More than just eczema

Abstract

D ermatology has been a low priority for most governments, and even within medicine, in less-developed countries. Despite the efforts of many dermatologists, this specialty has been regarded as non-fatal and thus nonessential. Many non-dermatologist physicians believe that skin problems are either eczema or fungal infections, and topical corticosteroids and antifungal agents have been considered the panacea for any skin ailment. The importance of dermatology is, however, grossly underestimated. According to data from the Ministry of Public Health, Thailand, skin complaints are among the commonest reasons for patients to seek medical attention and one of the five commonest causes of morbidity in rural areas. Many skin problems are preventable and easily treatable, although there are shortages of qualified health-care workers, equipment, and medicines. To help ameliorate the shortage of dermatologists in Asia, the National Institute of Dermatology, under the auspices of the governments of Thailand and Japan, was set up in 1984. The main mission is to train physicians from all developing countries in the region in dermatology. The trainees then teach others what they have learnt and give proper care to patients in their respective countries. Despite its success, the number of successful candidates can serve only a small proportion of the population. Thus, primary health-care workers have to deal with basic skin afflictions. Dermatologists are, however, vital in the care of difficult diseases, especially chronic disorders like psoriasis and vesiculobullous diseases. Without years of expertise, these conditions which require many treatments and have many complications cannot be managed with confidence. Dermatology in less-developed countries differs in some ways from that in more-developed countries. First, dermatologists and general medical practitioners are not the More than just eczema