Roberto Estrada

Can school teachers improve the management and prevention of skin disease? A pilot study based on head louse infestations in Guerrero, Mexico

Background The effect of health education provided by teachers, in three primary schools of Guerrero, Mexico, on the prevalence of head louse infestation was compared. Methods A cross‐sectional survey and rapid appraisal methods were performed, including a child questionnaire and qualitative data from teachers and focus groups of mothers in the same schools.

Managing skin disease in resource-poor environments - the role of community-oriented training and control programs.

Programs that have been devised to improve the lot of patients with skin disease, or disease presenting with skin signs and symptoms, in resource‐poor regions have focused mainly on education and training or community‐oriented control measures. However, both have in common an objective of managing disease at population level. Training has been delivered in different ways both by direct teaching for varying periods of time or by web‐based and electronic communication; control measures have been less in evidence and there is a great need for more support from funding agencies. Despite this, there is now a growing number of successful initiatives in health improvement for skin conditions that cover many parts of the world. This report describes many of these schemes as an example of what can be done to help patients.

Specialized dermatological care for marginalized populations and education at the primary care level: is community dermatology a feasible proposal?

Skin diseases have a very high frequency either in developed as well as in undeveloped countries. Guerrero, Chiapas, and Oaxaca are the most impoverished states in Mexico, where 24% of the population lacks basic health care, and only 15% are estimated to have access to specialists. Community Dermatology program was founded in 1991 with the intention of improving the dermatological health of remote, marginalized inhabitants of the state of Guerrero. The program consists of a two‐day visit to a pre‐selected community; the first day includes a basic dermatology training course for local providers, and day 2 is a “Jornada”,”which means a day of free medical consultation and treatment. Pityriasis albus Cloasma, vitiligo, and acne continue to be the most frequent diagnosed primary disorders, as in rural areas occupational obligations include prolonged sun exposure. The experience and success of Community Dermatology over the last 20 years has demonstrated that this model of healthcare delivery and instruction is economically feasible, provides practical and quantifiable benefits for the communities served, and could be emulated by other disciplines within medicine.

Paracoccidioidomycosis in Mexico: clinical and epidemiological data from 93 new cases (1972–2012)

Paracoccidioidomycosis (PCM) is an endemic systemic infection in several countries of Latin America. The few registered cases in Mexico most likely do not reflect the real frequency. Disseminate the epidemiological and clinical data of unreported cases of PCM in Mexico from 1972 until 2012 is the aim of this work. Epidemiological and clinical information of non‐published cases of PCM was requested from the principal mycological diagnosis centres in Mexico. A total of 93 cases were received. The infection was found predominantly in men (95.7%), peasants (88.5%) and individual between 31 and 60 years of age. Most of the cases were found in tropical areas of the Gulf of Mexico (54.84%) and the Pacific littoral (20.3%). The main sites of dissemination were the oral mucosa (39.38%) and skin (34.05%). The most effective treatments were itraconazole alone and the combination of itraconazole with sulfamethoxazole‐trimethoprim. PCM is a subdiagnosed pathology in Mexico. Therefore, adequate training is necessary to determine the current status of this mycosis.

Cervical and middle dorsal actinomycetomas from Guerrero State, Mexico

Mycetomas are frequent subcutaneous mycoses with typical clinical characteristics such as sinuses, blood‐stained, serous, or purulent exudates as well as local swelling. Even though the most commonly affected areas are the lower limbs, we report four cases affecting the neck and midback regions, of which three were young females. We draw attention to the importance of early identification of these cases for prevention and specific treatment in order to avoid severe consequences or irreversible complications such as quadriplegia.

Clinical Focus on Malassezia Folliculitis

Malassezia spp. folliculitis is a variant quite frequent at the tropics. The clinical aspect of perifollicular pustules on an erythematous base with a central hair is the clue for the diagnosis, especially on hairy surfaces. We describe this clinical form caused by Malassezia sp., with background, direct examination findings, and histopathology.