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Background: Anthropogenic climate change affects the burden of infectious diseases via several interconnected mechanisms. In recent years, there has been greater awareness of the ways in which climate-sensitive infectious diseases pose a growing threat to global public health. Objective: This study aimed to categorize and describe the effects of climate change on infectious diseases with skin manifestations. Methods: A scoping review of the MEDLINE and PubMed online databases for climate-sensitive infections was performed in February and March 2020. A representative selection of conditions with skin manifestations was included in this review. Results: Several representative climate-sensitive infectious diseases were identified in each of the following categories: vector-borne infectious diseases, infectious diseases associated with extreme weather events, and infectious diseases linked to human migration. Conclusion: Climate variables directly influence the survival and reproduction of infectious microorganisms, their vectors, and their animal reservoirs. Due to sustained warmer temperatures at higher latitudes, climate change has expanded the geographic range of certain pathogenic microbes. More frequent climate change-related extreme weather events create circumstances where existing infectious microorganisms flourish and novel infections emerge. Climate instability is linked to increased human migration, which disrupts health care infrastructure as well as the habitats of microbes, vectors, and animal reservoirs and leads to widespread poverty and overcrowding. Dermatologists should understand that climate change will affect the burden and geographic distribution of infectious diseases, many of which have cutaneous signs and might be encountered in their regular practice.

Abstract Introduction In order to manage skin conditions at a national referral hospital level in Kenya, specialized dermatology services, such as dermatologic surgery, dermatopathology, phototherapy, and sub-specialty care, should be offered, as is typically available in referral hospitals around the world. A Kenyan patient with prurigo nodularis, whose severe itch remitted after phototherapy treatment at the University of California, San Francisco (UCSF), inspired the development of a phototherapy service at Academic Model Providing Access to Healthcare (AMPATH), a partnership in Western Kenya between Moi Teaching and Referral Hospital, Moi University College of Health Sciences, and a consortium of North American academic medical centers. Methods Initial project funds were raised through a crowdfunding campaign and fundraising events. A new narrowband ultraviolet B phototherapy unit and replacement bulbs were donated and air shipped to Eldoret, Kenya. A team of dermatologists and phototherapy nurses from UCSF conducted a 2-day training session. US-based dermatologists affiliated with AMPATH provide ongoing support through regular communication and on-site visits. Results Early in implementation, challenges faced included training clinical staff with limited experience in phototherapy and improving communication between nurses and clinicians. More recent challenges include frequent rotation of specialty clinic nurses in the dermatology clinic, adaptation of phototherapy guidelines to balance patient volume with service delivery capacity, and training assessment of disease activity in darkly pigmented skin. Conclusion Strategies that have been helpful in addressing implementation challenges include: increasing on-site and remote training opportunities for clinicians and nurses, developing a tiered payment schema, educating patients to combat misconceptions about phototherapy, dynamic phototherapy referral guidelines to accommodate service delivery capacity, and prioritizing the engagement of a multidisciplinary team.

HIV has long been associated with a number of inflammatory, infectious, and neoplastic skin conditions. In the era of anti-retroviral therapy, we have discovered even more about the relationship between skin disease and chronic immunosuppression. In particular, clinicians still face the propensity of persons living with HIV to develop difficult-to-control viral infections, chronic skin inflammation, and pruritus and—particularly as patients age—various types of skin cancers. Here, we summarize recent updates in the field of HIV dermatology and make recommendations to providers caring for these patients.

Climate change affects all aspects of ecosystems, including humans and numerous microorganisms. Fungi are especially sensitive to climate extremes. Persistently warmer temperatures at increasingly higher latitudes are contributing to ongoing expansion of the geographic ranges of known fungal pathogens. Alongside fungal species’ advancement into new territories, many have the capacity to develop thermotolerance. Consequently, a greater number of previously unharmful or underappreciated fungal species may emerge due to climate change.More frequent extreme weather events - including heat waves, drought, and flooding - also foster circumstances that favor the survival and infectivity of pathogens. We reviewed the English language literature in order to describe what is known about the effects of climate change on fungal infections with cutaneous manifestations. We included candidal infections, dermatophytoses, other mold infections, and deep fungal infections, and focused on organisms with evidence of climate sensitivity, particularly those that are emerging, spreading to new geographic regions, or both. This may provide an important tool for understanding the epidemiological patterns underlying fungal transmission, predicting future outbreaks, and adopting effective control strategies.