Dermatologic care behind bars

Providing dermatologic care in a prison setting is a challenge to the practitioner's ingenuity and patience because of cumbersome methods of transporting prisoners, poor compliance with prescribed regimens, and follow-up care that is not only inadequate but almost nonexistent. Certain prevalent infections such as tinea pedis and condyloma acuminatum probably are specifically induced by the prison environment. Alopecia areata is unexpectedly common and apparently associated with stress. Pruritus, which is common, is related to both environment and stress. Dermatologic diseases seen commonly in blacks are more prevalent because of the population demographics, yet pseudofolliculitis barbae is unusual as a complaint. In this article we review our experiences in establishing a first in-prison dermatology clinic.