Epidemiology of Skin Diseases amongst Lowlanders in the High-Altitude Ladakh Region: A Retrospective Cross-Sectional Study.

Background: Skin diseases vary in different geographical areas as per their unique environmental characteristics. High-altitude skin diseases too are very different from that of plains. Aim: This study was undertaken to see the incidence and nature of skin diseases amongst temporary residents (soldiers) in the Ladakh region of India and their comparison with their native colleagues (soldiers) posted in the same area. Methods: The present study is a retrospective study wherein dermatology OPD data from a military hospital situated in Leh city were analyzed over 18 months period from September 2021 till February 2023. Results: Out of a total of 1832 patients, 1528 (83.40%) were lowlanders and 304 (16.60%) were native highlanders with a mean age of 32.5 years, ranging between 21 and 68 years. Appendageal disorders (25.10%) were the most common overall and in both groups. Infections/infestations (18.17%) were the second most common overall and in lowlanders, but in native highlanders, photodermatoses were the second most common disorders. Other disorders reported were eczemas (16.75%), photodermatoses (12.5%), pigmentary disorders (7.75%), papulosquamous disorders (5.34%), urticaria (5.02%), benign skin tumours (4.36%), keratinisation disorders (2.34%), chill blains (0.55%), metabolic disorders (0.5%), and insect bite reactions (0.33%). Limitations: Inclusion of soldiers/military men only and thereby a smaller number of native highlanders exist amongst soldiers representing disease in natives for comparison. Conclusion: This study highlights higher incidence of acne, alopecia areata, PMLE, discoid eczema, ACD, and keratosis pilaris amongst lowlanders or temporary residents at high-altitude areas.