Skin disease is among the most frequent causes of morbidity in Ethiopia, showing high prevalence in the general population and being the sixth most frequent cause of outpatient visits nationwide to health facilities. This study was aimed at describing skin disease patterns in Tigray region, northern Ethiopia through a retrospective analysis of 30618 outpatient and 1103 inpatient medical records from the Italian Dermatological Centre in Mekelle, the regional capital of Tigray, during the period 2005-2007. The leading causes of outpatient attendance were eczema (n=6998), mycosis (n=5065), pigmentation anomalies (n=3319), scabies (n=2229) and acne (n=2001). Different patterns were observed for inpatient services, with scabies being the leading cause of admission (n=213), followed by eczema (n=158), pyoderma (n=131), leishmaniasis (n=106) and mycosis (n=56). Since the most common and readily treatable skin diseases are related to household crowding and lack of hygiene, i.e. conditions reflecting low socio-economic status, they are considered to be important contributors to the 'disease profile of poverty' and, in general, to health inequalities. Cost-effective interventions are available to reduce the burden of skin disease. The control of skin disease should be considered a public health priority and included in strategies for health-sector development and poverty reduction.