“L” is a mother of 3 who was forced to flee her home country owing to political unrest. She now lives in a crowded refugee camp in a neighboring country and struggles to access basic necessities, let alone medical care. Her son aged 3 years suffers from severe eczema. When L sought care at the camp’s medical clinic, she received a tube of topical corticosteroid ointment, but with no follow-up and limited financial resources, she must ration the remaining ointment.
Across the ocean, “D” sleeps under a highway overpass in a major United States city. Over the past weeks, an unbearable itch has spread across his wrists and waistline and between his fingers. When he finally connects with a mobile outreach team, the provider recognizes the signs of scabies. However, treatment is complicated by D’s lack of access to clean clothes, hot water, or a private space to apply medications. Even with the correct diagnosis, the logistics of care make successful treatment challenging.
These stories reflect just 2 experiences among the millions of people experiencing homelessness (PEH) worldwide, whose dermatologic needs are often undertreated or dismissed. They underscore how structural barriers hinder care and highlight the need for dermatologists to meet patients where they are. In this commentary, we propose several strategies for improving the diagnosis and management of skin conditions among PEH.
