No abstract

Stigma is synonymous with leishmaniasis, an endemic deadly flesh-eating disease in Yemen that affects predominantly poor rural women and children. Women with leishmaniasis often present late and experience not only physical deformities and the risk of death, but also the painful stigma of the disease and its consequences, a similar situation to that of leprosy decades ago. The International Society of Dermatology–sponsored community dermatology project Eradication of Leishmaniasis from Yemen Project has made a difference in the leishmaniasis situation in Yemen and addressed its magnitude. The program eradicated leishmaniasis from some areas, dealt with and improved its alarming prevalence among children and women who are the neglected and highest risk groups, and solved some issues associated with poor access to proper drugs. Medicine donation has enabled women with leishmaniasis to freely receive medicine they otherwise would not have been able to afford, reduced their mortality and morbidity, and minimized the extensive impact the socio-aesthetic stigma has on their lives. Our cause has attracted local and global attention to these problematic issues.

Cutaneous, mucocutaneous, and visceral leishmaniases have significant endemicity in Yemen, especially in central areas. Al Bayda is the governorate with the highest endemicity, and rural children and women represent the populations at highest risk. Mucocutaneous leishmaniasis seems to be the most prevalent form and a single wet ulcer is the most common presentation. Infected refugees may represent new foci for imported Leishmania species. Ecology, geography, climate change, cultural gender- and age-specific duties, urban night activities, and use of popular treatments are among proven risk factors.

Leishmaniasis, a widely prevalent disease throughout tropical and subtropical regions of the world, is a chronic protozoan infection of humans and mammals that remains grossly underreported and causes significant global morbidity and mortality. Different species of the intracellular protozoan parasites of the genus Leishmania can cause human leishmaniasis, resulting in various visceral, cutaneous, and mucocutaneous manifestations. The risk of leishmaniasis manifesting as a more severe entity is dependent on the infecting parasites' immune evasion potential. Some causal associations between leishmaniasis and malignancy have been evidenced in experimental animals and humans. Leishmania spp. infection can play a significant, direct or indirect, role in the pathogenesis and prognosis of some malignant disorders through numerous pathophysiologic cascades. Aging, chronic ultraviolet radiation exposure, and popular treatment abuse (eg, chameleon saliva, cactus recipes, corrosive chemicals, and topical steroids) have been proposed as the principal triggering factors. Malignancy should be considered in the differential diagnosis of leishmaniasis in endemic regions, such as Yemen. Understanding this relationship could enrich the provision of early diagnosis, proper management, and prompt control of cancer.

Volume 4(1): 1-3 that predominantly prevail among poor rural children and women, Regional Leishmaniasis Control Center (RLCC) was founded during April 2013 as a first phase of the project ELYP. Immediately, as the second phase of the project ELYP, RLCC released several integrated programs for the same purpose. Because of the complex geography of Yemen, weak infrastructures, scarce medical facilities in rural areas, deteriorating economic status, high cost of health care, conflicts and instability, Teledermatology program was adopted as a standalone innovative program that may provide a communication tool between caregiver each other at different regional centers/units, them and their instructors and project supporters abroad and between leishmaniasis patients in distant disadvantaged areas and their treating doctors at center's regional clinics [2-4]. RLCC's teledermatology program resourcesDue to scarcity in resources, RLCC has not relied on specific telemedicine-specific hardware or software to implement teledermatology program, but it utilized all available resources as to support the program. IntroductionTelemedicine, a branch of e-health, is one of wide opportunities offered by the advance in both the medical sciences and electronic communication. It is not a specific technology, but a dynamic process that utilizes interactive telecommunications technology to share digitized medical data between two parties to provide patient care, as well as health education for patients and health care providers at a distance.Teledermatology, that can be defined as the remote delivery of skin care services and information using telecommunications technology, is indeed unique and most frequently used service of telemedicine due to the visual nature of skin and skin diseases. Generally, teledermatology can be categorized, upon the utilized technology, platform and application used, into three main types, (1) live-interactive (synchronous) teledermatology; (2) store-forward (asynchronous) teledermatology; and (3) Hybrid (combined) teledermatology [1].Live-interactive teledermatology usually utilizes web-based communications and requires the presence of both parties at the same time; it usually employ telephone call and videoconferencing technology for direct real time interaction. Store-forward teledermatology is the most commonly employed method due to its asynchronous nature; it does not require the presence of both parties at the same time; and hence, clinical data and skin photographs are captured, stored and forwarded at a convenient time for later review. Hybrid teledermatology covers features of both the above-mentioned types; it performs instant live-interactive as well as sore and forward teledermatology operations. Adoption of Teledermatology in Eradication of Leishmaniasis from Yemen Project (ELYP)To implement strategies of the ISD-and AAD-supported, community-led, Eradication of Leishmaniasis from Yemen Project (ELYP) to combat the neglected endemic leishmaniasis disease Al-Kamel MA (2017) Feasibility of telede...