Hussain Gadelkarim Ahmed et al, 2020;4(1):023–028.

International Journal of Medicine in Developing Countries

https://doi.org/10.24911/IJMDC.51-1565908705

ORIGINAL ARTICLE

Assessment of the level of general

knowledge and awareness of the public
toward skin diseases in Hail City
Hussain Gadelkarim Ahmed1, Ethar Abed Alsulami2, Amirah Eid Salem
Alshammari2, Maha Qasem Malhan Almutairi2, Alanoud Mansour Ayed
Albalawi2, Abdullah Abdulhadi Hammad Alharbi2, Dalal Ayedh Helaal Al-Harbi3

ABSTRACT
Background: Skin diseases are a very common group of diseases and few of them can spread easily between
individuals which make the person under fear and stress. Furthermore, few of them can also affect the obvi-
ous skin and this can affect the self-esteem of the individual. The prevalence of skin diseases varies among
different regions, enough knowledge about skin diseases will have an impact on their prevalence. The present
study was aimed to assess the knowledge and awareness of the general population regarding skin disease in
Hail City, Saudi Arabia.
Methodology: A survey-based study was conducted among the general population of Hail City, Saudi Arabia
during the period from November 15, 2018, to December 2, 2018. Statistical Package for the Social Sciences
program version 21 was used to analyse data, number and percentages were used to describe quantitative
variables.
Results: The current study included 2,348 individuals. Among them, 9.3%, 66.8%, and 23.9% of them reported
their knowledge about skin diseases to be excellent, good, and poor, respectively. There were 24.1% of sub-
jects who had good knowledge about skin diseases. Regarding job, individuals working in the military were
significantly having lower level of knowledge (p-value = 0.013).
Conclusion: The study found knowledge about skin disease among the Hail population to be inadequate.
Keywords: Knowledge, population, skin disease, Hail.

Introduction

Skin diseases are very common diseases that affect
almost 20-33% of the population [1]. Most skin
diseases don't represent a threat to human life; however,
patients can be under stress because of the outcome
of the diseases and may affect their quality of life [2].
Skin diseases that disfigure visible sites such as face
can result in low self-esteem, poorer job prospects,
and depression [3]. It was stated in 2013 that skin
condition represented 1.79% of the global burden of
306 diseases [4]. The prevalence and occurrence of
various skin conditions differ by different aspects,
including physical and environmental aspects [5]. One
study demonstrated the relation between the augmented
probability of skin disease incidence and low economic
and social levels [6]. One study from the US reported
that one-third of the population had one or more skin
condition [7], another study reported that 55% of the
population had a skin disease [8]. Inflammatory skin
diseases are very common in the population and these
diseases include contact dermatitis, atopic dermatitis,
acne, and hand eczema [9]. In Saudi Arabia, there
was a significant surge in skin disease incidence in the
past decade, where 20% of children with age range of
6 to 18 years were found to suffer from eczema [10].
A study from the Al Qassim region, Saudi Arabia,
found that among 3051 patients, there was a top five
skin disease included 19.5% dermatitis/eczema, 16.6%
Correspondence to: Abdullah Abdulhadi Hammad Alharbi
*University of Hail, Al-Hail, Saudi Arabia.
Email: dr.alslimi5@gmail.com
Full list of author information is available at the end of
the article.
Received: 19 September 2018 | Accepted: 25 December 2019

© IJMDC. https://www.ijmdc.com 23
 Assessment of the level of general knowledge and awareness of the public toward skin diseases

viral infections, 14.4% pilosebaceous disorders 11.2%, Results

and 7.6% pigmentary lesions and hair disorders,
respectively [11]. Another study from Riyadh showed
that dermatitis/eczema represents the top prevalent
disease representing 21.29%, followed by hair disease
and acne 11.9% and 11.88%, respectively [12]. A
previous study was conducted to report the pattern
skin diseases in Hail region [13], the study reported
that among 13,778 participants, there were 37% with
atopic dermatitis, 12% having eczema, followed by
20% having acne, 8% alopecia patients, 7% with other
pigmentary, and 7% with vitiligo, whereas 7%, 4%,4%,
2%, 1%, and 3% had viral wart, psoriasis, leishmania,
tinea, other pilosebaceous, and other diseases,
respectively. As the prevalence of skin diseases is high,
then enough awareness about skin diseases may reduce
their burden. A previous study from Canada reported
that there was low awareness and knowledge regarding
occupational skin disease [14]. There was no previous
Saudi study conducted to assess the level of knowledge
and awareness about skin diseases among the general
population, so we conducted this study.
Subjects and Methods
The present study included 2,348 individuals, females
were more dominant than males 1,532 (65.2%) versus 816
(34.8%), respectively. The most common age group was
those in the age of more than 25-years old 1,140 (48.6%).
Most of the participants were students 1,006 (42.8%),
demographics of participants are shown in Table 1. More
than half of participants 1,569 (66.8%) reported having
good knowledge about skin disease, whereas 219 (9.3%)
and 560 (23.9%) reported excellent and poor knowledge,
respectively (Figure 1). The description and details of
participants‘knowledge are shown in Table 2, there were
1,406 (59.9%) of participants reported that some skin
Table 1. Demographics of participants.
Description
Demographics of participants
(n = 2,348)
Sex
Male 816 (34.8)
Female 1532 (65.2)

This is a survey-based study that was conducted on Age

the population of Hail city, during the period from <15 years 62 (2.6)
November 15, 2018, to December 2, 2018. The study 15–20 years 333 (14.2)
was performed using a survey, comprised two parts, 20–25 years 813 (34.6)
the first part to investigate the demographics and the
>25 years 1140 (48.6)
second part to investigate the knowledge of participants.
Statistical Package for the Social Sciences program Job
version 21 was used to analyze data, number, and percent Students 1006 (42.8)
were used to describe quantitative variables, the level Education 445 (19)
of knowledge was considered well at ˃60% correct Health 178 (7.6)
answers, correlations were performed between the level
Military 137 (5.8)
of knowledge and demographics, a p-value at ˂0.05 was
considered as significant. Others 582 (24.8)

Figure 1. Knowledge of participants about skin diseases.

24
Assessment of the level of general knowledge and awareness of the public toward skin diseases

Table 2. Details of the participant's knowledge.

Description
Questions and answers
(n = 2,348)
All SDs are chronic
Yes 68 (2.9)
Some 1406 (59.9)
No 874 (37.2)
All SDs are infections
Yes 267 (11.4)
No 2081 (88.6)
All SDs are hereditary
Yes 1878 (80)
No 470 (20)
Exchange of personal belongings increases the risk of SDs
Yes 1836 (78.2)
May be 408 (17.4)
No 104 (4.4)
Does SD affect social life?
Yes 1750 (74.5)
No 598 (25.5)
SDs is a barrier between friends, relatives, and partner
Yes 1450 (61.8)
No 898 (38.2)
SD is
Common 768 (32.7)
Average 144 (6.1)
Rare 1436 (61.2)
Do you have any of the following diseases?
Acne 491 (20.9)
Skin sensitivity 297 (12.6)
Skin Dryness 283 (12.1)
Warts 173 (7.4)
Pityriasis alba 108 (4.6)
Psoriasis 60 (2.6)
None 936 (39.9)
Do you have any of the following skin Pigmentation disorders
Vitiligo 1762 (75)
Chloasma 227 (9.7)
Freckle 184 (7.8)
Nevus 159 (6.8)
Albinism 16 (0.7)
Do you have hair disorder
Hair loss 1209 (51.5)
Alopecia 756 (32.2)
Dandruff 365 (15.5)
Scabies 18 (0.8)

Continued

25
 Assessment of the level of general knowledge and awareness of the public toward skin diseases
Table 2. (Continued)
A chronic disease may affect the skin
Yes
May be
No
Acne pattern
++ in winter -- in summer
++ in summer -- in winter
No relation
I don't have acne
Figure 2. The level of knowledge of participants about skin diseases.
disease is chronic, 267 (11.4%) and 1,878 (80%) reported
that they all are infectious and hereditary, respectively.
There were 1,836 (78.2%) stated that the exchange of
personal belongings increases the risk of skin disease,
1,750 (74.5%) and 1,450 (61.8%) mentioned that skin
disease affects social life and acts as a barrier between
individuals, respectively. More than half of participants
1,436 (61.2%) reported that skin disease is rare and the
most known skin disease was acne 491 (20.9%), followed
by skin sensitivity and skin dryness 297 (12.6%) and 283
(12.1%), respectively. The most-reported skin disease
affected individuals were vitiligo 1,762 (75%), there
were 1,209 (51.5%) and 1,278 (54.4%) reported having
hair loss and chronic disease affect the skin respectively
and there were 1,105 (47.1%) reported that they don’t
have acne. Almost three-quarters of 1,781 (75.9%)
had low knowledge about skin diseases, whereas 567
(24.1%) had high knowledge (Figure 2). By investigating
the factors affecting the level of knowledge, it was found
that sex, age, job, and general knowledge of skin disease
were significantly affected the level of knowledge.
Females significantly had higher knowledge than males
(p-value = 0.0001), those with age less than 15-year old
26
1278 (54.4)
874 (37.2)
196 (8.3)
87 (3.7)
500 (21.3)
656 (27.9)
1105 (47.1)
significantly tended to have lower knowledge (p-value
= 0.007). Regarding jobs, individuals working in the
military were significantly had lower knowledge (p-value
= 0.013). Individuals who described their knowledge to
be excellent significantly had a higher level of knowledge
(p-value = 0.0001), whereas those who reported poor
knowledge had a significantly lower level of knowledge
(p-value = 0.0001).
Discussion
In the current study, females were more dominant than
males and those with age more than 25-year old. More
than half of the participants reported that their knowledge
about skin disease was good (66.8%). In this study, the
most common skin disease among participants was
vitiligo (75%), followed by chloasma (9.7%), then
freckle, nevus, and albinism (7.8%), (6.8%), and (0.7%),
respectively, whereas a previous study from Hail showed
that vitiligo was in the third rank and was prevalent
among 7% [13], this can be explained that the prevalence
in the present study is among population whereas the
previous study [13] conducted in hospital patients. The
 Assessment of the level of general knowledge and awareness of the public toward skin diseases

Table 3. The correlation between the level of knowledge and demographics.

Skin disease Knowledge
Demographic determinants High (>60%) Low (<60%) p value*
(n = 567) (n = 1,781)
Sex
Male 138 (24.3) 678 (38.1) 0.000
Female 429 (75.7) 1,103 (61.9)
Age
<15 years 6 (1.1) 56 (3.1) 0.007
15–20 years 77 (13.6) 256 (14.4) 0.637
20–25 Years 209 (36.9) 604 (33.9) 0.199
>25 Years 275 (48.5) 865 (48.6) 0.978
Job
Students 248 (43.7) 758 (42.6) 0.621
Education 98 (17.3) 347 (19.5) 0.244
Health 45 (7.9) 133 (7.5) 0.713
Military 21 (3.7) 116 (6.5) 0.013
Others 155 (27.3) 427 (24) 0.106
Your knowledge about skin disease (SD)
Excellent 77 (13.6) 142 (8) 0.000
Good 388 (68.4) 1,181 (66.3) 0.351
Poor 102 (18) 458 (25.7) 0.000
Bold value is significant p value < 0.05.

present study found that the alopecia was prevalent Conclusion

among 32.2% of the population, while in the previous
study from Hail hospital, alopecia accounted for 8% of
all dermatological diseases [13]. By investigating the
knowledge of participants, there were only 24.1% had
high knowledge. There were several factors were found
to affect the level of knowledge, females were more prone
to have higher knowledge than males, whereas those
with younger age tended to have low level of knowledge,
working in military was associated with low level of
knowledge and both of individuals who reported having
excellent knowledge significantly had high level of
knowledge, whereas those who reported poor knowledge
significantly had lower level of knowledge. One study
from Hail hospital reported that females were the more
attendant individuals to dermatology clinics as they have
more sensitivity [13], this may explain why women had
higher knowledge than males as they are more affected
by dermal diseases. Only one Saudi study conducted in
Abha on physicians showed that two-third of primary
health care physicians had insufficient knowledge about
the management of skin diseases [9]. The present study
is the first study conducted in Saudi Arabia to assess the
level of knowledge of population about skin disease,
there were no previous studies conducted on this subjects
neither in Saudi Arabia nor other countries, so the
strength point including the novelty of the subject and
the large number of the sample, whereas the limitation
include there was no comparison as there were no
previous results.
The present study found an inadequate level of knowledge
regarding skin diseases among the population of the Hail
region, especially among those with a younger age and
employed in military service.
Acknowledgments
The authors would like to thank Renad Meshal Ashban
Alharbi for her assistance in data collection.
List of Abbreviations
SD Skin disease
Conflict of interest
The authors declare that there is no conflict of interest
regarding the publication of this article.
Funding
None.
Consent for publication
Informed consent was obtained from all the participants.
Ethical Approval
Ethical approval got from Hail University, Ref No. : EC-00034/
CM/UOH.01/19. Approval of the clinical study—"EC-00034."
Author details
Hussain Gadelkarim Ahmed1, Ethar Abed Alsulami2, Amirah
Eid Salem Alshammari2, Maha Qasem Malhan Almutairi2,

27
 Assessment of the level of general knowledge and awareness of the public toward skin diseases
Alanoud Mansour Ayed Albalawi2, Abdullah Abdulhadi
Hammad Alharbi2, Dalal Ayedh Helaal Al-Harbi3
1. College of Medicine, Hail University, Al-Hail, Saudi Arabia
2. University of Hail, Al-Hail, Saudi Arabia
3. Batterjee Medical College, Jeddah, Saudi Arabia
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