A retrospective study of the association between cumulative doses of cyclosporine required for remission and IgE level in atopic dermatitis

Abstract

Background: The Travis Park Dermatology Clinic was established in 2009 in an effort to treat dermatologic conditions in the homeless, indigent, and uninsured population of San Antonio, Texas. The clinic operates twice a month. San Antonio serves one of the largest Hispanic populations in the United States, with Hispanics making up around 63.6% of the city’s population. Among Hispanics, and especially those who are homeless, uninsured, or underinsured, access to proper dermatologic care may be difficult, thus the clinic was established with the goal to reduce barriers to care. Objective: To identify the most common dermatologic diagnoses among patients seen at the clinic from January 2017 to September 2018 with attention given to age, gender, and diagnosis. Data will be used to help identify prevalent dermatologic conditions in the Hispanic population and will serve as a resource when medications and treatment supplies are ordered for future clinics. Methods: Patient charts from 43 dermatology clinics were reviewed and demographics and diagnosis were recorded. Results: Overall, 724 patients, between the ages of 0-87 (average 51, mode 45) were seen. Demographically, 62% were female and 38% were male with 69% identifying as Hispanic, 17.4% Caucasian, and 5.8% African American/Black (7.8% did not disclose their race). A total of 417 diagnoses were recorded. The top diagnoses (per total number of patients) were: atopic dermatitis (18.3%), acne (9.2%), seborrheic keratosis (4.9%), epidermal inclusion cyst (4.8%), alopecia areata (4.8%), and with <5% frequency psoriasis, actinic keratosis, tinea infections, verruca vulgaris, and rosacea. In addition, the rate of malignancy was 3.31% with patients presenting with lesions suspicious for basal cell carcinoma (13), squamous cell carcinoma (5), melanoma (5) and dysplastic nevus (1). Limitations: Diagnosis variability between attending dermatologists. Conclusions: The most common diagnosis at the clinic was atopic dermatitis with 132 out of 724 patients presenting with this condition. Hispanics continue to account for more of the nation’s overall population growth than any other race or ethnicity. Dermatologists will increasingly see conditions that are more prevalent in this population and must have an understanding about treatment for these conditions as well as cultural awareness of issues that may affect proper treatment. This chart review helps to better identify these conditions and will aid in decisions about medication and treatment supplies ordered for future clinics.