History of Latin American Dermatology

HISTORY OFNICARAGUANDERMATOLOGYALDO EDGAR MARTÍNEZ CAMPOS, JORGE ISAAC NEIRA CUADRAProviding an account of the history of Dermatology in Nicaragua is a complex task,since there is little written information; this is why the data that we have collected comebasically from interviews made to the few “actors” of past eras who are still alive. In thedevastating earthquake that destroyed the city of Managua in 1972, a large part of thefiles that contained very valuable information were lost. Despite this, through the minutesof the current Nicaraguan Association of Dermatology, we have come to know a littleabout what has taken place in the evolutionary process of Nicaraguan Dermatology.Historically, it has been the specialized medical field with the smallest membership,and projections into the future do not make us predict changes in this trend. At present,we are 42 dermatologist doctors, with women predominating (55%), for a population of5,500,000, which gives a ratio of 1 dermatologist for every 130,952 inhabitants. Fortyfivepercent of specialists are in the city of Managua, capital of Nicaragua, and the restare in different departments (districts); but there are important areas of the country thathave no dermatologists, such as the departments of Nueva Segovia, Madriz, Rivas, Chontales,Jinotega, Matagalpa, RAAN, RAAS and Río San Juan 1 , which concentrate 35% ofthe country’s population 2 . The departments with the largest number of dermatologistsare Managua and León.We have not found serious evidence of the practice of Dermatology by medicine men,but we can assert that they have treated varicose ulcers with ground coffee and herbleaves known by non-scientific popular names. Vitiligo, which is often associated withwitchcraft or spells cast on those who suffer it, is treated with annatto and medicinalherbs. Medicine men and sorcerers are not allowed under Nicaraguan law, but sincethere is no control over them, they continue to practice regularly.Development of the specialized field■ Development of the specialized fieldThe earliest data we have on the history of Dermatology in Nicaragua are related toleprosy.In 1893, the then-president of the Republic, General José Santos Zelaya, fearing thatthe ailment might spread around the country, ordered every leprosy patient to be secludedon Aserraderos Island (Cardón Island) at the port of Corinto, on the Pacific Ocean,Chinandega Department. In 1902, the first leprosarium was founded there, where273