Case Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

An American family medicine physician on a medical rotation in South America encountered an elderly woman with progressive skin thickening over the past 1-2 years.  Family members also reported progressive limitations in mobility, to the point that she has been unable to walk for the past two months.  In addition, she has lost weight and recently suffered a fractured hip.

The patient's physical examination showed dried, scaling plaques across her entire body, most pronounced on the legs. The case required a dermatology consult, not available at this South American hospital. Using the physician-to-physician template in The Addis Clinic telemedicine platform, the family medicine physician submitted the results of his thorough history and physical exam, along with photos, and the case was immediately allocated to a volunteer dermatologist at a major U.S. university.  Only a few hours later this volunteer responded with an initial diagnosis of pellagra.  Pellagra is a disease that results from a niacin deficiency and is often seen in areas of widespread poverty and malnutrition. The dermatologist recommended the immediate addition of meat, along with multivitamins and other nutritional elements that can enhance niacin intake. 

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The two physicians were able to communicate quickly and securely across thousands of miles as they worked together on this patient’s case.  This diagnosis had not been entertained prior to the consultation with the volunteer dermatologist, and his recommendations augmented the local medical team’s treatment plan for this patient.  After 1-2 weeks of improved nutrition and vitamin supplements, the patient’s skin condition began to improve.   We are grateful to this volunteer for taking time out of his busy schedule and responding quickly and thoroughly to this case!