History of Latin American Dermatology

RAFAEL FALABELLAalready beginning to experience. Thus we see that, for example, just one of the multipledoses of treatment with drugs for psoriasis designed with biomolecular techniques cancost from twice to four times — or more — the monthly wages of a worker. Meanwhile,there is an insistence on the copyright of patents for new drugs to be applied in the countriesthat sign free trade treaties, yet at the same time its inhabitants have no access tothem because of their prices. Knowing how much herbalism and phytotherapy, which arenowadays so in vogue, will continue to grow in the future as complements or substitutionsfor the new generation of sophisticated dermatological therapies 3 will depend onhow affordable these drugs are for a population that cannot obtain them because, amongother reasons, they are frequently not covered by their health plans.■ A A modern world world more than more ever communicated than ever by communicated technology by technologyThe development of new systems of communication, computers and the rapid transmissionof data make teleconferences with video and sound possible; this task will beroutine in a not too distant future, but currently, even though the method has been testedwith great success, its cost makes its benefits questionable 4 . Nevertheless, other advantages,such as the decrease in referral patients, patient satisfaction and the improvementin the knowledge of general practitioners involved in the process, cannot be ignored 5 Inthe future, the large dermatology centers will, as part of their task, attend cases of thesmaller cities and of some rural centers. It will then be possible to view lesions many kilometersaway, propose conducts to be followed, order complementary tests, and suggesttreatments; in sum, patients will receive the benefit of the opinions of experts whom theynow rarely have access to, saving time and money 6 . It will also be possible to recruit patientsto collaborate voluntarily in dermatology research projects, especially in unusualdermatoses.■ Dermatological education education and graduate and schools graduate schoolsCommunications technology will be increasingly present in medical education, andthe growing interaction among countries will make the unification of undergraduate andgraduate education programs necessary, controlled by international educational entitiesin charge of regulating program contents. Due to this growing interaction among the inhabitantsof Latin America and between them an those of other countries outside the region,the day will come when dermatological licensing exams will be carried out to makedegrees valid, if not in all, very likely in most Latin American countries, thus generatingan even quality standard in dermatological care in the entire American continent.As a consequence of this interaction, internships by guest professors will be more frequent,providing greater encouragement to dermatology teaching and research and tothe creation of doctorates in the basic sciences, allowing for the training of human resourcesthat are more versatile and prepared to solve the problems of Latin America. Inall likelihood, the access of the dermatology patient to the specialist will be quicker andmore timely, reducing morbidity and even mortality. At present, with the models of generalhealth plans, second opinions are unjustifiably denied or delayed for patients whorequire them, with the consequent rise in the cost of medical services and the complicationscaused by diagnosis or therapy problems.One of the most significant items in the design of Dermatology programs will have tobe the maximization of the available resources for undergraduate syllabuses, taking advantageof the administrative, faculty, research and treatment infrastructure of graduate444