History of Latin American Dermatology

History of Dermatology in Puerto Ricoover by Dr. Néstor P. Sánchez, who is also a dermatopathologist. The School currently includesDrs. Néstor P. Sánchez, Jorge L. Sánchez, Pablo I. Almodóvar, Miguel VázquezBotet, José R. González, Luz D. Figueroa, Aida Lugo-Somolinos, Aivlys Pérez, Rafael F.Martín, Francisco Colón, Hiram Ruiz Santiago, Alma Cruz and Hiram Ruiz Arroyo.The vacancies for the residency are in high demand, a situation that has allowed usto choose excellent candidates, many of them with another specialized field already completed,such as pediatrics, family medicine, internal medicine and anesthesiology. At present,we have dermatologists sub-specializing in phototherapy, immunodermatology,dermatopathology, pediatric dermatology, cosmetic surgery, Mohs surgery and lasertreatment. In this way, our specialized field is placed in a prominent position withinmedicine and earns a seat in the health field in our Island and at the international level.There are currently 65 dermatologists in active practice in Puerto Rico, more than athird of whom are women. There is approximately 1 dermatologist for every 60,000 inhabitants,and services are distributed throughout the island.Scientific Research■ Scientific researchScientific research began with Dr. Arturo Carrión, who published nearly 200 articlesover the course of his life. Other specialists who have contributed many internationallypublished research papers followed him.The Dermatology Department has been a great stimulus for research and for the productionof scientific work; every year, between 5 and 10 scientific essays are publishedin the world’s principal dermatology journals.Leprosy in Puerto Rico■ Leprosy in Puerto RicoVery little is known about the diseases and epidemics that occurred during the fourcenturies of Spanish domination. It is known that the Puerto Rican deputy before theSpanish Courts struggled unsuccessfully to set up a leprosarium for the many patients ofthis disease who (Figure 3) wandered around the Island. It is thought thatleprosy arrived in the island with the introduction of slaves from Africa; itsexistence is known through the transaction documents, where it was specifiedthat the owner would get his money back if the purchased slave developedthe disease.In 1898, with the change of sovereignty, the first attempt to isolate leprosypatients took place, with the creation of a shelter in the rear of the SanJuan prison. In 1902, the first leprosarium was set up on Cabras Island, anislet off San Juan harbor; the location, isolated by the sea, had for manyyears been a quarantine site. In 1926, the patients were moved to a locationnear the city of San Juan, with better facilities for treatment.The Insular Leprosarium served as an isolation spot in the pre-treatment era for patientswith the disease. Between 1943 and 1965, Dr. Honorato Estella headed the institutionand obtained the approval of legislation to mitigate the laws, since effectivetreatment already existed.In 1966, the management of the Leprosarium became part of the Dermatology sectionof the Medicine Department of the Medical School. At that moment, the name of theinstitution was changed to Dermatological Center, under which it operated until 1977,when it was finally closed, since, as in all other places where leprosariums existed, withthe arrival of multiple therapies it was no longer necessary to keep them in operation. In1984, the Tropical Dermatology clinic was set up; since then, leprosy patients receiveFigure 3. Ruins of theLeprosarium375