Skin and foot problems are said to be very common among homeless persons.  Common conditions include cellulitis and impetigo, venous stasis disease, scabies, body lice, foot ulcers, and immersion foot.  Immersion foot is a condition caused by prolonged exposure to moisture and damp footwear, and is characterized by cool, painful, tender, white wrinkled soles of the feet.

Exactly how  common are these conditions?  My clinical experience and that of others working with the homeless would suggest that they are very common.  However, there is an interesting study in which dermatologists examined 142 homeless men at a single shelter in Boston and found a very low prevalence of serious skin pathology. 

How can we explain this discrepancy?  It seems plausible that the prevalence of skin and foot disease depends on which group of homeless people you’re looking at.  Homeless people living on the street are going to have much more pathology than those living in shelters, and among homeless people living in shelters, the prevalence of skin problems will depend on hygiene conditions in the shelter.