Penn Dermatology Global Health

• Overview
• Teledermatology in Developing Countries
• Clinical Programs
• Educational Programs
• Research
• Collaborating Institutions

Overview

The goal of the Penn Dermatology Global Health program, developed in 2008, is to provide and improve dermatologic care in developing countries through teledermatology, clinical care, education, and research.

Director: Carrie Kovarik, MD
Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases
University of Pennsylvania
Carrie.kovarik@uphs.upenn.edu

Teledermatology in Developing Countries

Africa Teledermatology
The website was initiated in January 2007, with the aim of creating a  broad dermatologic teleconsultation network linking medical centers in Sub-Saharan Africa involved in treatment of skin diseases, especially Human Immunodeficiency Virus (HIV) - related cutaneous disorders, to more specialized dermatology units in Europe and USA. Participating African medical centers are located in Botswana, Malawi, Kenya, Lesotho, Swaziland, Tanzania, and Uganda, whereas primary collaborating institutions include Departments of Dermatology, Medical University of Graz, Austria, and University of Pennsylvania, USA. From February 2007 to May 2008, 140 consecutive problematic dermatological cases with 320 clinical images have been processed over the project website.

Mobile Teledermatology
ClickDiagnostics pioneers mobile teledermedicine service, which enables medical consultation to be provided by remote doctors via mobile camera-phones with customized diagnosis software. This service is delivered by health-workers (based in local health-care facilities) equipped with ClickDiagnostics’ mobile camera-phones to offer affordable, accessible, first-world healthcare to patients in developing countries. Click Diagnostics, in conjunction with Carrie Kovarik, MD, are developing and validating the use of mobile telemedicine in three areas where is medical assistance is critically needed, including the diagnosis of cervical cancer, HIV, and skin diseases in rural areas of developing countries.

The ClickDiagnostics mobile teledermedicine service is developed with resources from the MIT Media Lab, MIT Sloan School of Management, Harvard Kennedy School of Government, Harvard Medical School, University of Pennsylvania Dermatology Department of Dermatology, and Telederm.org/africa

Establishing Teledermatology Sites

Clinical sites for teledermatology can be established remotely (through online training and shipping necessary materials) or by sending medical students/physicians to conducting in-person training

In person training programs:

• Carrie Kovarik, MD: Botswana, Lesotho, Swaziland, Malawi, Uganda (2007, 2008)
• Amanda Iverson, University of South Dakota, Malawi (July 2008)
• James Click, University of Virginia medical student: Egypt and Malawi (Sept 2008)
• Kathleen Tran, University of Pennsylvania medical student: Egypt and Botswana (Sept 2008)

Clinical Programs

AAD Residents' International Grant

In keeping with its dedication to international educational opportunities, the American Academy of Dermatology is providing funding in 2008 and 2009 for six U.S. or Canadian senior dermatology residents to participate in a four week elective in a developing nation where the Education and Volunteers Abroad Committee (EVAC) is establishing dermatology support programs and teledermatology consulting services. The primary site is Gaborone, Botswana, where participants rotate between the Penn-Botswana Program at the Princess Marina Hospital and the Baylor International Pediatric AIDS Initiative (BIPAI). Residents take part in dermatologic HIV care for both children and adults, and will visit outreach sites. The grant allows residents an opportunity to learn about the care of tropical and HIV-related dermatologic conditions, as well as how to practice routine dermatology with finite resources. Residents are expected to prepare lectures and presentations, develop a database of photos, submit teledermatolgy consults, as well as present a report of activities to the Academy and their home programs.  Details and application are available from the AAD.

Resident Participants:

• Jackie Panko, MD, University of Utah (Aug 2008)
• Jennifer Mueller, MD, Drexel University (Aug/Sept 2008)
• Felisa (Sally) Lewis, MD, National Capital Consortium Dermatology Program (Sept 2008)
• Leslie Castelo-Socio, MD PhD, U Penn (Sept/Oct 2008)
• David Wartman, MD, Brown (Oct 2008)
• Chris Jones, MD, Penn State Hershey (Nov 2008)
• Rachael Moore, MD, Oregon Health Science Center, (Dec 2008-Feb 2009)

Other Clinical Rotations

Clinical rotations have been organized with alternate funding sources for medical students and residents.

Participants:

• Jeremy Kampp, MD, Stanford resident: Botswana (Sept 2007)
• Jean Tang, MD PhD, Stanford resident: Malawi (Oct 2007)
• Rahat Azfar, MD, U Penn resident: Botswana (Oct 2007)
• Juliette Lee, MD, Stanford resident: Botswana (March 2008)
• Robert Lee, MD PhD, U Penn resident: Malawi (March 2008)
• Eunice Tsai, MD, Stanford resident: Botswana (May 2008)
  

Educational Programs

• Volunteers Abroad Course at the American Academy of Dermatology (AAD) Annual Meeting
• Laminated Teaching Cards through the AAD
• Africa Teaching Curriculum

Research

1. A Cohort Study Evaluating the Improvement in the Cosmetic Appearance of Flat Warts with 15% Topical Glycolic Acid in HIV Infected Children and Young Adults on Antiretroviral Therapy, Gaborone, Botswana
   
   • Rachael L. Moore, MD, Oregon Health and Science University
   • Jason P. Lott, MA, University of Pennsylvania
   • Mosepele Mosepele, MBBS. BmedSc (Melb), Penn-Botswana Program
   • Carrie Kovarik, MD, University of Pennsylvania
     
2. Development and Pilot Testing of a Mobile Teledermatology Handset and Software, Cairo, Egypt
   
   • Mridul Chowdhury, CEO, Click Diagnostics
   • Augustin Cherng, Project Manager, GSM Development Fund
   • Carrie Kovarik, MD, Clinical Manager, African Teledermatology
   

Collaborating Institutions

• University of Pennsylvania, Department of Dermatology, Philadelphia, USA
• American Academy of Dermatology
• Medical University of Graz, Department of Dermatology, Austria
• Botswana UPenn Partnership
• University of Botswana
• Baylor International Pediatric AIDS Initiative (BIPAI)
• Mbarara University of Science and Technology, Uganda
• Makerere University, Uganda

Last updated:  August 27, 2008