History of Latin American Dermatology

History of Dermatology in PeruEpidemiology of leprosy in PeruThe epidemiological behavior of leprosy inPeru is circumscribed to endemic areas,where 3,218,109 people live, of whom1,255,062 are under 15 years of age. Accordingto the leprosy prevalence rates correspondingto 2000, and taking into accountWHO publications, it may be concluded thatleprosy in Peru constitutes a public healthproblem, particularly in Ucayali Department,an area with a prevalence of the diseaseabove the 1 x 10,000-inhabitants rate. ThisAños 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 TotalMulti-bacilar 1.205 672 220 245 202 195 227 237 221 151 126 3.701Pauci-bacilar 649 362 57 59 39 45 37 25 45 29 39 1.386Total 1.854 1.034 27 304 241 240 264 262 266 180 165 5.087C.N* - - - - 79 90 90 63 107 63 43 535D-OMS** - - - - 17 12 10 4 6 7 6 62** Casos nuevos.Discapacitados según grado 1 y 2 de la OMS.Fuente: Programa Nacional de Control de Enfermedades Transmisibles - Control de Lepra - MINSA.information allows us to prioritize control activities for the disease, seeking the commitmentof local authorities and of the community in general, in order to develop coordinatedactions that allow for the diagnosis and early treatment of all new cases of leprosy,achieving the prevention of disabilities and the effective reduction of the social impact ofthis disease (Figures 31, 32, 33).Figure 32. Cases ofleprosy reported inPeru, 1990-2000Peruvian legislation for the control of STDs. History of the current rules63, 64LEGISLATION FOR THE CONTROL OF VENEREAL DISEASESWe find the first official reference in theSupreme Resolution of July 1, 1910, which,considering “that it is the duty of the State totake care of the prophylaxis of venereal diseases,which, in addition to the damage thatthey cause to individuals who contract them,also attack the interests of society, and thoseof the race”; “that universal experience hasproven the inefficiency of police regulationson prostitution in the prophylaxis of thesediseases,” “that experience has also proven,that the most efficient measures in this respecthave been those related to inspectionand sanitary monitoring of public women andtolerance houses, and to free medical treatmentat appropriate dispensaries for thoseaffected by STDs,” resolves: to entrust the Public Health Office with the organization andoperation of the Prostitution Sanitary Service, setting up in the city of Lima and Callao,and later in the rest of the Republic, health dispensaries aimed at STDs; to grant freemedical tests and treatment carried out at the dispensaries, and to order the police toenforce the fulfillment of the sanitary stipulations that are issued for the operation of thatservice and in relation to the conservation of morals and public order.Abiding by this legal ruling, the internal Regulations of Lima’s Public Assistance, approvedby Supreme Resolution of June 30, 1923, set up the Anti-STD Prophylaxis Section,with the roles of monitoring the sanitary aspect of women subject to that control,opening a Record of Prostitutes, and giving applicants a Health Certificate that authorizesthem to the legal practice of prostitution. Police control and sanctions were indicatedfor clandestine prostitution and omissions in periodic sanitary control.In turn, the Armed Forces established, by supreme decrees, norms for the prophylaxisFigure 33. Rates ofprevalence ofleprosy per 10,000inhabitants in Peru,1990-2000351