Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL 33136, USA.
Division of Dermatology, Georgetown University School of Medicine, Washington, DC 20007, USA.
Int J Environ Res Public Health. 2023 Feb 9;20(4):3071. doi: 10.3390/ijerph20043071.
For patients in rural areas, primary care is often their only access to healthcare services, and skin concerns are among the most common diseases seen in these settings. This study aims to investigate the most common skin conditions, management trends and patterns of referral to dermatology in a rural and underserved community in South Florida. A retrospective chart review was conducted using medical records from the C.L. Brumback Primary Care Clinic in Belle Glade, FL. The most common skin conditions were fungal infections, unspecified dermatitis, pruritus, skin cancer concern, alopecia, and autoimmune skin disorders. The most frequent management strategy was medication prescription followed by specialist referral. Of the 21 percent of patients referred to a specialist, 55 percent of these were to dermatology. The most common diagnoses referred to dermatology were atopic dermatitis and alopecia. Only 20 percent of these patients reported attending their follow-up appointment, and the average distance to referral was 21 miles. Belle Glade is unique in its need for and access to dermatologic care. The lack of access to specialists in rural communities is a public health issue that more studies and outreach initiatives should address.
对于农村地区的患者来说，初级保健通常是他们获得医疗服务的唯一途径，而皮肤问题是这些地区最常见的疾病之一。本研究旨在调查佛罗里达州南部一个农村和服务不足社区中最常见的皮肤状况、管理趋势以及向皮肤科转诊的模式。使用佛罗里达州贝尔格拉德 C.L.布鲁姆巴克初级保健诊所的病历进行了回顾性图表审查。最常见的皮肤状况是真菌感染、未明确的皮炎、瘙痒、皮肤癌、脱发和自身免疫性皮肤疾病。最常见的管理策略是开处方药物，然后转介给专家。在 21%被转介给专家的患者中，有 55%转介到皮肤科。转介到皮肤科的最常见诊断是特应性皮炎和脱发。只有 20%的患者报告参加了他们的随访预约，平均转诊距离为 21 英里。贝尔格拉德的独特之处在于它对皮肤科护理的需求和可及性。农村社区缺乏获得专家的机会是一个公共卫生问题，应该有更多的研究和外展计划来解决。
