Traditional and ethnomedicinal dermatology practices in Pakistan Inayat Ur Rahman, MS a, ⁎ , Aftab Afzal, PhD a , Zafar Iqbal, PhD a , Farhana Ijaz, MS a , Niaz Ali, PhD a , Rainer W. Bussmann, PhD b,c a Department of Botany, Hazara University, Mansehra, Khyber Pakhtunkhwa, Pakistan b Saving Knowledge, La Paz, Bolivia c Museo Nacional de Historia Natural, Calle Ovidio Suarez 26, Cota Cota, La Paz, Bolivia Abstract In spite of the remarkable achievements in the health care sector over recent decades, inequities in accessibility and affordability of these facilities coexist throughout Pakistan, which has led us to explore and document the cultural knowledge of medicinal plants used in skin disorders by the local community members of Manoor Valley, Pakistan. Field investigations were undertaken during the summer seasons of 2015-2017, and cultural practices of medicinal plants usage for treating various ailments were gathered through interviews with the local inhabitants. Ethnomedicinal insights of the medicinal plants used for skin ailments were gained with recorded data assessed through different statistical packages for evaluation of principal components anal- ysis, species disease curve, and two-way cluster analysis. We conclude that plants play an important role as ethnomedicine in daily life and especially in the health care of the people living in the study area. © 2018 Elsevier Inc. All rights reserved. Introduction Skin is the largest organ of the body. 1 It serves many im- portant functions, including protection, percutaneous absorp- tion, temperature regulation, fluid maintenance, and sensory and disease control. 2 Skin diseases occur worldwide and ac- count for about 34% of all occupational diseases. 1 This affects people of all ages, from newborn to the elderly, and is one of five reasons for medical consultation. 3 Even the victims of HIV are sensitive to skin diseases, and more than 90% of HIV-infected individuals develop cutaneous and mucosal complications at some stage during the disease. 4 According to the World Health Organization (WHO), burns are also a serious public health problem due to a worldwide increase in burnout mortality. 5 Although the mortality rate for skin dis- eases is relatively low, they have a significant impact on the quality of life and are often persistent and difficult to treat. Burn victims are also susceptible to serious and often fatal in- fections with Pseudomonas aeruginosa. 6 A socioeconomic environment, such as large family size, plays an important role in the spread of skin infections. 7 In addition, hot and humid climatic conditions aggravate skin infections. Natural beauty is a blessing and sign of healthy life. Plants help in preserving and enhancing the beauty and personality of human beings. 1 Traditional medicinal resources, especially plants, play a major role in managing skin conditions 8 and have been employed for treating skin ailments in neighboring India 8-10 as well as around the world, and contribute signifi- cantly to the traditional system of health care. 3,11,12 Previous- ly, two surveys have documented medicinal plants used to ⁎ Corresponding author. Tel.: +92 3169234242. E-mail address: hajibotanist@outlook.com (I.U. Rahman). https://doi.org/10.1016/j.clindermatol.2018.03.016 0738-081X/© 2018 Elsevier Inc. All rights reserved. Clinics in Dermatology (2018) 36, 310–319