We report 73 cases of cutaneous sporotrichosis from the Community Dermatology
program, at the central and mountain areas of the state of Guerrero, Mexico. A
similar number of cases was found between children and adults, mostly peasants
and school-age children with rural occupations. Upper limbs were the mostly
affected and the predominant clinical form was lymphocutaneous (56.16%). All
cultures corresponded to Sporothrix schenckii (sl). Treatment
was done with potassium iodide in 54 patients, achieving clinical and
mycological cure in all cases.
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.
The uncontrolled sale of topical corticosteroids has become an important risk factor for the development of iatrogenic Cushing syndrome in children, especially in countries where medications are sold over the counter. This is exacerbated by the lack of information for both the patients and pharmacists. This report documents a series of eight cases of iatrogenic Cushing syndrome secondary to an inappropriate use of topical steroids, due to a misdiagnosis of scabies.
We describe three cases initially diagnosed clinically as cervical mycetomas and one in the middle dorsal thoracic region. All the cases were diagnosed at the Acapulco General Hospital of Guerrero State in Mexico.
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