History of Latin American Dermatology

HISTORY OFDERMATOLOGYIN PERUELBIO FLORES-CEVALLOS, LUIS FLORES-CEVALLOS, ZUÑO BURSTEININTRODUCCIÓN■ IntroductionLuis Flores-CevallosPeru is a privileged country, possessing great natural wealth — flora and fauna —which exert an enormous influence on human pathology and, consequently, on Dermatologyas well. The country also has a cultural history stretching back thousands of years.In order to know the environment in which historical events took place, as well as thetropical dermatological pathology, I consider it necessary to present some useful informationat this point.Peru is located in the sub-tropical area of South America, traversed from North toSouth by the Andes mountain range and bordered by the Pacific Ocean, with its coldHumboldt sea current, which moves northwards. These conditions make for the country’snatural wealth with its varied biological manifestations.The Coast corresponds to the western part, with desert-like, stable climate, frequentlycovered by thick fog and sporadic rains. It encompasses the area from the coastitself up to 500 meters above sea level, and it is 2070 Km long. This area is not suitablefor the presence of vectors that transmit tropical dermatological diseases.The Sierra is the central part, made up of the inter-Andean valleys, with a heightranging between 500 and 4,000 meters above sea level. This region is 150 km wide inthe North and 300 km in the South. Its climate is varied and its temperatures are between5 and 26°C. At 4,500 meters there is snow all year round. Over short distances,the valleys present different climates in the same season, with variations in the flora,fauna, and pathology. Between 1,200 and 2,800 meters the ecosystem provides a suitablehabitat for the transmitting agents of benign skin leishmaniasis, also known as “uta” and“Peruvian wart” (Bartonellosis).The Jungle is the eastern part, with an altitude of less than 1,000 meters above sealevel, and is the largest region. This area is crisscrossed by numerous rivers and presentscopious tropical vegetation. The abundant rainfall produces a humid and very hot climate,a suitable habitat for the transmitting agents of tropical dermatological diseasessuch as mucous-skin leishmaniasis, also known as “espundia.”301