the population level, there are many occupational, environmental, recreational, social, and cultural differences between men and women. Not only are the types and frequency of exposures often different between men and women, but the host’s responses to these exposures also differ and may have an impact on disease severity.⁷ In this section, we will review lifestyle and habits, diet, environmental and occupational exposures, stress levels, and cultural differences between men and women.

Lifestyle and Habits

In 2018, Statistics Canada reported gender differences in several health parameters. Overall, men have a higher frequency of daily cigarette smoking (12.3% vs. 9.4%), e-cigarette use (8.8% vs. 3.3%), marijuana use (9.0% vs. 5.9%), heavy alcohol consumption (23.5% vs. 14.8%), and are less likely to have a regular health care provider (81.6% vs. 88.9%). However, men are more likely to exercise at least 150 minutes per week than women (59.1% vs. 50.2%).^36
-38 These habits have many effects on the integumentary system, as described in Supplemental Table 5.

Diet

Diet and nutritional patterns differ between men and women. Women tend to avoid foods with high fat contents, are more likely to restrict salt and consume more fruits and vegetables. They are more likely to eat when experiencing stress or in group settings, and experience higher levels of frustration based on their diet-related choices.^1,39,40 In contrast, men tend to prefer fattier foods and meats, as well as foods with a stronger taste. Typically, they eat more snacks while watching television, consume more dietary supplements, and eat “fast food” more commonly.^1,41 Overall, men have higher rates of obesity (28.0% vs. 25.6%) which contributes in part to skin disease risk such as psoriasis, intertrigo, etc. (discussed in Part 2).^36
-38

Stress Levels

According to Statistics Canada, 19.1% of men (95% CI 18.3-20.0) and 22.9% of women (95% CI 22.0-23.7%) report that on most days their stress level is ‘quite a bit’ or ‘extreme’.³⁶ In addition, the proportion of individuals that self-reported ‘fair’ or ‘poor’ perceived mental health is 6.7% (95% CI 6.1-7.3%) and 8.6% (95% CI 8.1-9.3%) in men and women, respectively.³⁶ Although multiple biological factors, such as regulation of the hypothalamus-pituitary-adrenal axis, have been reported to contribute to the difference in stress responses observed in men and in women, studies have shown that gender-related factors also play an important if not predominant role.^42
-44 Stress has a significant impact on skin homeostasis, a process that is mediated by the ‘brain-skin’/neurocutaneous axis.⁴⁵ Indeed, high stress levels lead to altered immune function. Acute stress responses lead to immune activation in the skin with increased migration of Langerhans cells to lymph nodes. Clinical translation of this includes exacerbation of chronic spontaneous urticaria (CSU) or de novo onset of alopecia areata (AA) following stress.⁴⁶ In contrast, chronic stress leads to immunosuppression, impaired wound healing, altered barrier function, and lower resistance to infection.⁴⁵ This axis can also contribute to inflammation by causing the release of neuropeptides, neurotrophins, cytokines/lymphokines, and other mediators to the skin.⁴⁷ The impact of stress on the skin is also illustrated by psychocutaneous and neurocutaneous diseases (discussed in Part 2).

Environmental Exposures

Men and women are exposed to different environmental, recreational, and occupational exposures. In terms of occupational exposures and tasks, overall, men report higher exposures to dust, chemical substances, loud noises, welding fumes, herbicides, wood dust, solvents, medical radiation, vibrating tools, and physically demanding work.^48,49 While rare, this may translate into development of some gender-specific occupational dermatoses such as Erasmus syndrome (systemic sclerosis (SSc) seen in men exposed to silica at work). On the other hand, women are more frequently exposed to disinfectants, hair dyes, textile dust, and are more likely to perform repetitive tasks.⁴⁸ One European study found that, at home, women use more household cleaning products, decorative cosmetic products, hair dyes, and more personal care products.⁵⁰ This may lead to different presentations of contact dermatitis among men and women for instance Riehl melanosis being observed more commonly in women (Part 2).⁵¹ The impact of a given exposure on one’s health is determined not only by the substance itself, but also by the body’s absorption and excretion of the substance, which can vary between sexes as explained in Part 1.³ Men also report working more night shifts and irregular hours than women.⁴⁸ Though the pathophysiology has yet to be fully elucidated, shift work has been linked to an increased risk of developing metabolic diseases, including metabolic syndrome and type 2 diabetes.^52,53 It has been hypothesized that disruption of circadian rhythm promotes stress response and consequently a pro-inflammatory state.⁵⁴ Men spend more time outdoors than women.⁸ Indeed, compared to women, men report higher UV exposure, which has immunosuppressive properties, in addition to decreased sun protective behaviors predisposing men to higher rates of skin cancer.⁶

Social and Cultural Differences

At the population level, men and women exhibit significant differences in terms of social practices. Certain theories suggest that gender differences are the result of sociocultural expectations and gender roles, gender socialization, and power differentials within a societal structure.^39,55 In addition, multiple sociocultural factors are believed to play a role in the observed habits and life circumstances that differ between men and women as social groups, including social organization, dietary habits, roles in the households, culture, economic conditions, and education.³⁹ These factors have an impact on men and women’s health, on both a population and individual level, and can vary from one culture to another. For example, some cultures may perceive driving a car or being employed as more masculine behaviors and staying at home or caring for the family as more feminine behaviors.^39,44 Another example illustrating the sociocultural impact on gender-related behaviors are gender-specific hair and nail styles, which vary between cultures.⁸ These various sociocultural differences lead to different exposures between men and women, which could have an impact on the health of individuals.³

Part 2 - Sex and Gender Differences in Dermatological Diseases

In this part, we will present the epidemiological and clinical differences observed between males and females in most commonly seen acquired skin diseases in dermatology. In general, psychocutaneous diseases and conditions where autoimmunity plays a major role (e.g., CSU, rheumatologic-dermatologic conditions, and vesiculobullous disorders) show a female predominance. On the other hand, benign and malignant proliferative dermatoses are more common in males. Similarly, paraneoplastic conditions may be more common in males. Other disease categories, such as papulosquamous, lichenoid and eczematous dermatoses, pigmentary disorders, cutaneous adverse drug reactions, infectious diseases, and hair disorders either show no sex/gender predilection or vary depending on the specific disease within the category (e.g., autoimmune alopecia is more common in females vs. androgenetic alopecia is more common in males) (Figure 2). We will draw upon concepts presented in Part 1 to discuss possible sex/gender -related factors that could explain the observed differences. Because there is a paucity of studies exploring the impact of gender vs. sex in dermatology and the relationship between sex and gender is interconnected and complex, in this section we chose to use the male/female nomenclature regardless of the terms used in the original studies for simplicity.

Figure 2

Proportion of male vs. female cases of skin conditions commonly encountered by dermatologists. Trends may differ for specific subpopulations (e.g., children, elderly). For additional details, please refer to Part 2 of the main text.

Psychocutaneous Diseases

Psychocutaneous disease occurs when skin manifestations are secondary to a primary psychiatric disease and can be divided into delusional, obsessive-compulsive spectrum and related disorders, psychogenic pruritus/pain, factitious, and others.⁵⁶ In general, in adult patients, all psychocutaneous conditions are more common in females, where they represent 55 to 95% of all cases. However, for some conditions, the female-to-male ratio may be equal or reversed in children.⁵⁷ In addition to differences in prevalence, patient’s sex may impact the clinical presentation (e.g., extent, distribution, duration), treatment response, as well as the risk/type of comorbid diseases. Table 1 summarizes sex-related differences for the psychocutaneous diseases commonly seen by dermatologists. However, one should be careful when interpreting existing data in psychodermatology as some rates may be overestimated due to bias towards female patients as they are generally more inclined to seek medical attention and more likely to have their medical complaints mislabeled as psychosomatic.^58,59

Table 1

Sex-Gender Related Differences in Psychodermatology.

Disease	Epidemiology differences	Clinical differences	Ref.
Disorders related to schizophrenia spectrum and other psychotic disorders
Delusion of parasitosis (DP)	Female predominance with F:M ratio of ~2:1; sex differences become more pronounced with age (F:M 3:1 in those over age 50).	Females may have a longer lasting and harder to treat disease.	^139 -142
Obsessive compulsive and related disorders
Trichotillomania (TTM) and body-focused repetitive behavior disorders (BFRBD, e.g. onychotillomania, onychophagia)	Up to 77.3 to 94% of all cases occur in females.	Males have an earlier disease onset, account for more childhood cases and commonly present with many comorbidities. In adult male cases, there is a high risk of substance use. Onset is often in adolescence or adulthood for females. Females experience greater impact and disability from TTM.	^143 -147
Body dysmorphic disorder (BDD)	Female preponderance in the general population. Similar prevalence in the dermatological and cosmetic setting.	Females express concerns about a larger number of body areas and perform more repetitive behaviors associated to their BDD. Higher rates of concurrent eating disorders were reported. Males are more concerned over their general build, hair thinning, and appearance of genitalia. Males have more concurrent substance use disorders and are more likely to be off work due to their BDD.	^148,149
Excoriation disorder (including acné excoriée)	Approximately 55% of cases are female in the general population, but 75 to 90% of cases are female in the student population and in the dermatology setting. Acné excoriée is more common in females (F:M 10:1).	Legs are the most common affected site in males whereas it’s the face (e.g., acné excoriée des jeunes filles) in females. Higher rates of depressive symptoms in females.	^{58,145,150 -154}
Psychogenic pruritus and cutaneous sensory disorders (e.g., burning mouth, chronic idiopathic mucocutaneous pain syndromes)	Female predominance is reported.	N/A	⁵⁶
Somatic and related disorders
Dermatitis artefacta	Over 70% of patients are female with a F:M ratio of 3:1.	Lesion distribution and type differs among sexes with males more likely to report a single ulcer on their leg whereas females are more likely to complain of multiple (often facial) excoriations.	^155 -157
Other primary psychiatric disorders with cutaneous manifestations
Nonsuicidal self-injury (NSSI)	More common in females (F:M 1.5:1).	Females are more likely to choose methods of cutting, scratching, hair pulling and pinching. Males are more likely to choose methods of burning and hitting.	¹⁵⁸
Excessive tanning behavior	Twice more females than males meet criteria for dependence of tanning.	N/A	¹⁵⁹

Abbreviation: N/A, No data available.

Papulosquamous, Lichenoid, and Eczematous Diseases

In general, psoriasis prevalence is similar in both sexes. However, in early onset psoriasis, a slight male preponderance has been suggested (male to female ratio of ~1.2 to 1).^60,61 Disease severity is worse in males, notably male patients are twice as likely to require a systemic treatment^62

-65 and have ~1.5 times higher Psoriasis Area Severity Index (PASI) score for all body sites (except the scalp) than females.⁶⁶ Both sex (e.g., hormonal and immune mediated differences) and gender-related factors (e.g., dietary considerations, sedentarism, smoking, alcohol consumption, prevalence of metabolic diseases) are likely to be important.^67,68 In addition, trends for special-site psoriasis may be at least partially explained by gender-related practices contributing to koebnerization.^69
-71

Atopic dermatitis (AD) affects female and male children equally but is usually more prevalent in the female population as of puberty.^72

-76 This trend is also observed in other atopic conditions such as asthma and allergic rhinitis.⁷⁷ Gender-related factors including grooming, occupational exposures, cosmetics use, wet work, and stress levels may contribute to this trend.⁷⁴

Differences in allergic (ACD) and irritant contact dermatitis (ICD) prevalence between sexes have not been reported. The clinical presentation may however differ by sex. Head and neck dermatitis is 1.5-2 times more common in females^78
-80 likely associated with gender-related practices such as cosmetics and jewellery use.⁸⁰ Unsurprisingly, the contact allergy to nickel and cosmetics is more prevalent in females.^80,81 Occupational contact dermatitis is also 50% more common in females and is associated with high risk (wet work) gender-related occupations such as healthcare workers, housekeepers/cleaners, hairdressers, and kitchen workers such as cooks and bakers.^78,82 Males with contact dermatitis more frequently hold occupations as carpenters, electricians, construction workers, and rubber industry workers.^82,83 Sex and gender differences regarding the epidemiology of other papulosquamous conditions and lichenoid disorders are summarized in Table 2.

Table 2

Epidemiology and Clinical Differences Between Sexes for Papulosquamous, Eczematous, and Lichenoid Dermatoses.

Disease	Epidemiology differences	Clinical differences	Ref.
Papulosquamous diseases
Psoriasis	Equal prevalence except possible male predominance in early-onset psoriasis (M:F 1.2:1). Risk factors and comorbidities of psoriasis are more prevalent in males (cardiovascular disease, smoking, alcohol consumption).	Male sex is a risk factor for severe disease (M:F 1.4-2.5:1 in severe psoriasis). Worse disease is seen in males for special site psoriasis except scalp psoriasis (equal) and palmoplantar pustulosis (more prevalent in females). Studies in psoriatic arthritis patients show that oligoarthritis and nail involvement is more common in males, while females experience more polyarthritis.	^{60 -71,160}
Pityriasis rosea	Female predominance (F:M 3:1). More common in pregnant females than in the general population.	N/A	^161 -164
Eczematous conditions
Atopic dermatitis	Similar prevalence in children, but female predominance from puberty onwards.	No difference in disease severity. Sleep disturbances due to pruritus more common in females. No significant difference in clinical presentation.	^{72,74,77,165,166}
Contact dermatitis	Higher prevalence in females. Occupational dermatitis is 1.5-times more common in females and is related to gender risk (2, 5 times) of wet work occupations.	Head and neck dermatitis and allergy to nickel are more prevalent in females and is related to jewelry and cosmeceuticals.	^{78 -82,83,167,167}
Seborrheic dermatitis	More common in males (M:F 1.2:1). Hypothesized to be related to androgenic activity of sebaceous glands.	N/A	^168 -170
Venous statis dermatitis	Higher prevalence of chronic venous insufficiency in females.	N/A	¹⁷¹
Lichenoid diseases
Lichen planus	More common in females (F:M 1.2:1). Sex hormones, autoimmunity and stress may be implicated.	Oral lichen planus was reported up to 1.4-2 times more frequently in females.	^172 -178
Lichen striatus	Conflicting results regarding sex distribution.	N/A	¹⁷⁹
Lichen nitidus	No sex predilection.	N/A	¹⁸⁰
Lichen sclerosus and atrophicus (LSA)	Overall female predominance (F:M 1-10:1). Higher prevalence in males during childhood (M:F 1.7:1). Female disease peaks in prepuberty and post-menopause, whereas male disease peaks in childhood and in the fourth decade of life.	Females are more symptomatic from their disease and are more likely to report concurrent autoimmunity. Extragenital manifestations are more frequent in females. Female children report more cutaneous atrophy and hypopigmentation vs. males. Male children more frequently report scarring or changes in genital anatomy. No difference in squamous cell carcinoma prevalence between sexes.	^181 -185

Abbreviation: N/A, No data available.

Adnexal Diseases

Conditions resulting from dysfunction of hair follicles, sebaceous, eccrine, or apocrine glands are presented under the umbrella of adnexal diseases. Sex/gender considerations of the most common conditions are presented in Table 3. In general, acne vulgaris, rosacea, hidradenitis suppurativa (HS), and hyperhidrosis prevalence is reported to be higher in females; however, the severity and pattern may differ depending on the sex and the specific conditions. Both hormonal (e.g., sex hormones) and gender-related factors (e.g., smoking, obesity, occlusive cosmetics, occupation, likelihood to seek medical attention/treatment, personal/social/cultural perceptions) influence the observed trends.

Table 3

Epidemiology and Clinical Differences Between Sexes for Adnexal Diseases.

Disease	Epidemiology differences	Clinical differences	Ref.
Acne vulgaris	More common in males during puberty (ages 15-18). More common in females for all other age groups and especially among the adult population.	More severe acne in males (including higher rates of acne fulminans) which can be related to biologic factors (androgens); however, sex/gender-bias should also be considered as females are more likely to consult and receive treatments for acne (all severities) whether prescribed or over the counter. Pattern of skin involvement is generally similar with the exception of chin and lower face predominance in adult-onset female acne. More treatment options are available for female patients such as combined oral contraceptives and anti-androgens, and females respond better to topical dapsone. Greater psychological impact in females.	^{22,186 -199}
Rosacea	Female predominance (~60% overall and ~90% for fulminans) for all subtypes except for phymatous rosacea (more common in males).	Severity depends on the subtype, earlier diagnosis is seen in females, +/-role of gender/sex bias.	^{200 -207}
Hidradenitis suppurativa	F:M ratio is ~2-4:1 except studies from Asia reporting a male predominance with a M:F ratio of 2.5:1. There is no difference in the age of onset across sexes.	Different disease pattern and distribution including greater and more severe neck, retroauricular, and buttock disease in males. Greater and more severe axillary and inframammary involvement in females. Males present later in their disease course and have larger wounds that take longer to heal when managed surgically. Higher risk of malignant transformation (Marjolin’s ulcer) in males. Higher rate of sexual distress and more depressive symptoms in females.	^{208 -220}
Hyperhidrosis	While males tend to sweat more physiologically, the epidemiology of hyperhidrosis is conflicting. Clinical data suggests a slight female predominance (~60%) whereas population-based surveys showed no sex difference, suggesting female patients may be more likely to consult medical professionals than males.	No difference in disease severity. Males more frequently present with face and scalp hyperhidrosis in addition to the back, chest, abdomen, forearms, genitals and/or lower extremities. Conflicting evidence regarding the sex predominance of palmar, plantar, and axillary hyperhidrosis. Female patients are more likely to discuss their hyperhidrosis with physicians.	^221 -227

Urticaria, Eosinophilic and Neutrophilic Dermatoses

Diseases where the role of mast cells, eosinophils and/or neutrophils is predominant are included here. Conditions where autoimmunity plays an important role such as CSU and/or chronic inducible urticaria (CIndU) are female-predominant in adults (similar sex-ratio in children). While neutrophilic diseases (e.g., Behçet’s Disease (BD), Sweet’s Syndrome (SS), Pyoderma Gangrenosum (PG)) have a female predominance except for malignancy-induced cases (equal), mortality may be worse in males. Specific findings are summarized in Table 4.

Table 4

Epidemiology and Clinical Differences Between Sexes and Genders for Neutrophilic and Eosinophilic Dermatoses.

Disease	Epidemiology differences	Clinical differences	Ref.
Urticaria and Angioedema
Chronic spontaneous urticaria (CSU)	In adults, almost twice as common in females than in males, with an even higher female predilection in autoimmune (Type IIb) CSU. Both sex and gender related factors are likely to contribute including female predilection for autoimmunity (in particular for autoimmune CSU), stress, amongst others. No sex predilection in children nor elderly.	Females are more likely to be diagnosed with concomitant autoimmune diseases and to have clinical/serum markers of autoimmune CSU (e.g., positive autologous serum skin test). Disease flares reported around hormonal life events or treatments (e.g., perimenstrual, pregnancy, oral contraceptives). Female sex is associated with lower disease resolution and higher healthcare cost/number of office and/or emergency visits. Female sex is associated with increased disease severity and a greater prevalence of angioedema.	^{228 -241}
Chronic inducible urticaria (CIndU)	Male predominance seen with cholinergic urticaria. Female predominance seen with cold urticaria in adults (not children) and symptomatic dermographism with a F:M ratio 1.3-1.4:1. Sex-disaggregated data of other types of CIndU (delayed pressure, solar, aquagenic and heat urticaria) are insufficient to draw conclusions.	Female sex is associated with lower disease resolution. Females with cholinergic urticaria have a later age of onset.	^{231,236,242 -246}
Hereditary angioedema (HAE) and acquired angioedema (AAE)	HAE types I and II do not have any sex predominance. HAE type III and angiotensin converting enzyme inhibitor- induced AAE show a female predominance.	Females with HAE have more episodes per year than males. Oral contraceptives, estrogen replacement therapy, and pregnancy may trigger or worsen symptoms in HAE. In HAE types I and II, females report increased HAE-related stress and fear compared to males.	^247 -253
Neutrophilic Dermatoses
Behçet’s disease (BD)	No sex predilection.	Earlier age of onset in females (thirties vs. fifties in males). Female sex increases the risk of erythema nodosum, genital ulcers, and joint involvement. Male sex increases the risk of ocular involvement, folliculitis/papulopustular skin lesions, deep venous and superficial thrombosis, and pathergy test positivity. Up to 5-fold mortality risk increase in males.	^254 -256
Pyoderma gangrenosum (PG)	Limited data suggests higher prevalence in females (up to 2-fold); however, a similar incidence between sexes was reported.	N/A	^257,258
Sweet’s syndrome (SS)	More common in females (F:M 3-6:1) for the idiopathic and drug-induced subtypes. No sex predisposition in cancer-related cases. Because of pregnancy induced SS cases, hormonal influences may be of importance.	N/A	^{259 -266}
Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (SAPHO)	Female predominance, especially in children.	Female sex is associated with a more chronic disease course.	^267 -269
Eosinophilic Dermatoses
Granuloma faciale	Male predominance (M:F 1.7-2.1:1).	Mean age of onset is comparable between males and females.	^270 -272
Papuloerythroderma of Ofuji	Male predominance in infancy and in the immunosuppressed, but not the classic variant.	Younger age of onset in females. More facial involvement in females than males. More males complain of associated pruritus.	^273 -276
Wells Syndrome	No known sex predilection.	N/A	²⁷⁷
Hypereosinophilic syndrome	Male predominance.	Patients with FIP1L1-PDGFRA fusion gene positive chronic eosinophilic leukemia are almost exclusively male.	^278 -280
Erythema annulare centrifugum	Unclear sex predilection.	Similar age of onset between males and females.	^281 -283

Abbreviation: N/A, No data available.

Connective Tissue Diseases

Most autoimmune diseases have a higher predilection for females than males.⁷ While up to 90% of patients diagnosed with systemic lupus erythematosus (SLE) are female, a similar predominance is seen in cutaneous lupus erythematosus (CLE), systemic sclerosis (SSc), morphea, dermatomyositis, and Sjogren’s syndrome.^{84

-96} Interestingly, in general, males have a higher disease severity, greater prevalence of organ involvement and increased mortality.^97

-101 It is hypothesized that a combination of genetic, hormonal, and environmental influences (as discussed in Part 1) accounts for the female predominance and the differences in clinical presentation between the sexes.^7,102
-104 Other environmental factors such as infectious pathogens, diet, exposure to chemicals/toxins and UV light, stress and hormonal therapy vary between males and females and are linked to the development of autoimmune disease.^{7,103,105,106} Specific findings for connective tissue diseases are presented in Table 5.

Table 5

Epidemiology and Clinical Differences Between Sexes and Genders for Connective Tissue Diseases.

Disease	Epidemiology differences	Clinical differences	Ref.
Systemic Autoimmune Rheumatic Diseases (SARD)s
Systemic lupus erythematosus (SLE)	There is a female predominance in every age group. The F:M ratio is 2-6:1 before puberty, 8-15:1 in reproductive years, and 3-8:1 after menopause. Males account for approximately 4 to 22% of SLE cases. There is evidence that males with SLE have a higher number of risk alleles than females, suggesting that males need a greater cumulative genetic burden to develop the disease.	Males are older at diagnosis, have more frequent renal disease, skin involvement, hematological disease, serositis, neurological disease, vascular thrombosis, cardiovascular complications, hepatosplenomegaly, fever and weight loss at disease onset, neoplasms, hypertension, and vasculitis. Male sex is a risk factor for mortality. In males, discoid lesions and/or subacute lesions are more common, and malar rash is less common. Males have less frequent Raynaud phenomenon, photosensitivity, mucosal ulcers, lymphadenopathy, and thyroid disease than females. Possible decreased anti-Ro (or SSA) and anti-La (or SSB) antibodies, low complement component 3, low CH50, and higher frequency of anti-dsDNA, anti-Sm antibodies, anticardiolipin antibodies, anti-U1 nuclear ribonucleo- protein (U1RNP) antibodies and lupus anticoagulant in males.	^97,284
Systemic sclerosis (SSc)	Higher prevalence in females (F:M ~ 3–8:1).	Diagnostic delay (time from first non-Raynaud phenomenon until clinical diagnosis) is longer in females. Females have a higher frequency of limited cutaneous SSc and associated features, notably peripheral vascular disease, anticentromere antibody (ACA), anti-topoisomerase I and anti-U3RNP antibody positivity. Males have higher frequency of diffuse SSc, interstitial lung disease and mortality. Most common cause of death in males and females is interstitial lung disease and pulmonary hypertension, respectively. Occupational exposure to silica, organic solvents, and cigarette smoking are more frequently reported in males with SSc and contribute to a more severe disease phenotype and poor survival.	^86,98,99,106
Sjogren’s syndrome	Female predominance (F:M 9-14:1).	Males have a higher frequency of extra-glandular manifestations such as pulmonary involvement, vasculitis, and lymphadenopathy. Males are younger at diagnosis and have more interstitial lung disease and cutaneous vasculitis than females. Males who are SSA-positive have higher levels of anti-Ro52 than females.	¹⁰⁰
Dermatomyositis	Higher incidence in females (F:M ~ 2–3:1).	Possible increased risk of malignancy in males.	^101,285,286
Other Autoimmune/Rheumatic Diseases
Still’s disease	2-fold higher prevalence in females than males in the United States. In the elderly population, more common in females (F:M is 4:1). Equal distribution between sexes in Europe.	N/A	^287 -291
Relapsing polychondritis (RPC)	Most studies suggest no sex predominance; however, some studies report F:M ratio 1.5-3:1.	Males more frequently have myelodysplastic syndrome. Anecdotally, higher frequency of hearing loss, uveitis, vestibular disease, hypertension, diabetes mellitus was observed in males. Worse prognosis is generally reported in males. Females have higher rates of concomitant autoimmunity (e.g., SLE, other SARDs, thyroid autoimmune disease, etc.). No sex difference in dermatological symptoms.	^292 -295
Familial Mediterranean fever (FMF)	N/A	Earlier age at diagnosis in males. Anxiety, depression, migraines, and headaches are more common in females. No sex difference in disease severity.	²⁹⁶
Morphea (localized scleroderma)	Female predominance (F:M 2.4-4.2:1).	Female sex is a significant predictor of impaired health-related quality of life.	^297 -299
Vasculitides
Cutaneous small vessel vasculitis	Similar incidence between sexes.	Male sex is not a significant predictive factor for disease relapse.	^300,301
Small/ small and medium vessel vasculitis	Henoch-Schoenlein purpura (HSP) shows a male predominance below age 10, but a female predominance afterwards. Cryoglobulinemic and hypocomplementemic urticarial vasculitis have a female predominance. ANCA-associated vasculitis has no sex predominance in adults, but a female predilection in children.	No reported differences for HSP, cryoglobulinemic vasculitis, and hypocomplementemic urticarial vasculitis. In ANCA-associated vasculitis, male sex is a risk factor for all-cause mortality, and may be a risk factor for progression to end-stage renal disease.	^{300,302 -308}
Medium vessel vasculitis	Male predominance for Kawasaki disease. Conflicting data on sex predilection for polyarteritis nodosa.	In Kawasaki disease, severe cardiac complications are more common in males. No reported differences for polyarteritis nodosa.	^309 -313
Large vessel vasculitis	Female predominance for Takayasu’s and giant cell arteritis.	Females with Takayasu’s arteritis have a lower age of onset and a lower incidence of cardiac complications compared to males. In giant cell arteritis, males have an increased risk of aortic aneurysm and eye involvement, whereas females have a higher risk of jaw involvement and polymyalgia.	^314 -320

Abbreviation: N/A, No data available.

Pigmentary Disorders

Pigmentary disorders comprise de-, hypo- and hyperpigmentation. In this section, we will present the sex and gender differences seen in vitiligo, pityriasis alba, progressive macular hypomelanosis, idiopathic guttate hypomelanosis, post-inflammatory hypo- and hyperpigmentation, melasma, erythema dyschromicum perstans, and prurigo pigmentosa (Table 6). In general, beside vitiligo, data is scarce and hence, strong conclusions can not be drawn.

Table 6

Epidemiology and Clinical Differences Between Sexes and Genders for Pigmentary Disorders.

Disease	Epidemiology differences	Clinical differences	Ref.
Depigmented and hypopigmented conditions
Vitiligo	Multiple studies have shown no significant sex predominance.	Females have more frequent involvement of the trunk, hips, groin, arms, elbows, feet, and axilla. Males have more frequent involvement of the hands, fingertips, and genitals (lip-tip vitiligo), as well as leucotrichia. On the face, females have more periocular involvement, while males have more involvement at the beard area. Vitiligo is known to be induced by Koebner’s phenomenon; therefore, the documented sex differences may in fact be behavior-related (e.g., hair removal, cosmetic practices).	^321 -323
Pityriasis alba	Male predominance.	N/A	³²⁴
Progressive macular hypomelanosis	Possibly higher prevalence in females based on 1 study (F:M ~ 7:1).	N/A	³²⁵
Post-inflammatory hypopigmentation	No difference in incidence by sex.		³²⁶
Idiopathic guttate hypomelanosis	No sex predilection.	Possible earlier onset in females.	³²⁷
Hyperpigmented conditions
Melasma	Higher prevalence in females (F:M 1.2-10:1).Increased incidence in pregnant females and those on oral contraceptives or hormonal replacement therapy.	Females more frequently display centro-facial pattern of involvement.Males more frequently display malar involvement.	^328 -333
Erythema dyschromicum perstans	Possible female predominance based on 1 study.	N/A	³³⁴
Prurigo pigmentosa	Higher prevalence in females (F:M 2:1).Prurigo pigmentosa has been linked to restrictive ketogenic diets; however, it remains unclear if this diet is more commonly adopted by females.	N/A	^335,336
Post-inflammatory hyperpigmentation	No sex predilection.	N/A	³³⁷

Abbreviation: N/A, No data available.

Immune-Mediated Vesiculobullous Diseases

In general, vesiculobullous diseases either have a female predominance, likely due to the autoimmune nature of many of these diseases, or no clear sex predilection. Possibly, paraneoplastic immunobullous diseases are more common in males. Diseases in this category are summarized in Table 7.

Table 7

Epidemiology and Clinical Differences Between Sexes and Genders for Cutaneous Vesiculobullous Diseases.

Skin condition	Epidemiology differences	Clinical differences	Ref.
Pemphigoid	Conflicting evidence, but most studies suggest a female predominance in bullous pemphigoid (F:M 1.0-5.1:1).Female predominance in mucous membrane pemphigoid (F:M 4.3:1).	No difference between sexes in mortality rates or overall survival.	^338 -342
Pemphigus	Overall female predominance (F:M 1-5:1) for Pemphigus Vulgaris (PV).Conflicting results or equal sex distribution in Pemphigus Foliaceus (PF) and Herpetiform Pemphigus. Possibly higher risk of paraneoplastic pemphigus in males.	Males with PV are more likely to develop the disease before age 40, have more widespread cutaneous involvement, and express antibodies to both desmoglein-1 and desmoglein-3.Females with PV have more mucosal involvement and are more likely to have a personal or family history of autoimmune diseases.Sex does not have an impact on overall survival in PV or PF.	^343 -348
Dermatitis herpetiformis	No clear sex predilection.	Female sex is associated with delayed diagnosis, and males are diagnosed at an older age than females. Together, these findings could suggest an earlier onset of symptoms in females.Concomitant autoimmune thyroid disease is more common in females.	^349 -351
Linear IgA bullous dermatosis	N/A	N/A	³⁵²

Abbreviations: BP, bullous pemphigoid; N/A, No data available; PF, pemphigus foliaceus; PV, pemphigus vulgaris; RR, relative risk.

Cutaneous Adverse Drug Reactions

Overall, there is very limited data on sex and gender differences in adverse cutaneous drug reactions. Many epidemiology studies looking at Steven-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) have shown that females are overrepresented.^107

-113 For acute generalized exanthematous pustulosis (AGEP), generalized bullous fixed drug eruption (GBFDE), and exanthematous drug eruptions, there is no significant sex predominance or differences in clinical presentation that has been revealed conclusively by previous epidemiologic studies or case series.^114

-120 Table 8 summarizes the findings for cutaneous adverse drug reactions.

Table 8

Epidemiology and Clinical Differences Between Sexes and Genders for Cutaneous Adverse Drug Reactions.

Skin condition	Epidemiology differences	Clinical differences	Ref.
Steven-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN)	Overall female predominance.	More females hospitalized for TEN (F:M 2-2.6:1).More males hospitalized for SJS (M:F 1.6-2:1).	^{107 -353,354,354}
Drug reaction with eosinophilia and systemic symptoms (DRESS)	Some studies report higher prevalence in females.	N/A	,^{110 -113,355}
Acute generalized exanthematous pustulosis (AGEP)	No significant sex predominance has been reported.	N/A	^114 -120
Generalized bullous fixed drug eruption (GBFDE)	No significant sex predominance has been reported.	N/A
Exanthematous drug eruption	No significant sex predominance has been reported.	N/A

Abbreviation: N/A, No data available.

Infectious Diseases

For the scope of this review article, we focus on infectious diseases most commonly seen in clinical practice. In general, studies have shown that males are more susceptible to infections than females. As detailed in part 1, this may be attributable to an overall heightened immunity in females.² Gender-specific recreational and occupational activities can also lead to exposure to different types of pathogens, which could contribute to the observed differences.^2,8,121 Sex- and gender-related differences for infectious diseases are reviewed in Table 9.

Table 9

Epidemiology and Clinical Differences Between Sexes and Genders for Cutaneous Infectious Diseases.

Skin condition	Epidemiology differences	Clinical differences	Ref.
Bacterial infections
Bacterial cellulitis	Higher incidence in males (M:F 1.0-2.4:1) for both community- and hospital-acquired disease.	Females with cellulitis are older and usually have venous insufficiency or lymphedema as underlying conditions.Males are more likely to develop cellulitis following a wound.The most frequent location in both sexes is the lower extremities.	^356 -359
Lyme disease	Conflicting evidence, but possible higher incidence in males, may be related to gender-specific hobbies and exposures.	No difference between sexes in the staging at presentation.Females with Lyme disease are older.Females are more likely to be diagnosed during low-season months.	^360,361
Syphilis	Higher incidence and prevalence in males, especially among males who have sex with males (MSM).	Higher mortality rates in males.	^362,363
Viral infections
Herpes zoster	Overall higher risk in females (OR1.3, RR 1.4).	More females develop post-herpetic neuralgia.	^364 -367
Herpes simplex virus (HSV) 1 and 2	HSV-1 and HSV-2 are overall more common in females.	Systemic symptoms and complications (e.g., aseptic meningitis) more common in females.Commonly affected sites for females include the oropharynx, labia majora, labia minora, mons pubis, vaginal mucosa, buttock, and cervix.Commonly affected sites for males include the oropharynx and shaft of the penis.HSV-2 is more transmissible sexually from males to females than females to males.Herpes gladiatorum is seen in young athletes that play contact sports, especially wrestling.	^368 -372
Condyloma acuminatum	Conflicting evidence, but most studies report slight male predominance (M:F 0.9-1.3:1).Higher prevalence among MSM.	Males have slightly more frequent and longer duration of episodes than females.Peak occurrence of anogenital warts is later in life for males than females.Cost and resource utilization per disease episode are higher in males.HPV vaccine uptake is significantly higher in females than in males.	^{373 -381}
Warts (Verruca plana, vulgaris, and plantaris)	No sex predilection in children.Verruca vulgaris and plantaris show a male predilection in adults.Limited data is available on verruca plana in adults	N/A	^382 -385
Human immunodeficiency virus (HIV)	In North America, higher prevalence and incidence in males, especially MSM	Males have an increased risk for late disease presentation, progression to acquired immunodeficiency syndrome, and death.	^386 -389
Human herpesvirus 8 (HHV8)	No sex predominance of HHV8 in children or in adults.HHV8 seroprevalence is higher among MSM.	Data on primary HHV8 infection in HIV negative populations are scarce.HIV co-infected males are at increased risk of associated Kaposi’s sarcoma.	^390 -392
Molluscum contagiosum	No sex predominance.	N/A	^393,394
Fungal infections
Dermatophytes	Male predominance.	N/A	³⁹⁵
Candidiasis	Female predominance.	Common locations for females include intertriginous areas and the vulva.	³⁹⁵
Bites and infestations
Scabies	Increased risk in females (RR 1.24).	N/A	³⁹⁶

Abbreviation: N/A, No data available.

Cutaneous Neoplasms

Overall, males display higher incidence rates for most types of neoplasms, including many cutaneous neoplasms.¹²² Multiple biological and sociocultural factors likely play a role in the observed sexual dimorphism, as discussed in Part 1. In particular, both genders exhibit different health behaviors: females are more likely to engage in sun protective practices and tend to seek medical attention sooner, resulting in earlier skin cancer detection.² Occupational factors and clothing choices also differ, whereby males are more likely to work outdoors (increased sun exposure on the head/neck and trunk) and females tend to expose their skin to the sun because they perceive a tanned appearance as desirable.¹²³ Whereas UV radiation is a well-known risk factor for melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), risk factors for developing cutaneous T-cell lymphoma include hydrochlorothiazide diuretic use, immunosuppression, bacterial and viral infections, air pollution, chemical exposures and detergents, amongst others, which can also vary by sex/gender.¹²⁴ Additional information on various cutaneous neoplasms is presented in Table 10.

Table 10

Epidemiology and Clinical Differences Between Sexes and Genders for Cutaneous Neoplasms.

Skin condition	Epidemiology differences	Clinical differences	Ref.
Cutaneous melanoma	Males have an overall higher incidence (M:F 1.1-1.3:1).Females have a higher incidence before age 39 and after age 80.Most cutaneous melanoma subtypes except for mucosal lentiginous melanoma and acral lentiginous melanoma are more common in males.	Most common location is on the head, neck, and trunk in males. Males are diagnosed at a more advanced age than females.Most common location is on the extremities in females. Earlier diagnosis, thinner Breslow thickness, less metastases and increased survival in females.No significant association between sex and BRAF mutations.	^{397 -404}
Squamous cell carcinoma	Overall higher incidence in males (M:F 1.2-2.4:1).Higher incidence in females before age 50 (F:M 1.3:1).	Most common location is the head and neck in both sexes.No significant difference in the degree of differentiation or tumor size.Local recurrence, nodal metastasis, distant metastasis, and death more common in males.	^405 -411
Basal cell carcinoma	Overall higher incidence in males (M:F 1.1-4.4:1).Higher incidence in females before age 50 (F:M 1.4:1).	Most common location is the head and neck in both sexes.Most common subtype is nodular in both sexes.No difference in frequency of aggressive subtypes (infiltrating, micronodular, metatypical, morpheaform) between sexes.Larger tumors in males.	^{405 -412,410 -412}
Merkel cell carcinoma	Overall higher incidence in males (M:F 1.4-2.5:1).	Most common location is the head followed by the arms in both sexes.Higher incidence of regional and distant metastases in males.Higher relative survival rates in females.	^410,413 -415
Cutaneous T-cell lymphoma	Overall higher incidence in males (M:F 1.4-1.9:1).	Males have a higher age at diagnosis, especially for mycosis fungoides.Females with mycosis fungoides present more often with lesions on the trunk.Males have higher odds of presenting with a higher T-stage (T3-T4).Females have a better overall survival and disease-specific survival.No difference between males vs. females regarding the risk of large plaque parapsoriasis progressing to mycosis fungoides.	^{124,416 -421}
Cutaneous B-cell lymphoma	Overall higher incidence in males (M:F 1.72:1).	Females have a higher age at diagnosis.	⁴¹⁷
Kaposi sarcoma (KS)	Male predominance (classic KS M:F 17:1; endemic KS M:F 2:1; iatrogenic KS M:F 3:1)AIDS-related KS is almost exclusively seen in males in North America, especially MSM; however, its prevalence has decreased with the introduction of highly active antiretroviral therapy (HAART).	One study from subSaharan African found that HIV-infected females are more likely to present with lesions on the face and hard palate. Males are more likely to have lower extremity lesions.Another study from Tanzania found that males and females are more likely to have localized and disseminated lesions, respectively.	^422 -425
Dermatofibrosarcoma protuberans (DFSP)	Conflicting evidence, but most studies report a similar distribution between sexes.	No significant difference between sexes in mean age at diagnosis.Most common anatomic site is the trunk in both sexes.Higher mortality in males.Pregnancy can lead to tumor enlargement or change in color.	^426 -430

Hair Diseases

This section will review the epidemiological and clinical differences between sexes and genders for various hair conditions. Androgenic alopecia, which is also known as male- and female-pattern hair loss, is more common in males overall. Its the prevalence increases with age in both sexes with 17% and 74% of males ages 20-29 and 80+, respectively, being affected compared to 12% and 57% of females.¹²⁵ In general, apart from AA, hair loss caused by an autoimmune disorder (e.g., frontal fibrosing alopecia, central centrifuging scarring alopecia, lichen planopilaris) affects females more than males. Telogen effluvium is also more common in females. These findings are possibly biased since females are more likely to consult a dermatologist for hair loss.¹²⁶ Further, these conditions have a greater impact on the quality of life of females compared to males.^126,127 Additional information is presented in Table 11.

Table 11

Epidemiology and Clinical Differences Between Sexes and Genders for Hair Diseases.

Hair condition	Epidemiology differences	Clinical differences	Ref.
Androgenetic alopecia	Occurs more frequently in males, although it is the most common cause of hair loss in females.Increased incidence in females after menopause.	Males most commonly develop frontoparietal and frontal recession with subsequent vertex thinning.Females most commonly develop diffuse central thinning of the crown with preservation of the frontal hairline.	^431 -433
Telogen Effluvium (TE)	More common in females.TE is possibly triggered by stress (e.g., systemic, psychological) and endocrine disorders/changes (e.g., hypothyroidism, hyperthyroidism, post-partum state). Many of these triggers are more common in females.	N/A	^434 -436
Alopecia areata (AA)	Conflicting evidence, especially from international studies, which is likely attributable to cultural and religious factors.	In males, the most common complaint is AA of the beard. Males are more likely to be diagnosed in childhood and to have a positive family history.Females have a longer disease duration, are more likely to have nail involvement and a concomitant autoimmune and/or mental health disorder.Conflicting evidence regarding disease severity by sex.	^437 -441
Central centrifugal cicatricial alopecia	More common in females, especially African American females.Gender differences, including cultural hairstyling practices, contribute to the female predominance.	N/A	^442,443
Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA)	More common in females (LPP F:M 4.9:1; FFA F:M 31:1).	Disease onset later in females.Similar clinical and histologic features in both sexes.	^444,445
Folliculitis decalvans	Male predominance across multiple studies.	Later age of onset in females than males (42 years vs. 31 years).Males present more frequently with pustules and are more likely to have associated androgenic alopecia.	⁴⁴⁶
Dissecting cellulitis of the scalp	Male predominance.	N/A	^447,448

Abbreviation: N/A, No data available.

Part 3 – Dermatology in the Transgender Population

In recent years, there has been an increased awareness of the wide range of gender identities within our population. In particular, many individuals’ gender identity is incongruent with their assigned sex at birth. This population includes the transgender community, which encompasses individuals that have a fixed gender identity that is different from their assigned sex at birth, gender fluid individuals whose gender identity is not fixed, as well as nonbinary individuals who do not identify as a man or a woman.¹²⁸ Two spirit is a term used in some Indigenous communities that describes individuals who embody both a masculine and a feminine spirit. In the United States, it is estimated that 0.2 to 2.7% of the adult population identifies as transgender.^128
-130 These individuals may undergo a social, legal, and/or medical transition.¹³¹

The medical transitioning process can involve hormonal therapy and/or various procedures and surgeries to have a physical appearance that is congruent with one’s gender identity.^128,131 As such, one’s transition often requires a multidisciplinary approach. Many gender-affirming procedures can be performed by dermatologists, including botulinum toxin injections, cosmetic filler injections, scar revisions from prior surgeries and laser hair removal.¹²⁸ In addition, hormonal therapy inevitably affects the integumentary system and can have an impact on the prevalence and severity of many dermatologic conditions.^132,133 A list of skin conditions that may be overrepresented in transgender women and men is presented in Supplemental Table 6.

Transgender women are often prescribed exogenous estrogen and antiandrogen therapy to gain a more traditionally feminine appearance. These therapies lead to decreased facial and body hair growth density, decreased sebum production, as well as promote epidermal thickness, fat redistribution, collagen production, and increased melanocyte stimulation.^128,131,132 In turn, these treatments also have dermatological implications such as increased xerosis and hair/nail fragility, risk of asteatotic dermatitis and melasma, as well as a positive correlation with HIV-related dermatoses.^128,132,133 In addition, lichen sclerosus and HPV infections (and related skin diseases) have been reported in neovaginas.^132,133 On the other hand, exogenous estrogen and antiandrogen therapy may improve acne.¹²⁸

Similarly, transgender men often undergo medical treatment to have a more traditionally masculine appearance. For example, exogenous testosterone therapy increases body and facial hair growth, decreases scalp hair, redistributes adipose tissue, and increases sebum production, which can help achieve this goal.^128,132 Such therapies can have numerous dermatological implications, such as an increased risk of androgenic alopecia and acne vulgaris. In fact, among transgender men receiving masculinizing hormone therapy (MHT), the prevalence of acne increases from 6.3% to 31.1%.¹³⁴ Androgen therapy has also been associated with an increased risk of HIV-related dermatoses.^128,133

Treating the transgender population requires the clinician to be mindful of numerous bioethical principles. For example, acne (often severe) in transgender men may necessitate systemic therapy with isotretinoin. There are numerous bioethical factors to consider when prescribing isotretinoin, a highly teratogenic agent, to a transgender man that may still have native internal female reproductive organs. Treating physicians should also be aware that some transgender men with native internal female reproductive organs desire a planned pregnancy.¹³⁵ Richer et al have recommended respectfully addressing reproductive status, anatomy, and sexual practices to gauge pregnancy risk, guide counselling, and provide the best care for these patients.¹³⁶ For example, it is important to consider that a transgender man may no longer have a uterus or may engage in sexual activities with individuals who do not have a penis and/or testes with reproductive potential.¹³⁶ Previously, the iPLEDGE program (United States of America) required clinicians to categorize patients as either: male, female of nonchildbearing potential, or female of childbearing potential and only the latter had to undergo strict pregnancy monitoring. This classification system posed a significant dilemma for patients and clinicians who had to either categorize the patient according to their assigned sex at birth (and neglect the patient’s identity) or based on their gender identity (which did not respect prior iPLEDGE principles). Many groups have advocated to change the classification system in order to respect patient autonomy,¹³⁷ and as a result, starting at the end of 2021, the iPLEDGE program reduced the patient risk categories from three options to two: patients who can get pregnant and patients who cannot get pregnant. This change has the potential to help bridge the gap in transgender health services. A comprehensive review on dermatological care in transgender individuals is discussed elsewhere.^128,138

Conclusions and Future Directions

In conclusion, it is imperative for dermatologists and practicing clinicians to distinguish sex from gender and to recognize both as distinct broad risk factor categories for skin diseases. In this review, we highlight the sex-related differences between males and females, as well as the gender-related differences between men and women. We examine epidemiological and clinical differences between sexes and genders for numerous dermatological disease categories and proposed sex- and gender-related factors that could explain the observed differences. We also discuss populations where there is incongruence between the assigned sex at birth and the gender identity of an individual. Together, these discussions highlight the importance of studying sex, gender, and gender identity separately, as well as identifying and studying their intersections, instead of viewing these epidemiological categories as 1 single entity.

This article is a narrative review and has intrinsic limitations. First, reviews are subject to publication bias, where articles that report significant results are more likely to be published and therefore more likely to be included in reviews than studies that do not. In addition, a systematic review was not performed given the broadness of the chosen topic. Therefore, there may be an element of selection bias regarding the articles that were included in the review. Second, this study did not include all disease categories. For example, genital diseases and genodermatoses were not included, and are outside of the scope of this article. Third, there has been little research conducted with transgender populations to indicate to what extent they follow the gender norms and health-related habits presumed to be associated to their gender identity. Lastly, the impact of gender-affirming treatments and procedures on the integumentary system is an area of research which requires further exploration.

Through this article, we hope to highlight that there are many areas within the field of dermatology that can still be improved to ensure a more comprehensive patient-centered care and to provide the best care for all patients. It is important to practice compassionate and inclusive medicine, and to recognize that the population is becoming increasingly diverse. Strategies to provide a more inclusive practice could include asking one’s preferred name and pronouns, as well as using inclusive language that does not assume one’s gender identity or sexual orientation.

Supplemental Material

Supplementary material - Supplemental material for The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications

Supplemental material, Supplementary material, for The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications by François Lagacé, Kathleen D’Aguanno, Connor Prosty, Alexandra Laverde-Saad, Leila Cattelan, Lydia Ouchene, Sarah Oliel, Genevieve Genest, Philip Doiron, Vincent Richer, Abdulhadi Jfri, Elizabeth O’Brien, Philippe Lefrançois, Mathieu Powell, Linda Moreau, Ivan V. Litvinov, Anastasiya Muntyanu and Elena Netchiporouk in Journal of Cutaneous Medicine and Surgery

Footnotes

Acknowledgements

The figures were created in part with BioRender.com.

Author Contributions

FL, KD, CP, ALS, LC, LO and SO performed the literature search and wrote and reviewed the manuscript; FL, LC and SO prepared figures and reviewed the manuscript; GG, PD, VR, AJ, EO, PL, MP, LM and IVL wrote and reviewed the manuscript; EN wrote and reviewed the manuscript, prepared the figures and supervised the research activities.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

François Lagacé

Kathleen D’Aguanno

Connor Prosty

Leila Cattelan

Lydia Ouchene

Philip Doiron

Ivan V. Litvinov

Elena Netchiporouk

Supplemental Material

Supplemental material for this article is available online.

References

Grzymisławska

Puch

EA.

Zawada

Grzymisławski

. Do nutritional behaviors depend on biological sex and cultural gender? Adv Clin Exp Med. 2020;29(1):165-172.doi:10.17219/acem/111817

32017478

Gemmati

Varani

Bramanti

et al. "Bridging the Gap" Everything that Could Have Been Avoided If We Had Applied Gender Medicine, Pharmacogenetics and Personalized Medicine in the Gender-Omics and Sex-Omics Era. Int J Mol Sci. 2019;21(1):296 doi:10.3390/ijms21010296 31 Dec 2019.31906252

Arbuckle

. Are there sex and gender differences in acute exposure to chemicals in the same setting? Environ Res. 2006;101(2):195-204.doi:10.1016/j.envres.2005.08.015

16233896

Saraswat

Weinand

JD.

Safer

. Evidence supporting the biologic nature of gender identity. Endocr Pract. 2015;21(2):199-204.doi:10.4158/EP14351.RA

25667367

Rosenthal

. Transgender youth: current concepts. Ann Pediatr Endocrinol Metab. 2016;21(4):185-192.doi:10.6065/apem.2016.21.4.185

28164070

McCombe

PA.

Greer

. Chapter 24 - Sexual Dimorphism in the Immune System. In: Rose

NR.

Mackay

IR.

, eds. The Autoimmune Diseases. Fifth Edition. Academic Press; 2014.:319-328.

Ngo

ST.

Steyn

FJ.

McCombe

. Gender differences in autoimmune disease. Front Neuroendocrinol. 2014;35(3):347-369.doi:10.1016/j.yfrne.2014.04.004

24793874

Chen

Mempel

Traidl-Hofmann

Al Khusaei

Ring

. Gender aspects in skin diseases. J Eur Acad Dermatol Venereol. 2010;24(12):1378-1385.doi:10.1111/j.1468-3083.2010.03668.x

20384686

Libert

Dejager

Pinheiro

. The X chromosome in immune functions: when a chromosome makes the difference. Nat Rev Immunol. 2010;10(8):594-604.doi:10.1038/nri2815

20651746

10.

Basta

Pandya

11.

Bostwick

Van den Veyver

IB.

Sutton

. Focal Dermal Hypoplasia. In: Adam MP, Everman DB, Mirzaa GM, Pagon RA, Wallace SE, Bean LJH, et al., editors. GeneReviews(®). Seattle (WA): University of Washington, Seattle Copyright © 1993-2022, University of Washington, Seattle. GeneReviews is a registered trademark of the University of Washington, Seattle. All rights reserved. 1993

12.

Arnold

. A general theory of sexual differentiation. J Neurosci Res. 2017;95(1-2):291-300.doi:10.1002/jnr.23884

27870435

13.

Bartz

Chitnis

Kaiser

et al. Clinical advances in sex- and Gender-Informed medicine to improve the health of all: a review. JAMA Intern Med. 2020;180(4):574-583.doi:10.1001/jamainternmed.2019.7194

32040165

14.

Phuong

Maibach

. Gender Differences in Skin. In: Farage

MA.

Miller

KW.

Maibach

HI.

, eds. Textbook of Aging Skin. Springer Berlin Heidelberg; 2017:1729-1755.

15.

Wilkinson

HN.

Hardman

. The role of estrogen in cutaneous ageing and repair. Maturitas. 2017;103:60-64.doi:10.1016/j.maturitas.2017.06.026

28778334

16.

Nelson

LR.

Bulun

. Estrogen production and action. J Am Acad Dermatol. 2001;45(3 Suppl):S116-S124.doi:10.1067/mjd.2001.117432

11511861

17.

Shu

. Maibach HI. Estrogen and Skin. American Journal of Clinical Dermatology. 2011;12(5):297-311.

18.

Hermanns-Lê

Hermanns

J-F.

Lesuisse

Piérard

. Cyclic catamenial dermatoses. Biomed Res Int. 2013;2013:156459-5.doi:10.1155/2013/156459

24199187

19.

Raghunath

RS.

Venables

ZC.

Millington

GWM

. The menstrual cycle and the skin. Clin Exp Dermatol. 2015;40(2):111-115.doi:10.1111/ced.12588

25683236

20.

Elsaie

. Hormonal treatment of acne vulgaris: an update. Clin Cosmet Investig Dermatol. 2016;9:241-248.doi:10.2147/CCID.S114830

27621661

21.

Ceruti

JM.

Leirós

GJ.

Balañá

. Androgens and androgen receptor action in skin and hair follicles. Mol Cell Endocrinol. 2018;465:122-133.doi:10.1016/j.mce.2017.09.009

28912032

22.

Rosenfield

. Hirsutism and the variable response of the pilosebaceous unit to androgen. J Investig Dermatol Symp Proc. 2005;10(3):205-208.doi:10.1111/j.1087-0024.2005.10106.x

16382665

23.

Langan

EA.

Foitzik-Lau

Goffin

Ramot

Paus

. Prolactin: an emerging force along the cutaneous-endocrine axis. Trends Endocrinol Metab. 2010;21(9):569-577.doi:10.1016/j.tem.2010.06.001

20598901

24.

Hewagama

Patel

Yarlagadda

Strickland

FM.

Richardson

. Stronger inflammatory/cytotoxic T-cell response in women identified by microarray analysis. Genes Immun. 2009;10(5):509-516.doi:10.1038/gene.2009.12

19279650

25.

Cook

. Sexual dimorphism of humoral immunity with human vaccines. Vaccine. 2008;26(29-30):3551-3555.doi:10.1016/j.vaccine.2008.04.054

18524433

26.

Dao

Kazin

. Gender differences in skin: a review of the literature. Gend Med. 2007;4(4):308-328.doi:10.1016/S1550-8579(07)80061-1

18215723

27.

Taneja

. Sex hormones determine immune response. Front Immunol. 2018;9:1931 doi:10.3389/fimmu.2018.01931

30210492

28.

Shepherd

Cheung

AS.

Pang

Saffery

Novakovic

. Sexual dimorphism in innate immunity: the role of sex hormones and epigenetics. Front Immunol. 2020;11:604000 doi:10.3389/fimmu.2020.604000

33584674

29.

Mousavi

MJ.

Mahmoudi

Ghotloo

. Escape from X chromosome inactivation and female bias of autoimmune diseases. Mol Med. 2020;26(1):127 doi:10.1186/s10020-020-00256-1

33297945

30.

Zito

Davies

MN.

Tsai

P-C

et al. Heritability of skewed X-inactivation in female twins is tissue-specific and associated with age. Nat Commun. 2019;10(1):5339 doi:10.1038/s41467-019-13340-w

31767861

31.

Rahrovan

Fanian

Mehryan

Humbert

Firooz

. Male versus female skin: what dermatologists and cosmeticians should know. Int J Womens Dermatol. 2018;4(3):122-130.doi:10.1016/j.ijwd.2018.03.002

30175213

32.

Gupta

AK.

Bluhm

Cooper

EA.

Summerbell

RC.

Batra

. Seborrheic dermatitis. Dermatol Clin. 2003;21(3):401-412.doi:10.1016/S0733-8635(03)00028-7

12956195

33.

Soldin

OP.

Mattison

. Sex differences in pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 2009;48(3):143-157.doi:10.2165/00003088-200948030-00001

19385708

34.

Schwartz

. The influence of sex on pharmacokinetics. Clin Pharmacokinet. 2003;42(2):107-121.doi:10.2165/00003088-200342020-00001

12537512

35.

Mangoni

AA.

Jackson

SHD

. Age-Related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6-14.doi:10.1046/j.1365-2125.2003.02007.x

14678335

36.

. Table 13-10-0096-01 Health characteristics, annual estimates: Statistics Canada; [Available from:. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009601

37.

Mehra

VM.

Keethakumar

Bohr

YM.

Abdullah

Tamim

. The association between alcohol, marijuana, illegal drug use and current use of e-cigarette among youth and young adults in Canada: results from Canadian tobacco, alcohol and drugs survey 2017. BMC Public Health. 2019;19(1):1208 doi:10.1186/s12889-019-7546-y

31477067

38.

Keethakumar

Mehra

VM.

Khanlou

Tamim

. Cannabis use and patterns among middle and older aged Canadians prior to Legalization: a sex-specific analysis of the Canadian tobacco, alcohol and drugs survey. BMC Public Health. 2021;21(1):26 doi:10.1186/s12889-020-10074-z

33407292

39.

Varì

Scazzocchio

D'Amore

Giovannini

Gessani

Masella

. Gender-Related differences in lifestyle may affect health status. Ann Ist Super Sanita. 2016;52(2):158-166.doi:10.4415/ANN_16_02_06

27364389

40.

Westenhoefer

. Age and gender dependent profile of food choice. Forum Nutr. 2005;57:44-51.doi:10.1159/000083753

15702587

41.

Spinelli

Dinnella

Tesini

et al. Gender differences in fat-rich meat choice: influence of personality and attitudes. Nutrients. 2020;12(5):1374 doi:10.3390/nu12051374 11 May 2020.32403419

42.

Dedovic

Wadiwalla

Engert

Pruessner

. The role of sex and gender socialization in stress reactivity. Dev Psychol. 2009;45(1):45-55.doi:10.1037/a0014433

19209989

43.

Kajantie

Phillips

. The effects of sex and hormonal status on the physiological response to acute psychosocial stress. Psychoneuroendocrinology. 2006;31(2):151-178.doi:10.1016/j.psyneuen.2005.07.002

16139959

44.

Denton

Prus

Walters

. Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health. Soc Sci Med. 2004;58(12):2585-2600.doi:10.1016/j.socscimed.2003.09.008

15081207

45.

Hunter

HJ.

Momen

SE.

Kleyn

. The impact of psychosocial stress on healthy skin. Clin Exp Dermatol. 2015;40(5):540-546.doi:10.1111/ced.12582

25808947

46.

Pondeljak

Lugović-Mihić

. Stress-Induced interaction of skin immune cells, hormones, and neurotransmitters. Clin Ther. 2020;42(5):757-770.doi:10.1016/j.clinthera.2020.03.008

32276734

47.

Reich

Wójcik-Maciejewicz

Slominski

. Stress and the skin. G Ital Dermatol Venereol. 2010;145(2):213-219.20467395

48.

Eng

't Mannetje

McLean

Ellison-Loschmann

Cheng

Pearce

. Gender differences in occupational exposure patterns. Occup Environ Med. 2011;68(12):888-894.doi:10.1136/oem.2010.064097

21486991

49.

Biswas

Harbin

Irvin

Johnston

Begum

Tiong

. Sex and gender differences in occupational hazard exposures: a scoping review of the recent literature. Curr Environ Health Rep. 2021:1-14.

50.

Garcia-Hidalgo

von Goetz

Siegrist

Hungerbühler

. Use-patterns of personal care and household cleaning products in Switzerland. Food Chem Toxicol. 2017;99:24-39.doi:10.1016/j.fct.2016.10.030

27818321

51.

Shen

PC.

Chan

YP.

Huang

CH.

. Riehl’s Melanosis: A Multimodality. In: Vivo, Real-Time Skin Imaging Study with Cellular Resolution Optical Coherence Tomography and Advanced Skin Diagnosis System in a Tertiary Medical Center. Bioengineering; 2022:9.

52.

Muntyanu

Milan

Rahme

et al. Exposure to silica and systemic sclerosis: a retrospective cohort study based on the Canadian scleroderma Research Group. Front Med. 2022;9:984907 doi:10.3389/fmed.2022.984907

36250083

53.

Ouchene

Muntyanu

Lavoue

Baron

Litvinov IV

. Toward Understanding of Environmental Risk Factors in Systemic Sclerosis [Formula: see text]. J Cutan Med Surg. 2021;25(2):188-204.

54.

Reynolds

AC.

Paterson

JL.

Ferguson

SA.

Stanley

Wright

KP.

Dawson

. The shift work and health research agenda: considering changes in gut microbiota as a pathway linking shift work, sleep loss and circadian misalignment, and metabolic disease. Sleep Med Rev. 2017;34:3-9.doi:10.1016/j.smrv.2016.06.009

27568341

55.

Schmitt

DP.

Long

AE.

McPhearson

O'Brien

Remmert

Shah

. Personality and gender differences in global perspective. Int J Psychol. 2017;52 Suppl 1(Suppl 1):45-56.doi:10.1002/ijop.12265

27000535

56.

Kuhn

Mennella

Magid

Stamu-O'Brien

Kroumpouzos

. Psychocutaneous disease: clinical perspectives. J Am Acad Dermatol. 2017;76(5):779-791.doi:10.1016/j.jaad.2016.11.013

28411771

57.

Grant

JE.

Dougherty

DD.

Chamberlain

. Prevalence, gender correlates, and co-morbidity of trichotillomania. Psychiatry Res. 2020;288:112948 doi:10.1016/j.psychres.2020.112948

32334275

58.

Claréus

Renström

. Physicians' gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient-physician relations. Scand J Psychol. 2019;60(4):338-347.doi:10.1111/sjop.12545

31124165

59.

Bertakis

KD.

Azari

Helms

LJ.

Callahan

EJ.

Robbins

. Gender differences in the utilization of health care services. J Fam Pract. 2000;49(2):147-152.10718692

60.

Icen

Crowson

CS.

McEvoy

MT.

Dann

FJ.

Gabriel

SE.

Maradit Kremers

. Trends in incidence of adult-onset psoriasis over three decades: a population-based study. J Am Acad Dermatol. 2009;60(3):394-401.doi:10.1016/j.jaad.2008.10.062

19231638

61.

Colombo

Cassano

Bellia

Vena

. Gender medicine and psoriasis. World Journal of Dermatology. 2014;3(3):36-44.

62.

White

O'Shea

SJ.

Rogers

. Do men have more severe psoriasis than women? J Eur Acad Dermatol Venereol. 2012;26(1):126-127.doi:10.1111/j.1468-3083.2011.04026.x

21635564

63.

Saurat

J-H.

Stingl

Dubertret

et al. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (champion). Br J Dermatol. 2008;158(3):558-566.doi:10.1111/j.1365-2133.2007.08315.x

18047523

64.

Elewski

Leonardi

Gottlieb

et al. Comparison of clinical and pharmacokinetic profiles of etanercept 25 Mg twice Weekly and 50 Mg once Weekly in patients with psoriasis. Br J Dermatol. 2007;156(1):138-142.doi:10.1111/j.1365-2133.2006.07585.x

17199580

65.

Daudén

Griffiths

CE.

Ortonne

et al. Improvements in patient-reported outcomes in moderate-to-severe psoriasis patients receiving continuous or paused etanercept treatment over 54 weeks: the CRYSTEL study. J Eur Acad Dermatol Venereol. 2009;23(12):1374-1382.doi:10.1111/j.1468-3083.2009.03321.x

19563497

66.

Hägg

Sundström

Eriksson

Schmitt-Egenolf

. Severity of psoriasis differs between men and women: a study of the clinical outcome measure psoriasis area and severity index (PASI) in 5438 Swedish register patients. Am J Clin Dermatol. 2017;18(4):583-590.doi:10.1007/s40257-017-0274-0

28342016

67.

Prescott

Hippe

Schnohr

Hein

HO.

Vestbo

. Smoking and risk of myocardial infarction in women and men: longitudinal population study. Bmj. 1998;316(7137):1043 doi:10.1136/bmj.316.7137.1043

9552903

68.

Botega

NJ.

Mitsuushi

GN.

Azevedo

et al. Depression, alcohol use disorders and nicotine dependence among patients at a general hospital. Braz J Psychiatry. 2010;32(3):250-256.doi:10.1590/s1516-44462010005000016

20602014

69.

Weiss

Shemer

Trau

. The Koebner phenomenon: review of the literature. J Eur Acad Dermatol Venereol. 2002;16(3):241-248.doi:10.1046/j.1473-2165.2002.00406.x

12195563

70.

Langley

RG.

Krueger

GG.

Griffiths

. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64 Suppl 2(Suppl 2):ii18-ii23.doi:10.1136/ard.2004.033217

15708928

71.

Choon

SE.

Lai

NM.

Mohammad

NA.

Nanu

NM.

Tey

KE.

Chew

. Clinical profile, morbidity, and outcome of adult-onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia. Int J Dermatol. 2014;53(6):676-684.doi:10.1111/ijd.12070

23967807

72.

Lee

HH.

Patel

KR.

Singam

Rastogi

Silverberg

. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019;80(6):1526-1532.doi:10.1016/j.jaad.2018.05.1241

29864464

73.

Pesce

Marcon

Carosso

Antonicelli

Cazzoletti

Ferrari

. Adult eczema in Italy: prevalence and associations with environmental factors. Journal of the European Academy of Dermatology and Venereology. 2015;29(6):1180-1187.

74.

Sacotte

Silverberg

. Epidemiology of adult atopic dermatitis. Clin Dermatol. 2018;36(5):595-605.doi:10.1016/j.clindermatol.2018.05.007

30217272

75.

Osman

. Therapeutic implications of sex differences in asthma and atopy. Arch Dis Child. 2003;88(7):587-590.doi:10.1136/adc.88.7.587

12818904

76.

Pesce

Marcon

Carosso

et al. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol. 2015;29(6):1180-1187.doi:10.1111/jdv.12784

25363318

77.

Osman

Hansell

AL.

Simpson

CR.

Hollowell

Helms

. Gender-specific presentations for asthma, allergic rhinitis and eczema in primary care. Prim Care Respir J. 2007;16(1):28-35.doi:10.3132/pcrj.2007.00006

17297524

78.

Noiesen

Munk

MD.

Larsen

Høyen

Agner

. Gender differences in topical treatment of allergic contact dermatitis. Acta dermato-venereologica. 2009;89(1):79-81.doi:10.2340/00015555-0551

19197547

79.

Mauro

Bovenzi

Larese Filon

. Occupational contact dermatitis in a gender perspective: North East Italian data 1996-2016. Med Lav. 2021;112(1):34-43.doi:10.23749/mdl.v112i1.9794

33635293

80.

Beltrani

VS.

Bernstein

IL.

Cohen

DE.

Fonacier

. Contact dermatitis: a practice parameter. Ann Allergy Asthma Immunol. 2006;97(3 Suppl 2):S1-S38.doi:10.1016/S1081-1206(10)60811-3

17039663

81.

Alani

JI.

Davis

MD.

Yiannias

. Allergy to cosmetics: a literature review. Dermatitis. 2013;24(6):283-290.doi:10.1097/DER.0b013e3182a5d8bc

24201464

82.

Skoet

Olsen

Mathiesen

Iversen

Johansen

JD.

Agner

. A survey of occupational hand eczema in Denmark. Contact Dermatitis. 2004;51(4):159-166.doi:10.1111/j.0105-1873.2004.00423.x

15500664

83.

Bordel-Gómez

MT.

Miranda-Romero

Castrodeza-Sanz

. Epidemiology of contact dermatitis: prevalence of sensitization to different allergens and associated factors. Actas Dermosifiliogr. 2010;101(1):59-75.20109394

84.

Jarukitsopa

Hoganson

DD.

Crowson

et al. . . Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States. Arthritis Care Res (Hoboken). 2015;67(6):817-828. [Jr].doi:10.1002/acr.22502

25369985

85.

Fatoye

Gebrye

Svenson

. Real-world incidence and prevalence of systemic lupus erythematosus in Alberta, Canada. Rheumatol Int. 2018;38(9):1721-1726.doi:10.1007/s00296-018-4091-4

29987494

86.

Mayes

MD.

Lacey

JV.

Beebe-Dimmer

et al. . . Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population. Arthritis Rheum. 2003;48(8):2246-2255. [Jr].doi:10.1002/art.11073

12905479

87.

Christen-Zaech

Hakim

MD.

Afsar

FS.

Paller

AS.

morphea

. localized scleroderma): review of 136 patients. J Am Acad Dermatol. 2008;59(3):385-396.

88.

Furst

DE.

Amato

AA.

Iorga

Şerban R.

Gajria

Fernandes

. Epidemiology of adult idiopathic inflammatory myopathies in a U.S. managed care plan. Muscle Nerve. 2012;45(5):676-683.doi:10.1002/mus.23302

22499094

89.

Bendewald

MJ.

Wetter

DA.

Davis

. Incidence of dermatomyositis and clinically amyopathic dermatomyositis: a population-based study in Olmsted County, Minnesota. Arch Dermatol. 2010;146(1):26-30.doi:10.1001/archdermatol.2009.328

20083689

90.

Qin

Wang

Yang

et al. Epidemiology of primary Sjögren’s syndrome: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74(11):1983-1989.doi:10.1136/annrheumdis-2014-205375

24938285

91.

Chifflot

Fautrel

Sordet

Chatelus

Sibilia

. Incidence and prevalence of systemic sclerosis: a systematic literature review. Semin Arthritis Rheum. 2008;37(4):223-235.doi:10.1016/j.semarthrit.2007.05.003

17692364

92.

Muntyanu

Ouchene

Zhou

et al. Geographical distribution of systemic sclerosis in Canada: An ecologic study based on the Canadian Scleroderma Research Group. J Am Acad Dermatol. 2022;87(5):1095-1097.doi:10.1016/j.jaad.2021.12.055

35031410

93.

Kassamali

AA.

Muntyanu

Netchiporouk

Vleugels

RA.

LaChance

. Geographic distribution and environmental triggers of systemic sclerosis cases from 2 large academic tertiary centers in Massachusetts. J Am Acad Dermatol. 2022;86(4):925-927.doi:10.1016/j.jaad.2021.03.055

33771593

94.

Ouchene

Muntyanu

Assayag

et al. Skin disorders and interstitial lung disease: Part II-The spectrum of cutaneous diseases with lung disease association. J Am Acad Dermatol. 2022;88(4):767-782.doi:10.1016/j.jaad.2022.09.051

36228940

95.

Muntyanu

Ridha

et al. Novel role of long non-coding RNAs in autoimmune cutaneous disease. J Cell Commun Signal. 2022;16(4):487-504.doi:10.1007/s12079-021-00639-x

34346026

96.

Motamedi

Ferrara

Yacyshyn

Osman

Abril

Rahman

. Skin disorders and interstitial lung disease. Part I. Screening, Diagnosis and Therapeutic Principles. J Am Acad Dermatol. 2022

97.

L-J.

Wallace

DJ.

Ishimori

ML.

Scofield

RH.

Weisman

. Review: Male systemic lupus erythematosus: a review of sex disparities in this disease. Lupus. 2010;19(2):119-129.doi:10.1177/0961203309350755

19946032

98.

Peoples

Medsger

TA.

Lucas

Rosario

BL.

Feghali-Bostwick

. ., . Gender differences in systemic sclerosis: relationship to clinical features, serologic status and outcomes. J Scleroderma Relat Disord. 2016;1(2):177-240. [Jr].doi:10.5301/jsrd.5000209

29242839

99.

Hussein

Lee

Chau

Johnson

. The effect of male sex on survival in systemic sclerosis. J Rheumatol. 2014;41(11):2193-2200.doi:10.3899/jrheum.140006

25274896

100.

Ramírez Sepúlveda

JI.

Kvarnström

Brauner

Baldini

Wahren-Herlenius

. Difference in clinical presentation between women and men in incident primary Sjögren’s syndrome. Biol Sex Differ. 2017;8:16 doi:10.1186/s13293-017-0137-7

28507729

101.

Antiochos

BB.

Brown

LA.

Tosteson

TD.

Wortmann

RL.

Rigby

. Malignancy is associated with dermatomyositis but not polymyositis in Northern New England, USA. J Rheumatol. 2009;36(12):2704-2710.doi:10.3899/jrheum.090549

19918034

102.

Hughes

. Progesterone and autoimmune disease. Autoimmun Rev. 2012;11(6-7):A502-A14.doi:10.1016/j.autrev.2011.12.003

22193289

103.

Ellis

JA.

Kemp

AS.

Ponsonby

. Gene-environment interaction in autoimmune disease. Expert Rev Mol Med. 2014;16:e4 doi:10.1017/erm.2014.5

24602341

104.

Muntyanu

Netchiporouk

. IncRNAs and circRNAs provide insight into discoid lupus pathogenesis and progression. Annals of Translational Medicine. 2020;8(6):260.doi:10.21037/atm.2020.03.56

32355704

105.

Barragán-Martínez

Speck-Hernández

CA.

Montoya-Ortiz

Mantilla

RD.

Anaya

J-M.

Rojas-Villarraga

. Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis. PloS one. 2012;7(12):e51506 doi:10.1371/journal.pone.0051506

23284705

106.

Ouchene

Muntyanu

Lavoué

Baron

Litvinov

IV.

Netchiporouk

. Toward Understanding of Environmental Risk Factors in Systemic Sclerosis [Formula: see text. J Cutan Med Surg. 2021;25(2):188-204.doi:10.1177/1203475420957950

32988228

107.

Sousa-Pinto

Araújo

Freitas

Correia

Delgado

. Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database. Clin Transl Allergy. 2018;8:2 doi:10.1186/s13601-017-0188-1

29387340

108.

Bolognia

JL.

Schaffer

JV.

Duncan

KO.

. Dermatology essentials E-book: Elsevier Health Sciences; 2014.

109.

Irungu

Nyamu

Opanga

. Characterization of Stevens-Johnson syndrome and toxic epidermal necrolysis among patients admitted to Kenyatta national Hospital: a retrospective cross-sectional study. Drugs Real World Outcomes. 2017;4(2):79-85.doi:10.1007/s40801-017-0105-x

28401493

110.

Kardaun

SH.

Sekula

Valeyrie-Allanore

et al. Drug reaction with eosinophilia and systemic symptoms (dress): an original multisystem adverse drug reaction. results from the prospective RegiSCAR study. Br J Dermatol. 2013;169(5):1071-1080.doi:10.1111/bjd.12501

23855313

111.

Shiohara

Mizukawa

. Drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS): An update in 2019. Allergol Int. 2019;68(3):301-308.doi:10.1016/j.alit.2019.03.006

31000444

112.

Cacoub

Musette

Descamps

et al. The dress syndrome: a literature review. Am J Med. 2011;124(7):588-597.doi:10.1016/j.amjmed.2011.01.017

21592453

113.

Hiransuthikul

Rattananupong

Klaewsongkram

Rerknimitr

Pongprutthipan

Ruxrungtham

. Drug-Induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS): 11 years retrospective study in Thailand. Allergol Int. 2016;65(4):432-438.doi:10.1016/j.alit.2016.04.001

27134114

114.

Thienvibul

Vachiramon

Chanprapaph

. Five-Year retrospective review of acute generalized exanthematous pustulosis. Dermatol Res Pract. 2015;2015:260928-8.doi:10.1155/2015/260928

26783390

115.

Roujeau

JC.

Bioulac-Sage

Bourseau

et al. Acute generalized exanthematous pustulosis. Analysis of 63 cases. Arch Dermatol. 1991;127(9):1333-1338.1832534

116.

Choi

MJ.

Kim

HS.

Park

et al. Clinicopathologic manifestations of 36 Korean patients with acute generalized exanthematous pustulosis: a case series and review of the literature. Ann Dermatol. 2010;22(2):163-169.doi:10.5021/ad.2010.22.2.163

20548906

117.

Anderson

HJ.

Lee

. A review of fixed drug eruption with a special focus on generalized bullous fixed drug eruption. Medicina. 2021;57(9):925 doi:10.3390/medicina57090925

34577848

118.

Zaouak

Ben Salem

Ben Jannet

Hammami

Fenniche

. Bullous fixed drug eruption: a potential diagnostic pitfall: a study of 18 cases. Therapie. 2019;74(5):527-530.doi:10.1016/j.therap.2019.01.009

31006486

119.

Heng

YK.

Yew

YW.

Lim

DSY.

Lim

. An update of fixed drug eruptions in Singapore. J Eur Acad Dermatol Venereol. 2015;29(8):1539-1544.doi:10.1111/jdv.12919

25491106

120.

Lee

C-H.

Chen

Y-C.

Cho

Y-T.

Chang

C-Y.

Chu

C-Y

. Fixed-drug eruption: a retrospective study in a single referral center in Northern Taiwan. Dermatologica Sinica. 2012;30(1):11-15.doi:10.1016/j.dsi.2012.02.002

121.

Lebel

Mumcu

Pegoraro

LaVoi

NM.

Lough

Antunovic

. Re-thinking women's sport research: looking in the mirror and reflecting forward. Front Sports Act Living. 2021;3:746441 doi:10.3389/fspor.2021.746441

34708200

122.

Dorak

MT.

Karpuzoglu

. Gender differences in cancer susceptibility: an inadequately addressed issue. Front Genet. 2012;3(268):268 doi:10.3389/fgene.2012.00268

23226157

123.

Bleakley

Lazovich

B Jordan

Glanz

. Compensation behaviors and skin cancer prevention. Am J Prev Med. 2018;55(6):848-855.doi:10.1016/j.amepre.2018.06.019

30344038

124.

Ghazawi

FM.

Alghazawi

et al. Environmental and other extrinsic risk factors contributing to the pathogenesis of cutaneous T cell lymphoma (CTCL. Front Oncol. 2019;9:300 doi:10.3389/fonc.2019.00300

31106143

125.

Gan

DC.

Sinclair

. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc. 2005;10(3):184-189.doi:10.1111/j.1087-0024.2005.10102.x

16382660

126.

Malkud

. Telogen Effluvium: A Review. J Clin Diagn Res. 2015;9(9):WE01-WE3.doi:10.7860/JCDR/2015/15219.6492

26500992

127.

Cash

TF.

Price

VH.

Savin

. Psychological effects of androgenetic alopecia on women: comparisons with balding men and with female control subjects. J Am Acad Dermatol. 1993;29(4):568-575.doi:10.1016/0190-9622(93)70223-g

8408792

128.

Sullivan

Trinidad

Hamann

. Issues in transgender dermatology: A systematic review of the literature. J Am Acad Dermatol. 2019;81(2):438-447.doi:10.1016/j.jaad.2019.03.023

30885756

129.

Zucker

. Epidemiology of gender dysphoria and transgender identity. Sex Health. 2017;14(5):404-411.doi:10.1071/SH17067

28838353

130.

Kaltiala-Heino

Lindberg

. Gender identities in adolescent population: Methodological issues and prevalence across age groups. European Psychiatry. 2019;55:61-66.doi:10.1016/j.eurpsy.2018.09.003

30390473

131.

Dhingra

Bonati

LM.

Wang

EB.

Chou

Jagdeo

. Medical and aesthetic procedural dermatology recommendations for transgender patients undergoing transition. J Am Acad Dermatol. 2019;80(6):1712-1721.doi:10.1016/j.jaad.2018.05.1259

30678999

132.

Yeung

Kahn

BC.

Tangpricha

. Dermatologic Conditions in Transgender Populations. Endocrinol Metab Clin North Am. 2019;48(2):429-440.doi:10.1016/j.ecl.2019.01.005

31027550

133.

Hermosura Almazan

Kabigting

. Dermatologic care of the transgender patient. Dermatol Online J. 2016;22(10):13030/qt01j5z8ps 15 Oct 2016.28329583

134.

Thoreson

Park

JA.

Grasso

et al. Incidence and factors associated with acne among transgender patients receiving masculinizing hormone therapy. JAMA Dermatol. 2021;157(3):290-295.doi:10.1001/jamadermatol.2020.5347

33471082

135.

MacLean

LR-D

Preconception, pregnancy, birthing, and lactation needs of transgender men. Nurs Womens Health. 2021;25(2):129-138.doi:10.1016/j.nwh.2021.01.006

33651985

136.

Richer

Kuritzky

. Considerations in treating severe acne with isotretinoin in transgender men. J Cutan Med Surg. 2020;24(5):529-530.doi:10.1177/1203475420930224

32449627

137.

Yeung

Chen

SC.

Katz

KA.

Stoff

. Prescribing isotretinoin in the United States for transgender individuals: ethical considerations. J Am Acad Dermatol. 2016;75(3):648-651.doi:10.1016/j.jaad.2016.03.042

27543225

138.

Swink

SM.

Castelo-Soccio

. Dermatologic considerations for transgender and gender diverse youth. Pediatr Dermatol. 2021;38(Suppl 2):58-64.doi:10.1111/pde.14685

34250638

139.

Boggild

AK.

Nicks

BA.

Yen

et al. Delusional parasitosis: six-year experience with 23 consecutive cases at an academic medical center. Int J Infect Dis. 2010;14(4):e317-321.doi:10.1016/j.ijid.2009.05.018

19683952

140.

Trabert

. 100 years of delusional parasitosis. meta-analysis of 1,223 case reports. Psychopathology. 1995;28(5):238-246.doi:10.1159/000284934

8559947

141.

DC.

Thong

JY.

Chan

. Delusional parasitosis: case series of 8 patients and review of the literature. Ann Acad Med Singap. 2004;33(1):89-94.15008571

142.

Bhatia

MS.

Jagawat

Choudhary

. Delusional parasitosis: a clinical profile. Int J Psychiatry Med. 2000;30(1):83-91.doi:10.2190/BBDT-CGB9-BB3L-8HM3

10900563

143.

Diefenbach

GJ.

Tolin

DF.

Meunier

Worhunsky

. Emotion regulation and trichotillomania: a comparison of clinical and nonclinical hair pulling. J Behav Ther Exp Psychiatry. 2008;39(1):32-41.doi:10.1016/j.jbtep.2006.09.002

17207769

144.

Gershuny

BS.

Keuthen

NJ.

Gentes

et al. Current posttraumatic stress disorder and history of trauma in trichotillomania. J Clin Psychol. 2006;62(12):1521-1529.doi:10.1002/jclp.20303

16897695

145.

Odlaug

BL.

Kim

SW.

Grant

. Quality of life and clinical severity in pathological skin picking and trichotillomania. J Anxiety Disord. 2010;24(8):823-829.doi:10.1016/j.janxdis.2010.06.004

20594805

146.

Woods

DW.

Flessner

CA.

Franklin

ME.

Keuthen

NJ.

Goodwin

RD.

Stein

. The trichotillomania impact project (tip): exploring phenomenology, functional impairment, and treatment utilization. J Clin Psychiatry. 2006;67(12):1877-1888.doi:10.4088/jcp.v67n1207

17194265

147.

Snorrason

Ricketts

EJ.

Stein

et al. Sex differences in age at onset and presentation of trichotillomania and Trichobezoar: a 120-Year systematic review of cases. Child Psychiatry Hum Dev. 2022;53(1):165-171.doi:10.1007/s10578-020-01117-y

33420536

148.

Veale

Gledhill

LJ.

Christodoulou

Hodsoll

. Body dysmorphic disorder in different settings: a systematic review and estimated weighted prevalence. Body Image. 2016;18:168-186.doi:10.1016/j.bodyim.2016.07.003

27498379

149.

Phillips

KA.

Menard

Fay

. Gender similarities and differences in 200 individuals with body dysmorphic disorder. Compr Psychiatry. 2006;47(2):77-87.doi:10.1016/j.comppsych.2005.07.002

16490564

150.

Kwon

Sutaria

Khanna

et al. Epidemiology and comorbidities of Excoriation disorder: a retrospective case-control study. J Clin Med. 2020;9(9):2703 doi:10.3390/jcm9092703 21 08 2020.32825621

151.

Grant

JE.

Chamberlain

. Prevalence of skin picking (excoriation) disorder. J Psychiatr Res. 2020;130:57-60.doi:10.1016/j.jpsychires.2020.06.033

32781374

152.

Odlaug

BL.

Lust

Schreiber

LR.

Christenson

Derbyshire

Grant

. Skin picking disorder in university students: health correlates and gender differences. Gen Hosp Psychiatry. 2013;35(2):168-173.doi:10.1016/j.genhosppsych.2012.08.006

23123103

153.

Bohne

Wilhelm

Keuthen

NJ.

Baer

Jenike

. Skin picking in German students. prevalence, phenomenology, and associated characteristics. Behav Modif. 2002;26(3):320-339.doi:10.1177/0145445502026003002

12080904

154.

Anzengruber

Ruhwinkel

Ghosh

Klaghofer

Lang

UE.

Navarini

. Wide range of age of onset and low referral rates to psychiatry in a large cohort of acne excoriée at a Swiss tertiary hospital. J Dermatolog Treat. 2018;29(3):277-280.doi:10.1080/09546634.2017.1364693

28784003

155.

Niforatos

JD.

Chaitoff

. Factitious disorder commonly presents as dermatitis factitia: a U.S. population-based study. Gen Hosp Psychiatry. 2020;64:129-130.doi:10.1016/j.genhosppsych.2020.02.003

32081412

156.

Nielsen

Jeppesen

Simmelsgaard

Rasmussen

Thestrup-Pedersen

. Self-Inflicted skin diseases. A retrospective analysis of 57 patients with dermatitis artefacta seen in a dermatology department. Acta Derm Venereol. 2005;85(6):512-515.doi:10.1080/00015550510038250

16396799

157.

Rodríguez Pichardo

García Bravo

. Dermatitis artefacta: a review. Actas Dermosifiliogr. 2013;104(10):854-866.doi:10.1016/j.ad.2012.10.004

23266056

158.

Bresin

Schoenleber

. Gender differences in the prevalence of nonsuicidal self-injury: a meta-analysis. Clin Psychol Rev. 2015;38:55-64.doi:10.1016/j.cpr.2015.02.009

25795294

159.

Warthan

MM.

Uchida

Wagner

. Uv light tanning as a type of substance-related disorder. Arch Dermatol. 2005;141(8):963-966.doi:10.1001/archderm.141.8.963

16103324

160.

Eder

Thavaneswaran

Chandran

Gladman

. Gender difference in disease expression, radiographic damage and disability among patients with psoriatic arthritis. Ann Rheum Dis. 2013;72(4):578-582.doi:10.1136/annrheumdis-2012-201357

22589379

161.

Corson

EF.

Luscombe

. Coincidence of pityriasis rosea with pregnancy. AMA Arch Derm Syphilol. 1950;62(4):562-564.doi:10.1001/archderm.1950.01530170088012

14770492

162.

Drago

FMD.

Broccolo

FMD.

Rebora

AMD

. Pityriasis rosea: An update with a critical appraisal of its possible herpesviral etiology. J Am Acad Dermatol. 2009;61(2):303-318.doi:10.1016/j.jaad.2008.07.045

19615540

163.

Mahajan

Relhan

AK.

Garg

. Pityriasis rosea: an update on etiopathogenesis and management of difficult aspects. Indian J Dermatol. 2016;61(4):375-384.doi:10.4103/0019-5154.185699

27512182

164.

Joshi

TP.

Calderara

GA.

Lipoff

. Prevalence of pityriasis rosea in the United States: A cross-sectional study using the All of Us database. JAAD Int. 2022;8:45-46.doi:10.1016/j.jdin.2022.04.006

35620324

165.

Tabata

Tagami

Terui

. Dehydroepiandrosterone may be one of the regulators of cytokine production in atopic dermatitis. Arch Dermatol Res. 1997;289(7):410-414.doi:10.1007/s004030050213

9248620

166.

Johansson

EK.

Bergström

Kull

et al. Prevalence and characteristics of atopic dermatitis among young adult females and males-report from the Swedish population-based study BAMSE. J Eur Acad Dermatol Venereol. 2022;36(5):698-704.doi:10.1111/jdv.17929

35032357

167.

Diepgen

TL.

Ofenloch

RF.

Bruze

et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319-329.doi:10.1111/bjd.14167

26370659

168.

Del Rosso

. Adult seborrheic dermatitis: a status report on practical topical management. J Clin Aesthet Dermatol. 2011;4(5):32-38.21607192

169.

Gupta

AK.

Madzia

SE.

Batra

. Etiology and management of seborrheic dermatitis. Dermatology. 2004;208(2):89-93.doi:10.1159/000076478

15056994

170.

Borda

LJ.

Wikramanayake

. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol. 2015;3(2)doi:10.13188/2373-1044.1000019 15 12 2015.27148560

171.

Bergan

JJ.

Schmid-Schönbein

GW.

Smith

PD.

Nicolaides

AN.

Boisseau

MR.

Eklof

. Chronic venous disease. N Engl J Med. 2006;355(5):488-498.doi:10.1056/NEJMra055289

16885552

172.

Kyriakis

KP.

Terzoudi

Palamaras

Michailides

Emmanuelidis

Pagana

. Sex and age distribution of patients with lichen planus. J Eur Acad Dermatol Venereol. 2006;20(5):625-626.doi:10.1111/j.1468-3083.2006.01513.x

16684307

173.

Wagner

Rose

Sachse

. Clinical variants of lichen planus. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2013;11(4):309-319.

174.

Tang

Zheng

et al. Global prevalence and incidence estimates of oral lichen planus: a systematic review and meta-analysis. JAMA Dermatol. 2020;156(2):172-181.doi:10.1001/jamadermatol.2019.3797

31895418

175.

Tang

Zheng

et al. Global prevalence and incidence estimates of oral lichen planus: a systematic review and meta-analysis. JAMA dermatology. 2020;156(2):172-181.doi:10.1001/jamadermatol.2019.3797

31895418

176.

Lavanya

Jayanthi

Rao

UK.

Ranganathan

. Oral lichen planus: an update on pathogenesis and treatment. J Oral Maxillofac Pathol. 2011;15(2):127.doi:10.4103/0973-029X.84474

22529568

177.

Shen

Z-Y.

Liu

Zhu

L-K.

Feng

J-Q.

Tang

G-Y.

Zhou

Z-T

. A retrospective clinicopathological study on oral lichen planus and malignant transformation: analysis of 518 cases. Med Oral Patol Oral Cir Bucal. 2012;17(6):e943-e947.doi:10.4317/medoral.17778

22549677

178.

Weston

Payette

. Update on lichen planus and its clinical variants. Int J Womens Dermatol. 2015;1(3):140-149.doi:10.1016/j.ijwd.2015.04.001

28491978

179.

Charifa

Jamil

RT.

Ramphul

180.

Schwartz

Goodman

181.

Virgili

Borghi

Cazzaniga

et al. Gender differences in genital lichen sclerosus: data from a multicenter Italian study on 729 consecutive cases. G Ital Dermatol Venereol. 2020;155(2):155-160.doi:10.23736/S0392-0488.17.05819-9

29368855

182.

Fergus

KB.

Lee

AW.

Baradaran

et al. Pathophysiology, clinical manifestations, and treatment of lichen sclerosus: a systematic review. Urology. 2020;135:11-19.doi:10.1016/j.urology.2019.09.034

31605681

183.

Balakirski

Grothaus

Altengarten

Ott

. Paediatric lichen sclerosus: a systematic review of 4516 cases. Br J Dermatol. 2020;182(1):231-233.doi:10.1111/bjd.18267

31260081

184.

Chamli

Souissi

185.

Fistarol

SK.

Itin

. Diagnosis and treatment of lichen sclerosus: an update. Am J Clin Dermatol. 2013;14(1):27-47.doi:10.1007/s40257-012-0006-4

23329078

186.

Tan

JKL.

Bhate

. A global perspective on the epidemiology of acne. Br J Dermatol. 2015;172 Suppl 1(Suppl 1):3-12.doi:10.1111/bjd.13462

25597339

187.

Aksu

AE.

Metintas

Saracoglu

et al. Acne: prevalence and relationship with dietary habits in Eskisehir, Turkey. J Eur Acad Dermatol Venereol. 2012;26(12):1503-1509.doi:10.1111/j.1468-3083.2011.04329.x

22070422

188.

Shen

Wang

Zhou

et al. Prevalence of acne vulgaris in Chinese adolescents and adults: a community-based study of 17,345 subjects in six cities. Acta Derm Venereol. 2012;92(1):40-44.doi:10.2340/00015555-1164

21710106

189.

Shahzad

Nasir

Ikram

et al. Asmaa ul H, Qadir a, Sohail MA. frequency and psychosocial impact of acne on university and college students. J Coll Physicians Surg Pak. 2011;21(7):442-443.

190.

Silverberg

JI.

Silverberg

. Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study. Br J Dermatol. 2014;170(5):1136-1142.doi:10.1111/bjd.12912

24641612

191.

Lynn

DD.

Umari

Dunnick

CA.

Dellavalle

. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016;7:13-25.doi:10.2147/AHMT.S55832

26955297

192.

McCarty

. Evaluation and management of refractory acne vulgaris in adolescent and adult men. Dermatol Clin. 2016;34(2):203-206.doi:10.1016/j.det.2015.11.007

27015780

193.

Tan

Beissert

Cook-Bolden

et al. Impact of facial and truncal acne on quality of life: a multi-country population-based survey. JAAD Int. 2021;3:102-110.doi:10.1016/j.jdin.2021.03.002

34409378

194.

Zaenglein

AL.

Pathy

AL.

Schlosser

et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.doi:10.1016/j.jaad.2015.12.037

26897386

195.

Tanghetti

Harper

JC.

Oefelein

. The efficacy and tolerability of dapsone 5% gel in female vs male patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol. 2012;11(12):1417-1421.23377510

196.

Hassan

Grogan

Clark-Carter

Richards

Yates

. The individual health burden of acne: appearance-related distress in male and female adolescents and adults with back, chest and facial acne. J Health Psychol. 2009;14(8):1105-1118.doi:10.1177/1359105309342470

19858331

197.

Yousaf

Hagen

Delaney

Davis

Zinn

. The influence of social media on acne treatment: a cross-sectional survey. Pediatr Dermatol. 2020;37(2):301-304.doi:10.1111/pde.14091

31944359

198.

Knapik

JJ.

Steelman

RA.

Hoedebecke

SS.

Austin

KG.

Farina

EK.

Lieberman

. Prevalence of dietary supplement use by athletes: systematic review and meta-analysis. Sports Med. 2016;46(1):103-123.doi:10.1007/s40279-015-0387-7

26442916

199.

Vos

Flaxman

AD.

Naghavi

et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2163-2196.doi:10.1016/S0140-6736(12)61729-2

23245607

200.

Rainer

BM.

Kang

Chien

. Rosacea: epidemiology, pathogenesis, and treatment. Dermatoendocrinol. 2017;9(1):e1361574 doi:10.1080/19381980.2017.1361574

29484096

201.

Rainer

BM.

Fischer

AH.

Luz Felipe da Silva

Kang

Chien

. Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: results of a case-control study. J Am Acad Dermatol. 2015;73(4):604-608.doi:10.1016/j.jaad.2015.07.009

26256428

202.

Crawford

GH.

Pelle

MT.

James

. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol. 2004;51(3):327-341. [quiz 42-4.].doi:10.1016/j.jaad.2004.03.030

15337973

203.

Sibenge

Gawkrodger

. Rosacea: a study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol. 1992;26(4):590-593.doi:10.1016/0190-9622(92)70086-u

1534568

204.

Kyriakis

KP.

Palamaras

Terzoudi

Emmanuelides

Michailides

Pagana

. Epidemiologic aspects of rosacea. J Am Acad Dermatol. 2005;53(5):918-919.doi:10.1016/j.jaad.2005.05.018

16243167

205.

Second

Severac

Paix

Cribier

. Rhinophyma is associated with alcohol intake. J Am Acad Dermatol. 2019;81(1):249-250.doi:10.1016/j.jaad.2018.12.046

30630023

206.

Spoendlin

Voegel

JJ.

Jick

SS.

Meier

. A study on the epidemiology of rosacea in the U.K.. K. Br J Dermatol. 2012;167(3):598-605.doi:10.1111/j.1365-2133.2012.11037.x

22564022

207.

Walsh

RK.

Endicott

AA.

Shinkai

. Diagnosis and treatment of rosacea fulminans: a comprehensive review. Am J Clin Dermatol. 2018;19(1):79-86.doi:10.1007/s40257-017-0310-0

28656562

208.

Garg

Kirby

JS.

Lavian

Lin

Strunk

. Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States. JAMA Dermatol. 2017;153(8):760-764.doi:10.1001/jamadermatol.2017.0201

28492923

209.

Morss

PC.

Porter

ML.

Savage

KT.

Rosales Santillan

Giannotti

Kimball

. Investigating race and gender in age at onset of hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2020;34(3):e139-e41.doi:10.1111/jdv.16095

31736152

210.

Bianchi

Caposiena Caro

RD.

Ganzetti

et al. Sex-related differences of clinical features in hidradenitis suppurativa: analysis of an Italian-based cohort. Clin Exp Dermatol. 2019;44(5):e177-e80.doi:10.1111/ced.13861

30593710

211.

Cosmatos

Matcho

Weinstein

Montgomery

MO.

Stang

. Analysis of patient claims data to determine the prevalence of hidradenitis suppurativa in the United States. J Am Acad Dermatol. 2013;69(5):819 doi:10.1016/j.jaad.2013.06.042

24124817

212.

Benhadou

Villani

AP.

Guillem

. Which factors determine affected sites in hidradenitis suppurativa? Dermatology. 2020;236(1):15-20.doi:10.1159/000505292

31905351

213.

Burney

. 35-Year experience with surgical treatment of hidradenitis suppurativa. World J Surg. 2017;41(11):2723-2730.doi:10.1007/s00268-017-4091-7

28612149

214.

Jourabchi

Fischer

AH.

Cimino-Mathews

Waters

KM.

Okoye

. Squamous cell carcinoma complicating a chronic lesion of hidradenitis suppurativa: a case report and review of the literature. Int Wound J. 2017;14(2):435-438.doi:10.1111/iwj.12671

27681476

215.

Cuenca-Barrales

Ruiz-Villaverde

Molina-Leyva

. Sexual distress in patients with hidradenitis suppurativa: a cross-sectional study. J Clin Med. 2019;8(4):532 doi:10.3390/jcm8040532 18 04 2019.31003427

216.

Kurek

Peters

EM.

Chanwangpong

Sabat

Sterry

Schneider-Burrus

. Profound disturbances of sexual health in patients with acne inversa. J Am Acad Dermatol. 2012;67 8(3):422 [8 e1].doi:10.1016/j.jaad.2011.10.024

22182915

217.

Kluger

Sintonen

Ranta

Serlachius

. Health-Related quality of life of patients with hidradenitis suppurativa measured with the 15D instrument and comparison with the general population and patients with psoriasis. Skin Appendage Disord. 2018;4(3):131-135.doi:10.1159/000481117

30197887

218.

Yee

Collier

EK.

Atluri

Jaros

Shi

VY.

Hsiao

. Gender differences in sexual health impairment in hidradenitis suppurativa: A systematic review. Int J Womens Dermatol. 2021;7(3):259-264.doi:10.1016/j.ijwd.2020.10.010

34222580

219.

Yang

JH.

Moon

Kye

et al. Demographic and clinical features of hidradenitis suppurativa in Korea. J Dermatol. 2018;45(12):1389-1395.doi:10.1111/1346-8138.14656

30294846

220.

Jfri

AH.

O'Brien

EA.

Litvinov

IV.

Alavi

Netchiporouk

. Hidradenitis suppurativa: comprehensive review of predisposing genetic mutations and changes. J Cutan Med Surg. 2019;23(5):519-527.doi:10.1177/1203475419852049

31167568

221.

Lear

Kessler

Solish

Glaser

. An epidemiological study of hyperhidrosis. Dermatol Surg. 2007;33(1 Spec No.):S69-75.doi:10.1111/j.1524-4725.2006.32334.x

17241417

222.

Ricchetti-Masterson

Symons

JM.

Aldridge

et al. Epidemiology of hyperhidrosis in 2 population-based health care databases. J Am Acad Dermatol. 2018;78(2):358-362.doi:10.1016/j.jaad.2017.10.004

28993234

223.

Strutton

DR.

Kowalski

JW.

Glaser

DA.

Stang

. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004;51(2):241-248.doi:10.1016/j.jaad.2003.12.040

15280843

224.

Karimian-Teherani

Panhofer

Ringhofer

et al. New epidemiological aspects of patients with severe hyperhidrosis presenting for sympathetic surgery. J Eur Acad Dermatol Venereol. 2009;23(6):651-655.doi:10.1111/j.1468-3083.2009.03131.x

19250333

225.

Lenefsky

Rice

. Hyperhidrosis and its impact on those living with it. Am J Manag Care. 2018;24(23 Suppl):S491-s5.30589248

226.

Moraites

Vaughn

OA.

Hill

. Incidence and prevalence of hyperhidrosis. Dermatol Clin. 2014;32(4):457-465.doi:10.1016/j.det.2014.06.006

25152338

227.

Doolittle

Walker

Mills

Thurston

. Hyperhidrosis: an update on prevalence and severity in the United States. Arch Dermatol Res. 2016;308(10):743-749.doi:10.1007/s00403-016-1697-9

27744497

228.

Lapi

Cassano

Pegoraro

et al. Epidemiology of chronic spontaneous urticaria: results from a nationwide, population-based study in Italy. Br J Dermatol. 2016;174(5):996-1004.doi:10.1111/bjd.14470

26872037

229.

Netchiporouk

Sasseville

Moreau

Habel

Rahme

Ben-Shoshan

. Evaluating comorbidities, natural history, and predictors of early resolution in a cohort of children with chronic urticaria. JAMA Dermatol. 2017;153(12):1236-1242.doi:10.1001/jamadermatol.2017.3182

28973060

230.

Magen

Mishal

Schlesinger

. Clinical and laboratory features of chronic idiopathic urticaria in the elderly. Int J Dermatol. 2013;52(11):1387-1391.doi:10.1111/ijd.12109

23834467

231.

Zhong

Song

Chen

et al. Chronic urticaria in Chinese population: a hospital-based multicenter epidemiological study. Allergy. 2014;69(3):359-364.doi:10.1111/all.12338

24354882

232.

Amsler

Augey

Soria

et al. Chronic urticaria and hormones: Is there a link? J Eur Acad Dermatol Venereol. 2016;30(9):1527-1530.doi:10.1111/jdv.13644

27004766

233.

AP.

Souza

PK.

Rotta

Furlani

WdeJ.

Lima

AR.

Sabbag

. Quality of life assessment in patients with chronic urticaria. An Bras Dermatol. 2011;86(5):897-904.doi:10.1590/s0365-05962011000500006

22147026

234.

Młynek

Magerl

Hanna

et al. The German version of the chronic urticaria quality-of-life questionnaire: factor analysis, validation, and initial clinical findings. Allergy. 2009;64(6):927-936.doi:10.1111/j.1398-9995.2008.01920.x

19453340

235.

Savic

Leeman

El-Shanawany

et al. Chronic urticaria in the real-life clinical practice setting in the UK: results from the noninterventional multicentre AWARE study. Clin Exp Dermatol. 2020;45(8):1003-1010.doi:10.1111/ced.14230

32246853

236.

Gregoriou

Rigopoulos

Katsambas

et al. Etiologic aspects and prognostic factors of patients with chronic urticaria: nonrandomized, prospective, descriptive study. J Cutan Med Surg. 2009;13(4):198-203.doi:10.2310/7750.2008.08035

19706227

237.

Broder

MS.

Raimundo

Antonova

Chang

. Resource use and costs in an insured population of patients with chronic idiopathic/spontaneous urticaria. Am J Clin Dermatol. 2015;16(4):313-321.doi:10.1007/s40257-015-0134-8

26055728

238.

Cassano

Colombo

Bellia

Zagni

Vena

. Gender-related differences in chronic urticaria. G Ital Dermatol Venereol. 2016;151(5):544-552.26091277

239.

Kolkhir

Church

MK.

Weller

Metz

Schmetzer

Maurer

. Autoimmune chronic spontaneous urticaria: What we know and what we do not know. J Allergy Clin Immunol. 2017;139(6):1772-1781.doi:10.1016/j.jaci.2016.08.050

27777182

240.

Asero

. Sex differences in the pathogenesis of chronic urticaria. J Allergy Clin Immunol. 2003;111(2):425-426.doi:10.1067/mai.2003.15

12589367

241.

Confino-Cohen

Chodick

Shalev

Leshno

Kimhi

Goldberg

. Chronic urticaria and autoimmunity: Associations found in a large population study. J Allergy Clin Immunol. 2012;129(5):1307-1313.doi:10.1016/j.jaci.2012.01.043

22336078

242.

Munetsugu

Fujimoto

Oshima

et al. Revised guideline for the diagnosis and treatment of acquired idiopathic generalized anhidrosis in Japan. J Dermatol. 2017;44(4):394-400.doi:10.1111/1346-8138.13649

27774633

243.

Asady

Ruft

Ellrich

Hawro

Maurer

Altrichter

. Cholinergic urticaria patients of different age groups have distinct features. Clin Exp Allergy. 2017;47(12):1609-1614.doi:10.1111/cea.13023

28873238

244.

Yee

CSK.

El Khoury

Albuhairi

Broyles

Schneider

Rachid

. Acquired cold-induced urticaria in pediatric patients: a 22-year experience in a tertiary care center (1996-2017. J Allergy Clin Immunol Pract. 2019;7(3):1024-1031.doi:10.1016/j.jaip.2018.10.025

30385406

245.

Buss

YL.

Sticherling

. Cold urticaria; disease course and outcome – an investigation of 85 patients before and after therapy. Br J Dermatol. 2005;153(2):440-441.doi:10.1111/j.1365-2133.2005.06757.x

16086764

246.

Liu

Wang

. Symptomatic dermographism in Chinese population: an epidemiological study of hospital-based multicenter questionnaire survey. Curr Med Res Opin. 2022;38(1):131-137.doi:10.1080/03007995.2021.1984220

34550851

247.

Nzeako

UC.

Frigas

Tremaine

. Hereditary angioedema: a broad review for clinicians. Arch Intern Med. 2001;161(20):2417-2429.doi:10.1001/archinte.161.20.2417

11700154

248.

Bork

Barnstedt

SE.

Koch

Traupe

. Hereditary angioedema with normal C1-inhibitor activity in women. Lancet. 2000;356(9225):213-217.doi:10.1016/S0140-6736(00)02483-1

10963200

249.

Bork

Gül

Dewald

. Hereditary angio-oedema with normal C1 inhibitor in a family with affected women and men. Br J Dermatol. 2006;154(3):542-545.doi:10.1111/j.1365-2133.2005.07048.x

16445789

250.

Bork

Meng

Staubach

Hardt

. Hereditary angioedema: new findings concerning symptoms, affected organs, and course. Am J Med. 2006;119(3):267-274.doi:10.1016/j.amjmed.2005.09.064

16490473

251.

Bork

Fischer

Dewald

. Recurrent episodes of skin angioedema and severe attacks of abdominal pain induced by oral contraceptives or hormone replacement therapy. Am J Med. 2003;114(4):294-298.doi:10.1016/s0002-9343(02)01526-7

12681457

252.

Hews-Girard

Goodyear

. Psychosocial burden of type 1 and 2 hereditary angioedema: a single-center Canadian cohort study. Allergy Asthma Clin Immunol. 2021;17(1):61.doi:10.1186/s13223-021-00563-0

34187550

253.

Campo

Fernandez

TD.

Canto

Mayorga

. Angioedema induced by angiotensin-converting enzyme inhibitors. Curr Opin Allergy Clin Immunol. 2013;13(4):337-44 doi:10.1097/ACI.0b013e328362b835

23743513

254.

Calamia

KT.

Wilson

FC.

Icen

Crowson

CS.

Gabriel

SE.

Kremers

. Epidemiology and clinical characteristics of Behçet's disease in the US: a population-based study. Arthritis Rheum. 2009;61(5):600-604.doi:10.1002/art.24423

19405011

255.

Bonitsis

NG.

Luong Nguyen

LB.

LaValley

et al. Gender-specific differences in Adamantiades–Behçet’s disease manifestations: an analysis of the German registry and meta-analysis of data from the literature. Rheumatology (Oxford). 2015;54(1):121-133.doi:10.1093/rheumatology/keu247

25118314

256.

Saadoun

Wechsler

Desseaux

et al. Mortality in Behçet’s disease. Arthritis Rheum. 2010;62(9):2806-2812.doi:10.1002/art.27568

20496419

257.

Langan

SM.

Groves

RW.

Card

TR.

Gulliford

. Incidence, mortality, and disease associations of pyoderma gangrenosum in the United Kingdom: a retrospective cohort study. J Invest Dermatol. 2012;132(9):2166-2170.doi:10.1038/jid.2012.130

22534879

258.

Balgobind

Strunk

Garg

Alloo

. Prevalence estimates for pyoderma gangrenosum in the United States: an age- and sex-adjusted population analysis. J Am Acad Dermatol. 2020;83(2):425-429.doi:10.1016/j.jaad.2019.08.001

31400451

259.

von den Driesch

. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-556.doi:10.1016/S0190-9622(94)70215-2

8089280

260.

Amouri

Masmoudi

Ammar

et al. Sweet’s syndrome: a retrospective study of 90 cases from a tertiary care center. Int J Dermatol. 2016;55(9):1033-1039.doi:10.1111/ijd.13232

26967709

261.

Sáez

García-Bustínduy

Noda

et al. Drug-induced Sweet’s syndrome. J Eur Acad Dermatol Venereol. 2004;18(2):233.doi:10.1111/j.1468-3083.2004.00866.x

15009320

262.

Cohen

PR.

Kurzrock

. Sweet’s syndrome and cancer. Clinics in Dermatology. 1993;11(1):149-157.doi:10.1016/0738-081x(93)90112-p

8339190

263.

Heath

MS.

Ortega-Loayza

. Insights into the pathogenesis of sweet's syndrome. Front Immunol. 2019;10:414 doi:10.3389/fimmu.2019.00414

30930894

264.

Satra

Zalka

Cohen

PR.

Grossman

. Sweet’s syndrome and pregnancy. J Am Acad Dermatol. 1994;30(2):297-300.doi:10.1016/s0190-9622(08)81068-7

8294585

265.

Cohen

. Pregnancy-Associated sweet's syndrome: world literature review. Obstet Gynecol Surv. 1993;48(8):584-587.doi:10.1097/00006254-199308000-00027

8371901

266.

Giovanna Brunasso

AM.

Massone

. Clinical images. sweet syndrome during pregnancy. CMAJ. 2008;179(9):967.doi:10.1503/cmaj.080250

18936462

267.

Hayem

Bouchaud-Chabot

Benali

et al. Sapho syndrome: a long-term follow-up study of 120 cases. Semin Arthritis Rheum. 1999;29(3):159-171.doi:10.1016/S0049-0172(99)80027-4

10622680

268.

Colina

Govoni

Orzincolo

Trotta

. Clinical and radiologic evolution of synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: A single center study of a cohort of 71 subjects. Arthritis Rheum. 2009;61(6):813-821.doi:10.1002/art.24540

19479702

269.

Zuo

et al. Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome: a single centre study of a cohort of 164 patients. Rheumatology (Oxford). 2016;55(6):1023-1030.doi:10.1093/rheumatology/kew015

26917545

270.

Kavand

Lehman

JS.

Gibson

. Granuloma faciale and erythema elevatum diutinum in relation to immunoglobulin G4-related disease: an appraisal of 32 cases. Am J Clin Pathol. 2016;145(3):401-406.doi:10.1093/ajcp/aqw004

27124923

271.

Ortonne

Wechsler

Bagot

Grosshans

Cribier

. Granuloma faciale: a clinicopathologic study of 66 patients. J Am Acad Dermatol. 2005;53(6):1002-1009.doi:10.1016/j.jaad.2005.08.021

16310061

272.

Radin

DA.

Mehregan

. Granuloma faciale: distribution of the lesions and review of the literature 72(3):213-9;. Cutis quiz. 2003;08(3):213-9; quiz 208.14533833

273.

Mufti

Lytvyn

Abduelmula

Kim

Sachdeva

Yeung

. Treatment outcomes in patients with papuloerythroderma of Ofuji: A systematic review. JAAD International. 2021;3:18-22.doi:10.1016/j.jdin.2021.02.001

34409367

274.

Torchia

Miteva

Cohen

Romanelli

. Papuloerythroderma 2009: two new cases and systematic review of the worldwide literature 25 years after its identification by Ofuji, et al. Dermatol. 2010;220(4):311-320.doi:10.1159/000301915

20339287

275.

Nomura

Katoh

Yamamoto

Kabashima

Miyachi

. Eosinophilic pustular folliculitis: The transition in sex differences and interracial characteristics between 1965 and 2013. J Dermatol. 2015;42(4):343-352.doi:10.1111/1346-8138.12783

25675987

276.

Katoh

Nomura

Miyachi

Kabashima

. Eosinophilic pustular folliculitis: a review of the Japanese published works. J Dermatol. 2013;40(1):15-20.doi:10.1111/1346-8138.12008

23083212

277.

Moossavi

Mehregan

. Wells' syndrome: a clinical and histopathologic review of seven cases. Int J Dermatol. 2003;42(1):62-67.doi:10.1046/j.1365-4362.2003.01705.x

12581147

278.

Crane

MM.

Chang

CM.

Kobayashi

MG.

Weller

. Incidence of myeloproliferative hypereosinophilic syndrome in the United States and an estimate of all hypereosinophilic syndrome incidence. J Allergy Clin Immunol. 2010;126(1):179-181.doi:10.1016/j.jaci.2010.03.035

20639012

279.

Pardanani

Brockman

SR.

Paternoster

et al. FIP1L1-PDGFRA fusion: prevalence and clinicopathologic correlates in 89 consecutive patients with moderate to severe eosinophilia. Blood. 2004;104(10):3038-3045.doi:10.1182/blood-2004-03-0787

15284118

280.

Ogbogu

PU.

Bochner

BS.

Butterfield

et al. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 2009;124(6):1319-1325.doi:10.1016/j.jaci.2009.09.022

19910029

281.

Kim

DH.

Lee

JH.

Lee

JY.

Park

. Erythema annulare Centrifugum: analysis of associated diseases and clinical outcomes according to histopathologic classification. Ann Dermatol. 2016;28(2):257-259.doi:10.5021/ad.2016.28.2.257

27081281

282.

Kim

KJ.

Chang

SE.

Choi

JH.

Sung

KJ.

Moon

KC.

Koh

. Clinicopathologic analysis of 66 cases of erythema annulare centrifugum. J Dermatol. 2002;29(2):61-67.doi:10.1111/j.1346-8138.2002.tb00167.x

11890297

283.

Weyers

Diaz-Cascajo

Weyers

. Erythema annulare centrifugum: results of a clinicopathologic study of 73 patients. Am J Dermatopathol. 2003;25(6):451-62 doi:10.1097/00000372-200312000-00001

14631185

284.

Hughes

Adler

Merrill

et al. Analysis of autosomal genes reveals gene-sex interactions and higher total genetic risk in men with systemic lupus erythematosus. Ann Rheum Dis. 2012;71(5):694-699.doi:10.1136/annrheumdis-2011-200385

22110124

285.

Chang

YC.

Werth

. Update on epidemiology and clinical assessment tools of cutaneous lupus erythematosus and dermatomyositis. Curr Dermatol Rep. 2013;2(1):48-57.doi:10.1007/s13671-012-0037-3

33585073

286.

DeWane

ME.

Waldman

. Dermatomyositis: clinical features and pathogenesis. J Am Acad Dermatol. 2020;82(2):267-281.doi:10.1016/j.jaad.2019.06.1309

31279808

287.

Lenert

GYeon.

Ombrello

MJ.

Kim

. Clinical characteristics and comorbidities in adult-onset still's disease using a large US administrative claims database. Rheumatology. 2020;59(7):1725-1733.doi:10.1093/rheumatology/kez622

31965185

288.

Mollaeian

Chen

Chan

NN.

Nizialek

GA.

Haas

. Adult onset Still’s disease in the elderly: a case-based literature review. BMC Rheumatol. 2021;5(1):12.doi:10.1186/s41927-021-00183-6

33875007

289.

Sfriso

Priori

Valesini

et al. Adult-onset Still’s disease: an Italian multicentre retrospective observational study of manifestations and treatments in 245 patients. Clin Rheumatol. 2016;35(7):1683-1689.doi:10.1007/s10067-016-3308-8

27207567

290.

Pay

Turkcapar

Kalyoncu

et al. A multicenter study of patients with adult-onset Still’s disease compared with systemic juvenile idiopathic arthritis. Clin Rheumatol. 2006;25(5):639-644.doi:10.1007/s10067-005-0138-5

16365690

291.

Gerfaud-Valentin

Maucort-Boulch

Hot

et al. Adult-onset still disease: manifestations, treatment, outcome, and prognostic factors in 57 patients. Medicine (Baltimore). 2014;93(2):91-99.doi:10.1097/MD.0000000000000021

24646465

292.

Smylie

Malhotra

Brassard

. Relapsing Polychondritis: A Review and Guide for the Dermatologist. Am J Clin Dermatol. 2017;18(1):77-86.doi:10.1007/s40257-016-0226-0

27696147

293.

Hazra

Dregan

Charlton

Gulliford

MC.

D'Cruz

. Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study. Rheumatology (Oxford). 2015;54(12):2181-2187.doi:10.1093/rheumatology/kev240

26187053

294.

Frances

el Rassi

Laporte

JL.

Rybojad

Papo

Piette

. Dermatologic manifestations of relapsing polychondritis. A study of 200 cases at a single center. Medicine (Baltimore). 2001;80(3):173-179.doi:10.1097/00005792-200105000-00003

11388093

295.

Pallo

PAO.

Levy-Neto

Pereira

RMR.

Shinjo

. Relapsing polychondritis: prevalence of cardiovascular diseases and its risk factors, and general disease features according to gender. Rev Bras Reumatol Engl Ed. 2017;57(4):338-345.doi:10.1016/j.rbre.2017.02.003

28743361

296.

Duruöz

MT.

Ozer

Gezer

et al. POS1354 gender differences in clinical features and burden in patients with familial Mediterranean fever: preliminary report. Annals of the Rheumatic Diseases. 2021;80(Suppl 1):959-960.doi:10.1136/annrheumdis-2021-eular.2317

297.

Bali

Kárpáti

Sárdy

Brodszky

Hidvégi

Rencz

. Association between quality of life and clinical characteristics in patients with morphea. Qual Life Res. 2018;27(10):2525-2532.doi:10.1007/s11136-018-1897-1

29922914

298.

Fett

Werth

. Update on morphea: part I. Epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol. 2011;64(2):217-228. [quiz 29-30.].doi:10.1016/j.jaad.2010.05.045

21238823

299.

Herrick

AL.

Ennis

Bhushan

Silman

AJ.

Baildam

. Incidence of childhood linear scleroderma and systemic sclerosis in the UK and Ireland. Arthritis Care Res (Hoboken). 2010;62(2):213-218.doi:10.1002/acr.20070

20191520

300.

Arora

Wetter

DA.

Gonzalez-Santiago

TM.

Davis

MDP.

Lohse

. Incidence of leukocytoclastic vasculitis, 1996 to 2010: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc. 2014;89(11):1515-1524.doi:10.1016/j.mayocp.2014.04.015

24981218

301.

Bouiller

Audia

Devilliers

et al. Etiologies and prognostic factors of leukocytoclastic vasculitis with skin involvement: A retrospective study in 112 patients. Medicine (Baltimore). 2016;95(28):e4238 doi:10.1097/MD.0000000000004238

27428231

302.

Lei

W-T.

Tsai

P-L.

Chu

S-H

et al. Incidence and risk factors for recurrent Henoch-Schönlein purpura in children from a 16-year nationwide database. Pediatr Rheumatol Online J. 2018;6(1 1):25 doi:10.1186/s12969-018-0247-8

29661187

303.

Yang

YH.

Hung

CF.

Hsu

et al. A nationwide survey on epidemiological characteristics of childhood Henoch–Schönlein purpura in Taiwan. Rheumatology (Oxford). 2005;44(5):618-622.doi:10.1093/rheumatology/keh544

15671050

304.

Jachiet

Flageul

Deroux

et al. The Clinical Spectrum and Therapeutic Management of hypocomplementemic urticarial vasculitis: Data from a French Nationwide study of fifty-seven patients. Arthritis Rheumatol. 2015;67(2):527-534.doi:10.1002/art.38956

25385679

305.

Kitching

AR.

Anders

HJ.

Basu

et al. ANCA-associated vasculitis. Nat Rev Dis Primers. 2020;6(1):71.doi:10.1038/s41572-020-0204-y

32855422

306.

Iudici

Quartier

Terrier

Mouthon

Guillevin

Puéchal

. Childhood-onset granulomatosis with polyangiitis and microscopic polyangiitis: systematic review and meta-analysis. Orphanet J Rare Dis. 2016;11(1):141 doi:10.1186/s13023-016-0523-y

27770813

307.

Bjørneklett

Solbakken

Bostad

Fismen

. Exploring sex-specific differences in the presentation and outcomes of ANCA-associated vasculitis: a nationwide registry-based cohort study. Int Urol Nephrol. 2018;50(7):1311-1318.doi:10.1007/s11255-018-1888-8

29790004

308.

Kwon

HC.

Pyo

JY.

Lee

et al. Male sex is a significant predictor of all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis. J Korean Med Sci. 2021;36(18):e120 doi:10.3346/jkms.2021.36.e120

33975396

309.

Robinson

Chanchlani

Gayowsky

et al. Incidence and short-term outcomes of Kawasaki disease. Pediatr Res. 2021;90(3):670-677.doi:10.1038/s41390-021-01496-5

33785879

310.

Yan

Pan

Sun

Tian

. Risk factors of coronary artery abnormality in children with Kawasaki disease: a systematic review and meta-analysis. Front Pediatr. 2019;7:374 doi:10.3389/fped.2019.00374

31612117

311.

Pagnoux

Seror

Henegar

et al. Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French vasculitis Study Group database. Arthritis Rheum. 2010;62(2):616-626.doi:10.1002/art.27240

20112401

312.

Kanecki

Nitsch-Osuch

Gorynski

Wierzba

Tarka

Tyszko

. Polyarteritis nodosa: decreasing incidence in Poland. Arch Med Sci. 2019;15(5):1308-1312.doi:10.5114/aoms.2017.68407

31572478

313.

Ungprasert

Koster

MJ.

Cheungpasitporn

Wijarnpreecha

Thongprayoon

Kroner

. Inpatient burden and association with comorbidities of polyarteritis nodosa: national inpatient sample 2014. Semin Arthritis Rheum. 2020;50(1):66-70.doi:10.1016/j.semarthrit.2019.07.009

31362895

314.

Gudbrandsson

Molberg

Ø.

Garen

Palm

Prevalence, incidence, and disease characteristics of Takayasu arteritis by ethnic background: data from a large, population-based cohort resident in southern Norway. Arthritis Care Res. 2017;69(2):278-285.doi:10.1002/acr.22931

27159262

315.

Saritas

Donmez

Direskeneli

Pamuk

. The epidemiology of Takayasu arteritis: a hospital-based study from northwestern part of Turkey. Rheumatol Int. 2016;36(7):911-916.doi:10.1007/s00296-016-3445-z

26936260

316.

Watanabe

Miyata

Tanemoto

. Current clinical features of new patients with Takayasu arteritis observed from Cross-Country research in Japan: age and sex specificity. Circulation. 2015;132(18):1701-1709.doi:10.1161/CIRCULATIONAHA.114.012547

26354799

317.

Nordborg

. Giant cell arteritis: epidemiological clues to its pathogenesis and an update on its treatment. Rheumatology (Oxford). 2003;42(3):413-421.doi:10.1093/rheumatology/keg116

12626790

318.

Robson

JC.

Kiran

Maskell

et al. The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. Ann Rheum Dis. 2015;74(1):129 doi:10.1136/annrheumdis-2013-204113

24095936

319.

Nir-Paz

Gross

Chajek-Shaul

. Sex differences in giant cell arteritis. J Rheumatol. 2002;29(6):1219

12064839

320.

Sturm

Dechant

Proft

Schulze-Koops

Hoffmann

Czihal

. Gender differences in giant cell arteritis: a case-control study. Clin Exp Rheumatol. 2016;34(3 Suppl 97):S70-72.27049638

321.

Speeckaert

van Geel

. Distribution patterns in generalized vitiligo. J Eur Acad Dermatol Venereol. 2014;28(6):755-762.doi:10.1111/jdv.12171

23651011

322.

Patil

Gautam

Nadkarni

Saboo

Godse

Setia

. Gender differences in clinicoepidemiological features of vitiligo: a cross-sectional analysis. ISRN Dermatol. 2014;2014:186197 doi:10.1155/2014/186197

24696786

323.

van Geel

Speeckaert

Taieb

et al. Koebner's phenomenon in vitiligo: European position paper. Pigment Cell Melanoma Res. 2011;24(3):564-573.doi:10.1111/j.1755-148X.2011.00838.x

21324101

324.

Blessmann Weber

Sponchiado de Avila

Albaneze

Magalhães de Oliveira

OL.

Sudhaus

BD.

Cestari

. Pityriasis alba: a study of pathogenic factors. J Eur Acad Dermatol Venereol. 2002;16(5):463-468.doi:10.1046/j.1468-3083.2002.00494.x

12428838

325.

Relyveld

GN.

Menke

HE.

Westerhof

. Progressive macular hypomelanosis: an overview. Am J Clin Dermatol. 2007;8(1):13-19.doi:10.2165/00128071-200708010-00002

17298102

326.

Vachiramon

Thadanipon

. Postinflammatory hypopigmentation. Clin Exp Dermatol. 2011;36(7):708-714.doi:10.1111/j.1365-2230.2011.04088.x

21671990

327.

Juntongjin

Laosakul

. Idiopathic guttate hypomelanosis: a review of its etiology, pathogenesis, findings, and treatments. Am J Clin Dermatol. 2016;17(4):403-411.doi:10.1007/s40257-016-0195-3

27206417

328.

عدالتخواه, حسن

امانی

. The correlation between melasma, ovarian cysts and androgenic hormones (a case-control study. Research Journal of Biological Sciences. 2007;2(5):593-596.

329.

IB.

Lambert

Lotti

TM.

Hercogová

Sintim-Damoa

Schwartz

. Melasma. G Ital Dermatol Venereol. 2012;147(4):413-418.23007216

330.

Vachiramon

Suchonwanit

Thadanipon

. Melasma in men. J Cosmet Dermatol. 2012;11(2):151-157.doi:10.1111/j.1473-2165.2012.00613.x

22672280

331.

Sialy

Hassan

Kaur

Dash

. Melasma in men: a hormonal profile. The Journal of dermatology. 2000;27(1):64-65.doi:10.1111/j.1346-8138.2000.tb02122.x

10692830

332.

Resnik

. Melasma induced by oral contraceptive drugs. JAMA. 1967;199(9):601-605.doi:10.1001/jama.1967.03120090043007

6071249

333.

Handel

AC.

Miot

LD.

Miot

. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89(5):771-782.doi:10.1590/abd1806-4841.20143063

25184917

334.

Combemale

Faisant

Guennoc

Dupin

Heyraud

. Erythema dyschromicum perstans: report of a new case and critical review of the literature. The Journal of dermatology. 1998;25(11):747-753.doi:10.1111/j.1346-8138.1998.tb02495.x

9863289

335.

Böer

Misago

Wolter

Kiryu

Wang

XD.

Ackerman

. Prurigo pigmentosa: a distinctive inflammatory disease of the skin. The American journal of dermatopathology. 2003;25(2):117-129.doi:10.1097/00000372-200304000-00005

12652193

336.

Shahrigharahkoshan

AlHalees

Pehr

. Ketogenic diet-induced prurigo pigmentosa: a rising association. Int J Dermatol. 2021;61(7):779-782.doi:10.1111/ijd.15991

34826138

337.

Callender

VD.

St.Surin-Lord

Davis

EC.

Maclin

. Postinflammatory hyperpigmentation. Am J Clin Dermatol. 2011;12(2):87-99.doi:10.2165/11536930-000000000-00000

338.

Wertenteil

Garg

Strunk

Alloo

. Prevalence estimates for pemphigoid in the United States: A sex-adjusted and age-adjusted population analysis. J Am Acad Dermatol. 2019;80(3):655-659.doi:10.1016/j.jaad.2018.08.030

30165164

339.

Persson

MSM.

Harman

KE.

Vinogradova

et al. Incidence, prevalence and mortality of bullous pemphigoid in England 1998-2017: a population-based cohort study. Br J Dermatol. 2021;184(1):68-77.doi:10.1111/bjd.19022

32147814

340.

Brick

KE.

Weaver

CH.

Lohse

et al. Incidence of bullous pemphigoid and mortality of patients with bullous pemphigoid in Olmsted County, Minnesota, 1960 through 2009. J Am Acad Dermatol. 2014;71(1):92-99.doi:10.1016/j.jaad.2014.02.030

24704091

341.

Cortés

Khelifa

Clivaz

et al. Mortality rate in bullous pemphigoid: a retrospective monocentric cohort study. Dermatology. 2012;225(4):320-325.doi:10.1159/000345625

23257934

342.

Lee

Seiffert-Sinha

Attwood

Sinha

. A retrospective study of patient-reported data of bullous pemphigoid and mucous membrane pemphigoid from a US-Based registry. Front Immunol. 2019;10(2219):2219 doi:10.3389/fimmu.2019.02219

31608053

343.

Naseer

SY.

Gill

Shah

Sinha

. Gender-Based variability in disease presentation in pemphigus vulgaris. J Drugs Dermatol. 2014;13(10):1225-1230.25607557

344.

Baican

Chiorean

Leucuta

et al. Prediction of survival for patients with pemphigus vulgaris and pemphigus foliaceus: a retrospective cohort study. Orphanet J Rare Dis. 2015;10(1):48 doi:10.1186/s13023-015-0263-4

25896794

345.

Kridin

Schmidt

. Epidemiology of pemphigus. JID Innov. 2021;1(1):100004 doi:10.1016/j.xjidi.2021.100004

34909708

346.

Kridin

. Pemphigus group overview. Immunol Res. 2018;66(2):255-270.doi:10.1007/s12026-018-8986-7

29479654

347.

Lepe

Yarrarapu

SNS.

Zito

348.

Zaheri

Pas

HH.

Bremer

et al. Paraneoplastic pemphigus: A detailed case series from the Netherlands revealing atypical cases. J Eur Acad Dermatol Venereol. 2023;37(1):147-153.doi:10.1111/jdv.18557

35993495

349.

Reunala

Hervonen

Salmi

. Dermatitis herpetiformis: an update on diagnosis and management. Am J Clin Dermatol. 2021;22(3):329-338.doi:10.1007/s40257-020-00584-2

33432477

350.

Salmi

TT.

Hervonen

Kautiainen

Collin

Reunala

. Prevalence and incidence of dermatitis herpetiformis: a 40-year prospective study from Finland. Br J Dermatol. 2011;165(2):354-359.doi:10.1111/j.1365-2133.2011.10385.x

21517799

351.

West

Fleming

KM.

Tata

LJ.

Card

TR.

Crooks

. Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study. Official journal of the American College of Gastroenterology | ACG. 2014;109(5)-768.doi:10.1038/ajg.2014.55

352.

Feinstein

JA.

Jambal

Peoples

et al. Assessment of the timing of milestone clinical events in patients with epidermolysis bullosa from North America. JAMA Dermatol. 2019;155(2):196-203.doi:10.1001/jamadermatol.2018.4673

30586139

353.

Sanmarkan

AD.

Sori

Thappa

DM.

Jaisankar

. Retrospective analysis of Stevens-Johnson syndrome and toxic epidermal necrolysis over a period of 10 years. Indian J Dermatol. 2011;56(1):25-29.doi:10.4103/0019-5154.77546

21572786

354.

Schöpf

Stühmer

Rzany

et al. And Stevens-Johnson syndrome: an epidemiologic study from West Germany. Archives of Dermatology. 1991;127(6):839-842.

355.

Cardones

. Drug reaction with eosinophilia and systemic symptoms (dress) syndrome. Clin Dermatol. 2020;38(6):702-711.doi:10.1016/j.clindermatol.2020.06.008

33341203

356.

McNamara

DR.

Tleyjeh

IM.

Berbari

et al. Incidence of lower-extremity cellulitis: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc. 2007;82(7):817-821.doi:10.4065/82.7.817

17605961

357.

Liu

Graber

CJ.

Karr

et al. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, 2004-2005. Clin Infect Dis. 2008;46(11):1637-1646.doi:10.1086/587893

18433335

358.

Collazos

de la Fuente

et al. Sex differences in hospitalized adult patients with cellulitis: a prospective, multicenter study. Int J Infect Dis. 2021;104:584-591.doi:10.1016/j.ijid.2021.01.044

33508477

359.

Peterson

RA.

Polgreen

LA.

Cavanaugh

JE.

Polgreen

. Increasing incidence, cost, and seasonality in patients hospitalized for cellulitis. Open Forum Infect Dis. 2017;4(1):ofx008 doi:10.1093/ofid/ofx008

28480281

360.

Rebman

AW.

Wang

Yang

et al. Incidence of Lyme disease diagnosis in a Maryland Medicaid population, 2004-2011. Am J Epidemiol. 2018;187(10):2202-2209.doi:10.1093/aje/kwy133

29955850

361.

Naleway

AL.

Belongia

EA.

Kazmierczak

JJ.

Greenlee

RT.

Davis

. Lyme disease incidence in Wisconsin: a comparison of state-reported rates and rates from a population-based cohort. Am J Epidemiol. 2002;155(12):1120-1127.doi:10.1093/aje/155.12.1120

12048226

362.

Spicknall

IH.

Kreisel

KM.

Weinstock

. Estimates of the prevalence and incidence of syphilis in the United States, 2018. Sex Transm Dis. 2021;48(4):247-252.doi:10.1097/OLQ.0000000000001364

363.

Peterman

TA.

Kidd

. Trends in deaths due to syphilis, United States, 1968-2015. Sex Transm Dis. 2019;46(1):37-40.doi:10.1097/OLQ.0000000000000899

30044338

364.

Yawn

BP.

Saddier

Wollan

PC.

St Sauver

JL.

Kurland

MJ.

, . A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007;82(11):1341-1349.doi:10.4065/82.11.1341

17976353

365.

Marra

Chong

Najafzadeh

. Increasing incidence associated with herpes zoster infection in British Columbia, Canada. BMC Infect Dis. 2016;16(1):589 doi:10.1186/s12879-016-1898-z

27765026

366.

Kawai

Yawn

. Risk factors for herpes zoster: a systematic review and meta-analysis. Mayo Clin Proc. 2017;92(12):1806-1821.doi:10.1016/j.mayocp.2017.10.009

29202939

367.

Opstelten

Van Essen

GA.

Schellevis

Verheij

TJM.

Moons

KGM

. Gender as an independent risk factor for herpes zoster: a population-based prospective study. Ann Epidemiol. 2006;16(9):692-695.doi:10.1016/j.annepidem.2005.12.002

16516488

368.

James

Harfouche

Welton

et al. Herpes simplex virus: global infection prevalence and incidence estimates, 2016. Bull World Health Organ. 2020;98(5):315-329.doi:10.2471/BLT.19.237149

32514197

369.

Fleming

DM.

Cross

KW.

Cobb

WA.

Chapman

. Gender difference in the incidence of shingles. Epidemiol Infect. 2004;132(1):1-5.doi:10.1017/s0950268803001523

14979582

370.

Whitley

Kimberlin

DW.

Prober

et al. Pathogenesis and disease. In: Arvin

Campadelli-Fiume

Mocarski

Moore

PS.

Roizman

Whitley

, eds. Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press; 2007.

371.

Ayoub

HH.

Chemaitelly

Abu-Raddad

. Characterizing the transitioning epidemiology of herpes simplex virus type 1 in the USA: model-based predictions. BMC Med. 2019;17(1):57 doi:10.1186/s12916-019-1285-x

30853029

372.

Usatine

RP.

Tinitigan

. Nongenital herpes simplex virus. Am Fam Physician. 2010;82(9):1075-1082.21121552

373.

Marra

Ogilvie

Colley

Kliewer

Marra

. Epidemiology and costs associated with genital warts in Canada. Sex Transm Infect. 2009;85(2):111-115.

374.

Kliewer

EV.

Demers

AA.

Elliott

Lotocki

Butler

JRG.

Brisson

. Twenty-Year trends in the incidence and prevalence of diagnosed anogenital warts in Canada. Sex Transm Dis. 2009;36(6):380-386.doi:10.1097/OLQ.0b013e318198de8c

19556932

375.

Hoy

Singhal

PK.

Willey

VJ.

Insinga

. Assessing incidence and economic burden of genital warts with data from a US commercially insured population. Curr Med Res Opin. 2009;25(10):2343-2351.

376.

Insinga

RP.

Dasbach

EJ.

Myers

. The health and economic burden of genital warts in a set of private health plans in the United States. Clin Infect Dis. 2003;36(11):1397-1403.doi:10.1086/375074

12766834

377.

Andersen

LK.

Davis

MDP

. Sex differences in the incidence of skin and skin-related diseases in Olmsted County, Minnesota, United States, and a comparison with other rates published worldwide. Int J Dermatol. 2016;55(9):939-955.doi:10.1111/ijd.13285

27009931

378.

Marra

Ogilvie

Colley

Kliewer

Marra

. Epidemiology and costs associated with genital warts in Canada. Sex Transm Infect. 2009;85(2):111 doi:10.1136/sti.2008.030999

18981170

379.

Hoy

Singhal

PK.

Willey

VJ.

Insinga

. Assessing incidence and economic burden of genital warts with data from a US commercially insured population. Curr Med Res Opin. 2009;25(10):2343-2351.doi:10.1185/03007990903136378

19650749

380.

Patel

Wagner

Singhal

Kothari

. Systematic review of the incidence and prevalence of genital warts. BMC Infect Dis. 2013;13:39 doi:10.1186/1471-2334-13-39

23347441

381.

Bird

Obidiya

Mahmood

Nwankwo

Moraros

. Human papillomavirus vaccination uptake in Canada: a systematic review and meta-analysis. Int J Prev Med. 2017;8:71 doi:10.4103/ijpvm.IJPVM_49_17

28983400

382.

Silverberg

JI.

Silverberg

. The U.S. prevalence of common warts in childhood: a population-based study. J Invest Dermatol. 2013;133(12):2788-2790.doi:10.1038/jid.2013.226

23657500

383.

Liu

Yang

et al. Epidemiology and clinical profile of cutaneous warts in Chinese college students: a cross-sectional and follow-up study. Sci Rep. 2018;8(1):15450 doi:10.1038/s41598-018-33511-x

30337549

384.

Kilkenny

Merlin

Young

Marks

. The prevalence of common skin conditions in Australian school students: 1. Common, plane and plantar viral warts. Br J Dermatol. 1998;138(5):840-845.doi:10.1046/j.1365-2133.1998.02222.x

9666831

385.

Johnson

MT.

Roberts

. Skin conditions and related need for medical care among persons 1-74 years. United States, 1971-1974. Vital Health Stat 11. 1978(212):i-0. [1-72].741665

386.

Jiang

Yin

Fan

et al. Gender difference in advanced HIV disease and late presentation according to European consensus definitions. Sci Rep. 2015;5(1):14543 doi:10.1038/srep14543

26412578

387.

GBD 2017 HIV collaborators ;. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the global burden of diseases, injuries, and risk factors study 2017. Lancet HIV. 2019;6(12):e831-e859.doi:10.1016/S2352-3018(19)30196-1

31439534

388.

Castilho

JL.

Melekhin

VV.

Sterling

. Sex differences in HIV outcomes in the highly active antiretroviral therapy era: a systematic review. AIDS Res Hum Retroviruses. 2014;30(5):446-456.doi:10.1089/AID.2013.0208

24401107

389.

Jarrin

Geskus

Bhaskaran

et al. Gender differences in HIV progression to AIDS and death in industrialized countries: slower disease progression following HIV seroconversion in women. Am J Epidemiol. 2008;168(5):532-540.doi:10.1093/aje/kwn179

18663213

390.

Anderson

LA.

Graubard

et al. Human herpesvirus 8 seroprevalence among children and adolescents in the United States. Pediatr Infect Dis J. 2008;27(7):661-664.doi:10.1097/INF.0b013e3181691740

18536622

391.

Engels

EA.

Atkinson

JO.

Graubard

et al. Risk factors for human herpesvirus 8 infection among adults in the United States and evidence for sexual transmission. J Infect Dis. 2007;196(2):199-207.doi:10.1086/518791

17570106

392.

. The AIDS-defining cancer project Working group for IeDEA and Cohere in EuroCoord. Comparison of Kaposi sarcoma risk in human immunodeficiency virus-positive adults across 5 continents: a Multiregional Multicohort study. Clin Infect Dis. 2017;65(8):1316-1326.

393.

Olsen

JR.

Gallacher

Piguet

Francis

. Epidemiology of molluscum contagiosum in children: a systematic review. Fam Pract. 2014;31(2):130-136.doi:10.1093/fampra/cmt075

24297468

394.

Meza-Romero

Navarrete-Dechent

Downey

. Molluscum contagiosum: an update and review of new perspectives in etiology, diagnosis, and treatment. Clin Cosmet Investig Dermatol. 2019;12:373-381.doi:10.2147/CCID.S187224

31239742

395.

Metin

Dilek

Demirseven

. Fungal infections of the folds (intertriginous areas). Clin Dermatol. 2015;33(4):437-447.doi:10.1016/j.clindermatol.2015.04.005

26051058

396.

Lassa

Campbell

MJ.

Bennett

. Epidemiology of scabies prevalence in the U.K. from general practice records. Br J Dermatol. 2011;164(6):1329-1334.doi:10.1111/j.1365-2133.2011.10264.x

21574970

397.

Ghazawi

FM.

Cyr

Darwich

et al. Cutaneous malignant melanoma incidence and mortality trends in Canada: A comprehensive population-based study. J Am Acad Dermatol. 2019;80(2):448-459.doi:10.1016/j.jaad.2018.07.041

30092328

398.

Ghazawi

FM.

Lagacé

et al. Incidence, mortality, and spatiotemporal distribution of cutaneous malignant melanoma cases across Canada. J Cutan Med Surg. 2019;23(4):394-412.doi:10.1177/1203475419852048

31132871

399.

Ghazawi

FM.

Alghazawi

et al. Trends in incidence of cutaneous malignant melanoma in Canada: 1992-2010 versus 2011-2015. J Am Acad Dermatol. 2019;80(4):1157-1159.doi:10.1016/j.jaad.2018.10.055

30395916

400.

Lowe

GC.

Saavedra

Reed

et al. Increasing incidence of melanoma among middle-aged adults: an epidemiologic study in Olmsted County, Minnesota. Mayo Clin Proc. 2014;89(1):52-59.doi:10.1016/j.mayocp.2013.09.014

24388022

401.

Reed

KB.

Brewer

JD.

Lohse

CM.

Bringe

KE.

Pruitt

CN.

Gibson

. Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Mayo Clin Proc. 2012;87(4):328-334.doi:10.1016/j.mayocp.2012.01.010

22469345

402.

Nikolaou

Stratigos

. Emerging trends in the epidemiology of melanoma. Br J Dermatol. 2014;170(1):11-19.doi:10.1111/bjd.12492

23815297

403.

Behbahani

Maddukuri

Cadwell

JB.

Lambert

WC.

Schwartz

. Gender differences in cutaneous melanoma: demographics, prognostic factors, and survival outcomes. Dermatol Ther. 2020;33(6):e14131 doi:10.1111/dth.14131

32757248

404.

Kim

SY.

Kim

SN.

Hahn

HJ.

Lee

YW.

Choe

YB.

Ahn

. Metaanalysis of BRAF mutations and clinicopathologic characteristics in primary melanoma. J Am Acad Dermatol. 2015;72(6):1036-1046.doi:10.1016/j.jaad.2015.02.1113

25819940

405.

Christenson

LJ.

Borrowman

TA.

Vachon

et al. Incidence of basal cell and squamous cell carcinomas in a population younger than 40 years. JAMA. 2005;294(6):681-690.doi:10.1001/jama.294.6.681

16091570

406.

Demers

AA.

Nugent

Mihalcioiu

Wiseman

MC.

Kliewer

. Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population. J Am Acad Dermatol. 2005;53(2):320-328.doi:10.1016/j.jaad.2005.03.043

16021129

407.

Hayes

RC.

Leonfellner

Pilgrim

Liu

Keeling

. Incidence of nonmelanoma skin cancer in new Brunswick, Canada, 1992 to 2001. J Cutan Med Surg. 2007;11(2):45-52.doi:10.2310/7750.2007.00010

17374314

408.

Harris

RB.

Griffith

Moon

. Trends in the incidence of nonmelanoma skin cancers in southeastern Arizona, 1985-1996. J Am Acad Dermatol. 2001;45(4):528-536.doi:10.1067/mjd.2001.114742

11568742

409.

Duran

Morgan

FC.

Karia

PS.

Schmults

. An evaluation of high-stage cutaneous squamous cell carcinoma outcomes by sex. Br J Dermatol. 2017;177(4):1131-1133.doi:10.1111/bjd.15208

27893152

410.

Muzic

JG.

Schmitt

AR.

Wright

et al. Incidence and trends of basal cell carcinoma and cutaneous squamous cell carcinoma: a population-based study in Olmsted County, Minnesota, 2000 to 2010. Mayo Clin Proc. 2017;92(6):890-898.doi:10.1016/j.mayocp.2017.02.015

28522111

411.

Lubeek

SF.

van Vugt

LJ.

Aben

KK.

van de Kerkhof

PC.

Gerritsen

. The epidemiology and clinicopathological features of basal cell carcinoma in patients 80 years and older: a systematic review. JAMA Dermatol. 2017;153(1):71-78.doi:10.1001/jamadermatol.2016.3628

27732698

412.

McCusker

Basset-Seguin

Dummer

et al. Metastatic basal cell carcinoma: prognosis dependent on anatomic site and spread of disease. Eur J Cancer. 2014;50(4):774-783.doi:10.1016/j.ejca.2013.12.013

24412051

413.

Stang

Becker

JC.

Nghiem

Ferlay

. The association between geographic location and incidence of Merkel cell carcinoma in comparison to melanoma: an international assessment. Eur J Cancer. 2018;94:47-60.doi:10.1016/j.ejca.2018.02.003

29533867

414.

Olsen

CM.

Pandeya

Whiteman

. International increases in Merkel cell carcinoma incidence rates between 1997 and 2016. J Invest Dermatol. 2021;141(11):2596-2601.doi:10.1016/j.jid.2021.04.007

33932460

415.

Freeman

MB.

Holman

DM.

Qin

Lunsford

. Merkel cell carcinoma incidence, trends, and survival rates among adults aged ≥50 years from United States Cancer Statistics. J Am Acad Dermatol. 2019;80(4):1154-1156.doi:10.1016/j.jaad.2018.10.045

30876535

416.

Criscione

VD.

Weinstock

. Incidence of cutaneous T-cell lymphoma in the United States, 1973-2002. Arch Dermatol. 2007;143(7):854-859.doi:10.1001/archderm.143.7.854

17638728

417.

Wilson

LD.

Hinds

GA.

JB.

Age

YJB

. Age, race, sex, stage, and incidence of cutaneous lymphoma. Clin Lymphoma Myeloma Leuk. 2012;12(5):291-296.doi:10.1016/j.clml.2012.06.010

23040434

418.

Agar

NS.

Wedgeworth

Crichton

et al. Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for cutaneous Lymphomas/European organisation for research and treatment of cancer staging proposal. J Clin Oncol. 2010;28(31):4730-4739.doi:10.1200/JCO.2009.27.7665

20855822

419.

Ghazawi

FM.

Netchiporouk

Rahme

et al. Comprehensive analysis of cutaneous T-cell lymphoma (CTCL) incidence and mortality in Canada reveals changing trends and geographic clustering for this malignancy. Cancer. 2017;123(18):3550-3567.doi:10.1002/cncr.30758

28493286

420.

Behbahani

Yeh

CJ.

Fernandez

JM.

Chen

. Gender differences in clinical presentation, treatment, and outcomes in mycosis fungoides. J Am Acad Dermatol. 2022;86(1):174-177.doi:10.1016/j.jaad.2021.01.026

33465428

421.

Väkevä

Sarna

Vaalasti

Pukkala

Kariniemi

A-L.

Ranki

. A retrospective study of the probability of the evolution of Parapsoriasis en plaques into mycosis fungoides. Acta Derm Venereol. 2005;85(4):318-323.doi:10.1080/00015550510030087

16191852

422.

Bishop

BN.

Lynch

423.

Armstrong

AW.

Lam

KH.

Chase

. Epidemiology of classic and AIDS-related Kaposi’s sarcoma in the USA: incidence, survival, and geographical distribution from 1975 to 2005. Epidemiol Infect. 2013;141(1):200-206.doi:10.1017/S0950268812000325

22404880

424.

Phipps

Ssewankambo

Nguyen

et al. Gender differences in clinical presentation and outcomes of epidemic Kaposi sarcoma in Uganda. PLoS One. 2010;5(11):e13936 doi:10.1371/journal.pone.0013936

21103057

425.

Chalya

PL.

Mbunda

Rambau

et al. Kaposi’s sarcoma: a 10-year experience with 248 patients at a single tertiary care hospital in Tanzania. BMC Res Notes. 2015;8:440 doi:10.1186/s13104-015-1348-9

26374100

426.

Acosta

AE.

Vélez

. Dermatofibrosarcoma Protuberans. Curr Treat Options Oncol. 2017;18(9):56 doi:10.1007/s11864-017-0498-5

28795284

427.

Dimitropoulos

. Dermatofibrosarcoma protuberans. Dermatol Ther. 2008;21(6):428-432.doi:10.1111/j.1529-8019.2008.00242.x

19076619

428.

Kuzel

Metelitsa

AI.

Dover

DC.

Salopek

. Epidemiology of dermatofibrosarcoma protuberans in Alberta, Canada, from 1988 to 2007. Dermatol Surg. 2012;38(9):1461-1468.doi:10.1111/j.1524-4725.2012.02482.x

22691126

429.

Kreicher

KL.

Kurlander

DE.

Gittleman

HR.

Barnholtz-Sloan

JS.

Bordeaux

. Incidence and survival of primary dermatofibrosarcoma protuberans in the United States. Dermatol Surg. 2016;42 Suppl 1:S24-31.doi:10.1097/DSS.0000000000000300

26730971

430.

Kibbi

Wang

et al. Dermatofibrosarcoma protuberans in pregnancy: a case series and review of the literature. Int J Dermatol. 2021;60(9):1114-1119.doi:10.1111/ijd.15497

33818755

431.

Piraccini

BM.

Alessandrini

. Androgenetic alopecia. G Ital Dermatol Venereol. 2014;149(1):15-24.24566563

432.

Sood

Zito

433.

Fabbrocini

Cantelli

Masar

Annunziata

MC.

Marasca

Cacciapuoti

. Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol. 2018;4(4):203-211.doi:10.1016/j.ijwd.2018.05.001

30627618

434.

Coleman

. Types and Treatment of Hair loss in men and women. Plast Surg Nurs. 2020;40(4):222-235.doi:10.1097/PSN.0000000000000350

33259424

435.

Ramos

PM.

Miot

. Female Pattern Hair Loss: a clinical and pathophysiological review. An Bras Dermatol. 2015;90(4):529-543.doi:10.1590/abd1806-4841.20153370

26375223

436.

Hughes

EC.

Saleh

437.

Mirzoyev

SA.

Schrum

AG.

Davis

MDP.

Torgerson

. Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009. J Invest Dermatol. 2014;134(4):1141-1142.doi:10.1038/jid.2013.464

24202232

438.

Kyriakis

KP.

Paltatzidou

Kosma

Sofouri

Tadros

Rachioti

. Alopecia areata prevalence by gender and age. J Eur Acad Dermatol Venereol. 2009;23(5):572-573.doi:10.1111/j.1468-3083.2008.02956.x

18771448

439.

Abedini

Hallaji

Lajevardi

Nasimi

Karimi Khaledi

Tohidinik

. Quality of life in mild and severe alopecia areata patients. Int J Womens Dermatol. 2018;4(2):91-94.doi:10.1016/j.ijwd.2017.07.001

29872683

440.

Tzur Bitan

Berzin

Kridin

Cohen

. The association between alopecia areata and anxiety, depression, schizophrenia, and bipolar disorder: a population-based study. Arch Dermatol Res. 2022;314(5):463-468.doi:10.1007/s00403-021-02247-6

34089375

441.

Lundin

Chawa

Sachdev

Bhanusali

Seiffert-Sinha

Sinha

. Gender differences in alopecia areata. J Drugs Dermatol. 2014;13(4):409-413.24719059

442.

Gathers

RC.

Jankowski

Eide

Lim

. Hair grooming practices and central centrifugal cicatricial alopecia. J Am Acad Dermatol. 2009;60(4):574-578.doi:10.1016/j.jaad.2008.10.064

19293007

443.

Herskovitz

Miteva

. Central centrifugal cicatricial alopecia: challenges and solutions. Clin Cosmet Investig Dermatol. 2016;9:175-181.doi:10.2147/CCID.S100816

27574457

444.

Meinhard

Stroux

Lünnemann

Vogt

Blume-Peytavi

. Lichen planopilaris: Epidemiology and prevalence of subtypes - a retrospective analysis in 104 patients. J Dtsch Dermatol Ges. 2014;12(3):229-235. [-36.].doi:10.1111/ddg.12264

24533855

445.

Cantwell

HM.

Wieland

CN.

Proffer

SL.

Imhof

RL.

Torgerson

RR.

Tolkachjov

. Lichen planopilaris in men: a retrospective clinicopathologic study of 19 patients. Int J Dermatol. 2021;60(4):482-488.doi:10.1111/ijd.15285

33128471

446.

Vañó-Galván

Molina-Ruiz

AM.

Fernández-Crehuet

et al. Folliculitis decalvans: a multicentre review of 82 patients. J Eur Acad Dermatol Venereol. 2015;29(9):1750-1757.doi:10.1111/jdv.12993

25682915

447.

Segurado-Miravalles

Camacho-Martínez

FM.

Arias-Santiago

et al. Epidemiology, clinical presentation and therapeutic approach in a multicentre series of dissecting cellulitis of the scalp. J Eur Acad Dermatol Venereol. 2017;31(4):e199-e200.doi:10.1111/jdv.13948

27558283

448.

Gamissans

Romaní

López-Llunell

Riera-Martí

Sin

. Dissecting cellulitis of the scalp: A review on clinical characteristics and management options in a series of 14 patients. Dermatol Ther. 2022;35(8):e15626 doi:10.1111/dth.15626

35674720

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