Karen Stolman, MD
Karen Stolman, MD
Dermatology · South Jordan, UT

Dermatology in Central America

March 19th
Puntarenas, Costa R

Project Description

I am a registered medical volunteer with Health Volunteers Overseas, and U.S. board-certified dermatologist. I have been invited to help see and care for dermatology patients at a rural Spanish-speaking pop-up specialty health clinic in Costa Rica. The event is organized by the University of Costa Rica School of Medicine and the Costa Rican public healthcare system. There is a shortage of dermatologists and an urgent need for help in certain parts of the country. I am fluent in Spanish and have participated before in one of these clinics. I join a team of 20-30 doctors and nurses and we are able to see 1000’s of patients in a few days. We get them started on much needed treatment, or provide needed biopsies or surgeries. Some patients have delayed their care for their disease for many months and are truly suffering. Most of these patients have never seen a dermatologist or any specialist, and are lucky if they see a primary care doctor once a year. I also can share knowledge from the American Academy of Dermatology and bring spare medical supplies to give to the program.

It is expensive airfare and travel and time away from my income in the United States or I would do it more.

Population Served

The patients I will help are impoverished or have poor access to good healthcare and live far away from specialists and sometimes primary care doctors. They have diseases that have been neglected and they have diseases that the primary care doctors do not have experience managing: severe debilitating psoriasis, pemphigus, leishmaniasis, lupus, severe pruritic eczema, chronic disabling skin infections, skin cancers. We diagnose, treat, and prescribe cheap or free treatments with the help of the Costa Rican government.

Expected Impact

We are able to help 1000’s of people in a few days at this popup clinic. I volunteered at this clinic a year and half ago in a different underserved region of Costa Rica. I was told we helped about 1500 patients. It was so helpful that they are doing it again. I am taking what I learn from this to help Health Volunteers Overseas start other dermatology volunteer projects in other places in Latin America.

Trip Photos & Recap

Through the generous support of Health Volunteers Overseas (Ref. 2) and the Doximity Foundation, I have been able to help provide care twice in pop-up dermatology clinics in Costa Rica. In September 2017 with the support of Health Volunteers Overseas, I participated by seeing Spanish-speaking patients in a rural pop-up dermatology clinic in Talamanca, Costa Rica. At the time, there were no permanent, practicing dermatologists in this more remote region of Costa Rica on the Caribbean side. This past month, I participated in another dermatology pop-up clinic in Puntarenas, Costa Rica. There is currently just one dermatologist within a 40+ mile radius in this coastal region of Costa Rica. Patients were traveling many hours or delaying their care due to unavailability of appointments. Both the Talamanca and Puntarenas pop-up dermatology clinics were performed over a two-day period, where 30+ dermatology providers and staff, myself included, were able to see patients. In Puntarenas, a total of 1471 patients were seen over 14 hours of operation. There were 570 procedures performed at this clinic including: skin biopsies, minor skin surgeries, injections, lab tests, and cryosurgery. At least six probable melanomas were detected, biopsy was performed, and pathology was sent. 80 plus probable basal cell carcinomas were detected, and tested. (Ref.3) Beyond skin cancer, some other skin problems that were also managed during the pop-up clinic, include: chromoblastomycosis, tinea corporis/capitis, tinea versicolor, leishmaniasis, pemphigus, actinic keratoses, contact dermatitis, lymphedema, psoriasis, scabies, cutaneous larva migrans, and neurofibromatosis.