ABSTRACT
This Viewpoint discusses actionable approaches in providing dermatologic care for displaced persons.
Subject(s)
Delivery of Health Care , Dermatology , Refugees , HumansSubject(s)
Transients and Migrants , Humans , United States , Dermatologists , Health Services AccessibilityABSTRACT
"Currently, an estimated 70.8 million individuals worldwide are forcibly displaced due to war, violence, and persecution. Barriers to providing dermatologic care include the large number of affected people, their movement within and across international borders, security issues, and limited access to dermatology expertise and formularies. Screening protocols for skin diseases and sexually transmitted infections differ worldwide, raising the need for shared guidelines to assess migrants' health. This article reviews the literature of skin and sexually transmitted infections in migrants and displaced persons, highlighting the impact of social determinants on skin health and challenges faced in providing care."
Subject(s)
Deficiency Diseases , Environmental Exposure , Refugees , Skin Diseases , Transients and Migrants , Violence , Coinfection/diagnosis , Coinfection/therapy , Culturally Competent Care , Deficiency Diseases/diagnosis , Deficiency Diseases/therapy , Drugs, Essential , Gender-Based Violence , HIV Infections/diagnosis , HIV Infections/therapy , Health Services Accessibility , Humans , Malnutrition/diagnosis , Malnutrition/therapy , Neglected Diseases , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/therapy , Skin Diseases/diagnosis , Skin Diseases/therapy , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/therapy , Torture , Tuberculosis/diagnosis , Tuberculosis/therapy , Vaccine-Preventable Diseases/diagnosis , Vaccine-Preventable Diseases/therapyABSTRACT
There are 70.8 million persons displaced worldwide due to war, persecution, and violence. Eighty percent of displaced persons reside in low- and middle-income countries with limited healthcare resources. Cutaneous diseases are commonly reported among displaced persons owing to numerous interrelated factors such as inadequate housing, overcrowding, food insecurity, environmental exposures, violence including torture, and breakdown of healthcare infrastructure. Diagnosis and management of these conditions, as well as an understanding of the context in which they present, is crucial to providing dermatologic care for displaced populations worldwide. Herein, we define displaced populations and, within this context, review the epidemiology of skin diseases, discuss pertinent skin conditions, examine challenges to care provision, and present approaches for improving dermatologic care. Inflammatory and communicable infectious disorders are the most common skin diseases seen in displaced populations. Other relevant conditions include skin manifestations of heat injuries, cold injuries, immersion foot syndromes, macronutrient and micronutrient deficiencies, torture, and sexual and gender-based violence. Provision of dermatologic care to displaced populations is hampered by limited diagnostic and therapeutic resources and specialist expertise. Medical screening for cutaneous disorders, context-relevant dermatology training, and telemedicine are potential tools to improve diagnosis and management of skin diseases in displaced populations.
