Dermatology in Mexico – Mexican institutions related to dermatology
There are two national dermatological groups, the Mexican Society of Dermatology, founded in 1936 and the Mexican Academy of Dermatology in 1952.
Both belong to the International League of Dermatological Societies (ILDS) and were in charge of the organization in 1977 of the 11th World Congress of Dermatology.
In 1994 the Mexican Society of Dematologic and Oncologic Surgery was founded.
In 1996 the Mexican College of Pediatric Dermatology was founded.
EMINENT MEXICAN DERMATOLOGISTS
INTERNATIONAL CONGRESSES HELD IN MEXICO
1977 – 15th World Congress of Dermatology
1978 – International Congress of Leprosy
2001 -XXIII Annual Congress of the International Society for Dermatology
2010 – 18th IBERO LATIN AMERICAN CONGRESS OF DERMATOLOGY
In the 1960s, the concept of community health first emerged in the United States. At the time, it was implemented by voluntary agencies or state bodies in places where public and private medicine did not reach, linked to medical schools as part of preventive medicine, and characterized by the work of several institutions and professionals, especially in the most marginalized areas.
A chronological retrospective review of dermatologic community medical activities in Mexico.
In 1958, Dr. Fernando Latapí, the director of the Dermatology Center, and community dermatology pioneer. Dr. Ladislao de la Pascua presented to the then Ministry of Health (SSA) a program of extramural work to combat leprosy with brigades that were made up of a doctor, a nurse, and a jeep, called “commandos contra la lepra” (commandos against leprosy). Their geographic areas of focus were; High endemic areas in the center of the country, consisting of the states of Guanajuato, Querétaro, and Michoacán; the Western Zone, which was comprised of Jalisco and Colima; and Zone 3, which included Sinaloa, Nayarit, Guerrero, and Morelos. More than 10,000 new cases were diagnosed and treated throughout these areas of the country, approximately four times more than the annual average, thus forging a new paradigm in public health.
Fundación Mexicana para la Dermatología A.C. (Mexican Dermatology Foundation) (FMD), a non-profit civil association, was established on February 16, 1995, in Mexico City with a board of 350 physicians. One of its objectives is to provide information on skin diseases and care, consultancy, dermatological surgery, and education for the population regarding photoprotection, with the ultimate aim of detecting skin cancer in a timely manner.
Dermatología Comunitaria A.C (Community Dermatology).
During the period from 1989 to 1997, personnel from the Centro de Investigación de Enfermedades Tropicales (Center for Tropical Disease Research) (CIET) and professors from the Facultad de Medicina de la Universidad Autónoma de Guerrero (Faculty of Medicine of the Guerrero Autonomous University) visited more than 70 communities in the state of Guerrero, called “sitios centinelas” (sentinel sites).
Dermatología Comunitaria A.C. is a non-profit organization that was formally established in 2004 to serve the low-income population and teach basic dermatology to health personnel. It has a multidisciplinary team integrated at the local level by doctors Roberto A. Estrada Castañón, María de Guadalupe Chávez López, Guadalupe E. Estrada Chávez, as well as multiple international members such as Roderick J Hay, from the International Foundation for Dermatology, Kevin StClaire, and Neil Prose, from the American Academy of Dermatology, Isabel Casas, from community dermatology in Argentina.
Their work has been supported by the Secretaría de Salud de Guerrero (Guerrero Ministry of Health) (DIF), as well as the Fundación Mexicana para la Dermatología (Mexican Foundation for Dermatology) (FMD), the International Foundation for Dermatology (IFD), the International League of Dermatological Societies (ILDS), the American Academy of Dermatology (AAD), the Colegio de la Frontera Sur (South Border College)(ECOSUR), and Direct Relief-Vaseline. Their objectives are:
- Provide dermatological care to communities that lack it.
- Provide free medicines during the care days.
- Teach health personnel how to recognize and manage the most common skin diseases.
- Detect and provide care to compromised patients.
- Conduct research on neglected diseases.
- Advise appropriate agencies on priorities affecting the community.
- Share their program with other locations with the same health problems.
The Dr. Roberto Arenas Foundation A.C. was established on March 31, 2021 by its founding partners: Roberto Arenas, Aureliano Castillo Solana, Marina Romero Navarrete, Balfré Torres Bibiano and Angélica Beirana Palencia. It is a non-profit, independent, non-partisan civil association. Its main objectives are: to provide non-profit dermatology consultation, pediatric dermatology, tumor surgery, biopsies, sampling fungal cultures, and otorhinolaryngology consultation.
OUR CONTRIBUTIONS DURING THE COVID-19 EPIDEMIC
In our country, due to the COVID-19 lockdown, the CDC recommended that no more than ten people gather in the same location. Due to this, the University Hospital implemented an education scheme that consisted of virtual classes via the Zoom platform, which covered various academic fields, such as Dermatopathology, Dermatologic Therapeutics, STI, Dermatologic Surgery, Basic Dermatology, Genodermatosis, Trichology, Contact Dermatitis, Hospital Dermatology.
Joint and collaborative sessions – with the General Hospital of Mexico in Mexico City or the Rheumatoid Arthritis Specialists Center in Nuevo Leon – and those organized by societies and colleges such as the Colegio Ibero Latinoamericano de Dermatología (Ibero-Latin American College of Dermatology) (CILAD) and the Colegio de Médicos Dermatólogos del estado de Nuevo León (Nuevo Leon College of Medical Dermatologists) (CMDNL) were made available. Due to limited clinical exposure, after each theoretical or joint session, inpatient cases were discussed to optimize diagnoses and treatments as well as to improve prognoses by discussing different faculty members’ opinions.
It is also worth mentioning we cancelled all consultations and elective procedures services for five months. In the case of the residents in the dermatologic surgery high specialty course, they received an additional course in advanced surgery. After each class, the professors presented a hypothetical case in which the resident had to present the best surgical approach (Mohs vs. wide margin excision). Using a bust-type model (IL Duomo, DermSurg Scientific), the residents designed multiple skin grafts and practiced surgical skills in a realistic setting. To ensure proper understanding, the residents had to explain the concepts and justify the uses of each graft.
Teledermatology is a digital follow-up tool that allows us to monitor suspicious lesions and track them over time. It has a profound impact on the timely diagnosis of neoplastic lesions (particularly melanoma), thereby helping with prognoses. Teledermatology seems to be a very effective method of tracking patients, and this is something we have particularly seen in our private practice. Patients seem to have no objection to follow-up consultations via remote means. They use technology to send photographs or participate in video calls to be advised and assessed regarding changes in their disease, as well as allowing for the ability to maintain close communication after procedures. However, some experts (with which we agree) recommend that the first consultation should be essentially face-to-face, especially in order to establish the doctor-patient bond, assess first-hand the reason for the consultation, and educate the patient about their disease and the use of ICTs for subsequent follow-ups.
FUTURE OUTLOOK – THE COVID 19 PANDEMIC
The COVID-19 pandemic has produced a profound change in public health systems worldwide, mainly due to the increased demand on healthcare resources, including personnel. Additionally, in order to prevent the spread of the disease, the utilization of telemedicine and virtual services was increased for services such as medical consultation, health education, and treatment updates for patients with chronic degenerative diseases.
However, during the COVID-19 pandemic, it became apparent that physicians and patients were poorly educated on how to use digital services essential for telemedicine. Throughout 2020, groups of researchers, including Ocampo-Candiani, gave a series of recommendations on how best to provide safe dermatology and teledermatology consultations. The recommendations cover activities before, during, and after consultations.
Aspects such as office layout, workflow control, aseptic procedures, time and care of dermatological areas, as well as the use of digital media for care are discussed. They concluded that the design of appropriate protocols depends on specialists understanding the characteristics of COVID-19 case behavior in their locality, maintaining contact with health authorities and symptom care centers to determine the appropriate office closing and reopening times.
Ultimately, during the COVID-19 pandemic, owing to the use of AI, teledermatology, interactions with other physicians and dermatological centers around the world, and the proximity to the general population, a comprehensive registry of dermatological disorders in Ibero Latin America was developed, as part of a study headed by Dr. Jorge Ocampo Candiani. The study was published in the International Journal of Dermatology and managed to document dermatological disorders in 347 patients in more than 25 countries. This could benefit dermatologists and first-contact physicians, since this registry positioned dermatological disorders as an important criterion for establishing the diagnosis of COVID-19 infection in our population.
This article is now an important part of history owing to the fact that, in the midst of a global health crisis, it proved that the ability of humans to adapt and continue doing science in tandem with technology is essential to ensure our place on this planet. The use of telemedicine as a tool to provide health services is not new, and it seems that its use will continue to grow over the next few years. Some classes and academic sessions are and will continue to be virtual. Not only that, but the way congresses are conducted may also be hosted completely virtually or in some hybrid form, making novel information available to a greater number of people. Likewise, dermatologists will continue to adopt new tools in their clinical practice in order to optimize positive patient outcomes. Since ultimately, adaptation is something that characterizes us.