Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, 233 S. 10th Street, Philadelphia, PA, 19107, USA.
Arch Dermatol Res. 2024 Aug 19;316(8):534. doi: 10.1007/s00403-024-03274-9.
Homelessness in the United States is a significant public health issue, with dermatologic disease being the most prevalent health concern among the undomiciled and sheltered populations. Despite a growing need for dermatologic care, the supply of dermatologists remains insufficient, contributing to disparities in healthcare access for this vulnerable group. This review aims to detail the spectrum of dermatologic conditions experienced by homeless individuals, identify barriers to adequate care, and explore teledermatology as a potential solution to bridge these gaps. A comprehensive literature review was conducted, analyzing studies and reports on dermatologic issues prevalent among the homeless population and the efficacy of teledermatology in addressing these concerns. Homeless individuals face a wide range of dermatologic problems, from common conditions like acne and eczema to severe issues such as cellulitis, leg ulcers, and skin cancer. Drug abuse, domestic and sexual abuse, and parasitic infestations further complicate the dermatologic health of this population. Teledermatology has emerged as a promising tool to enhance access to dermatologic care, showing significant improvements in clinical outcomes and accessibility, especially in underserved urban settings. However, challenges remain, such as the digital divide affecting the elderly and low-income populations, which could potentially exacerbate disparities. Addressing the dermatologic needs of the homeless population requires a multifaceted approach. Teledermatology offers a viable solution to improve care access and efficiency, but additional efforts are necessary to ensure inclusivity and avoid further marginalization. Volunteer-driven multidisciplinary clinics also play a crucial role in providing care, though they face challenges in continuity and resource availability. Future strategies should focus on integrating teledermatology with other supportive services to create a comprehensive care model for this underserved population.
美国的无家可归问题是一个重大的公共卫生问题，皮肤病是无家可归者和有住所人群中最普遍的健康问题。尽管对皮肤科护理的需求不断增长，但皮肤科医生的供应仍然不足，导致这个弱势群体获得医疗保健的机会存在差异。本综述旨在详细描述无家可归者所经历的皮肤病谱，确定充分护理的障碍，并探讨远程医疗作为解决这些差距的潜在解决方案。进行了全面的文献综述，分析了有关无家可归人群中常见皮肤病和远程医疗解决这些问题的功效的研究和报告。无家可归者面临着广泛的皮肤病问题，从痤疮和湿疹等常见疾病到蜂窝织炎、腿部溃疡和皮肤癌等严重问题。药物滥用、家庭和性虐待以及寄生虫感染进一步使该人群的皮肤健康复杂化。远程医疗已成为增强皮肤科护理机会的有前途的工具，在改善临床结果和可及性方面显示出显著的效果，特别是在服务不足的城市环境中。然而，仍存在挑战，例如影响老年人和低收入人群的数字鸿沟，这可能会加剧差异。满足无家可归者的皮肤科需求需要采取多方面的方法。远程医疗提供了改善护理机会和效率的可行解决方案，但需要做出额外努力以确保包容性并避免进一步边缘化。志愿者驱动的多学科诊所也在提供护理方面发挥着至关重要的作用，但它们在连续性和资源可用性方面面临挑战。未来的策略应侧重于将远程医疗与其他支持服务相结合，为这个服务不足的人群创建一个综合护理模式。
