History of Latin American Dermatology

History of Dermatology in the Dominican RepublicIn the year 1500, the first surgeon arrived, Master Alonso; in 1533, the first autopsyin the New World was carried out, on female Siamese twins, carried out by surgeon JuanCamacho, who in his description placed special emphasis on the skin 4 .In 1519, the first Protomedicato (medical inspection board) in the Americas was setup, to regulate the practice of medicine; in 1562, by the papal bull “Apostolatus Culmine,”the first University of the New World was created, St. Thomas Aquinas, whichtoday is the Autonomous University of Santo Domingo (UASD). In 1582, the first Shelterfor Children was inaugurated, which as Dr. Pedro López records, was frequently attackedby epidemics of scabies and rashes 2 .With the arrival of slaves from different parts of Africa, new illnesses arrived; in thisway, the island, according to the chroniclers, was scourged by filariasis, gusarolas, smallpox,leprosy, dysentery, yellow fever, scabies, buboe, chancres, sores and varicose ulcers.In the 18th century, cutaneous illnesses were described such as filaria, frambesia,blennorrhea, black smallpox, measles, gusarola, verola (spot marks), chiggers, ulcersand various types of chancres 9, 11, 12 .Buboe are one of the first pathologies described on the island. In 1730, Damier Chevalierdescribed some skin lesions that could well correspond to leprosy, stating that “theyare a consequence of smallpox (syphilis)”; in 1747, he published a treatise about the ailmentson the island, in which he pointed to leprosy as a common pathology in the blackand white population, considering it a modified syphilis 2, 12 .As with the Indians, the medicine of the black slaves was also animist and empirical,based on the use of poultices and brews together with magic rituals performed by thebokor 12 .In 1804, Emmanuel Chopitre — a French physician who had settled in the Frenchpart of Hispaniola — made one of the first descriptions of leprosy in the Americas, alsoconsidering it a type of syphilis. In Paris, this author described what we today know asfascies leonina, as well as some aftereffects of the disease; he also described frambesiaor buboe in three clinical forms — small yaws, red yaws and large yaws 12, 13 .Another French doctor, Charlevoix, defined leprosy as a pathology that was not indigenousto these lands, but as coming from Europe, one that was common in the citiesand rare in the country 13 .Figure 3. Old St.LazarusHospitalDrawing ofwhat was thefirstleprosarium inthe AmericasFigure 4. OldSt. LazarusHospital.Currentcondition ofthe firstleprosarium ofthe New WorldDermatology under the Republic■ Dermatology under the RepublicSince 1845, an order existed for the confinement of leprosy patients at the Hospital ofSt. Nicholas of Bari. In 1881, the first Medical Association was founded; during theseyears physicians were still general practititoners or surgeons; specialized fields were unknown,as they only began to be conceived in 1852, after the opening of two medicalschools, in Santo Domingo and Santiago 14 .379