Dermatologists step up in public emergencies

National report - Dermatologists can play a key role in responding to many public emergencies - including a pandemic illness, bioterrorism, a localized public health crisis or a natural disaster such as Hurricane Katrina, experts say.

On the front lines

Accordingly, he says, "Dermatologists have always been cognizant of the idea that they play a role in the diagnosis of many of these bioterrorism agents."

"Our experience in late 2001 with the anthrax incidents on the East Coast showed that at least half the patients who developed anthrax developed the cutaneous form, though bioterrorism experts were expecting the inhalational form of the disease," he says.

Post-Katrina

In other emergencies such as chemical or radiological attacks and natural disasters, Dr. Lushniak says, "Having a skin expert may be appropriate and useful," depending on the situation.

After Hurricane Katrina, for instance, he says, "Dermatologists were needed to provide consultation services when skin diseases occurred in that population."

"I was probably the only dermatologist in New Orleans for two to three weeks" post-Katrina, says Richard Keller, M.D., chief of dermatologic surgery at Ochsner Clinic.

He says that in addition to handling all ward consultations there, one of his duties was to dispel rumors about any atypical skin eruptions that were occurring. Although responders and the CDC were worried that these eruptions represented an arboviral infection afflicting responders, he explains, "It turned out actually to bug bites."

Dr. Keller says that in Katrina's aftermath, he functioned also as a general practitioner, providing immunizations to police and other responders. (For more on lessons learned from Katrina, see story.)

"The other thing that a dermatologist who has some emergency or disaster medicine training or experience can do is to work as a medical liaison" between his or her institution and local officials, as Dr. Keller reports he did.

"When 9-11 hit New York," says Mark Lebwohl, M.D., "every doctor was on call."