Letters to the editor

A transformative teaching experience in Cambodia – sharing knowledge and building connections

Authors: Sévrine Ouellette and Flavie Roy

Division of Dermatology, Department of Medicine, Université de Montréal, 1051 Sanguinet St, H2X 3E4, Montreal, Qc, Canada

We are two senior dermatology residents from the Université de Montréal in Canada who would like to share our rewarding experience of teaching dermatology to medical students and residents in Cambodia during the summer of 2024. This initiative, organized in collaboration with Health Volunteers Overseas (HVO), allowed us to contribute to medical education in a resource-limited setting while gaining invaluable insights into dermatological care in Cambodia.

Support from Health Volunteers Overseas

We highlight the exceptional support we received from HVO (hvousa.org/volunteer), a nonprofit organization focusing on improving healthcare accessibility and quality in resource-limited countries through education, training, and professional development. The HVO programmes, grounded in values of sustainability, equity, and innovation, strongly resonated with us. Furthermore, from the moment we expressed interest in volunteering through to the completion of our teaching sessions, the group ensured we were well-prepared and guided us every step of the way. Their dedication to facilitating meaningful volunteer work in global healthcare settings is truly remarkable, and we are grateful for their commitment.

Clinical experience in Cambodia

During our one-month stay in Phnom Penh, we had the privilege of working with enthusiastic medical students and residents. We participated in clinical dermatology sessions at Preah Kossamak Hospital, gaining hands-on experience with a variety of tropical dermatological diseases and exchanging valuable perspectives with the local dermatology team. We encountered numerous fascinating cases, including systemic sclerosis, severe eczema, paederus dermatitis, and jellyfish-induced contact dermatitis. Despite resource limitations, including the $10 consultation fee being a barrier for many patients, we were impressed by the dedication and resourcefulness of the Cambodian medical team, which went above and beyond to provide care to those in need. Some patients were fortunate to receive free consultations due to the generosity of local staff.

Teaching dermatology and fostering cultural exchange

We taught foundational dermatology concepts to medical students and residents through interactive lectures, quizzes, and case-based discussions. To evaluate our teaching sessions, we used the Student Evaluation of Educational Quality Questionnaire (SEEQ), completed by over 50 participants. The feedback was incredibly positive, with many students requesting additional educational sessions, highlighting the value of such initiatives in regions with limited access to specialized dermatology education.

One of the most popular sessions involved an interactive exercise during which students were divided into small teams, with one team being asked to describe clinical images of dermatological lesions while the others faced away. The medical students who had not seen the images then used the verbal description to make differential diagnoses. This engaging activity fostered critical thinking, teamwork, and diagnostic skills. The SEEQ responses confirmed that students favoured interactive teaching formats, such as quizzes and clinical image discussions, which were central to their learning experience.

Building connections and lasting impact

The volunteering experience was not one-sided. While teaching, we also learnt immensely from the students' knowledge and enthusiasm – their passion for the specialism and eagerness to improve their skills were truly inspiring. We met remarkable individuals who, despite limited resources, were deeply committed to advancing dermatology and patient care in their country. Their dedication motivated us to reflect on our practices.

Cultural exchange was another highlight. On our final day, we organized a Canadian meal featuring maple syrup to celebrate our diverse backgrounds. This shared meal fostered deeper connections with the students and encouraged meaningful conversations about our respective cultures and medical perspectives.

Our experience was profoundly personal because we formed lasting relationships with the students and local healthcare providers. One of the most memorable moments was a sunset boat ride along the Mekong River with some of the students we had taught – an opportunity to bond outside the hospital setting. We also learnt a great deal from the resilience of the Cambodian medical community, whose commitment to patient care inspired us. These experiences have deeply influenced our professional perspectives and motivated us to continue engaging in similar global health initiatives in the future.

Conclusion

In conclusion, our time in Cambodia was transformative, enhancing our teaching skills, broadening our clinical expertise, and deepening our understanding of dermatology in the global context. We strongly encourage other medical professionals to undertake such international teaching experiences, given the invaluable opportunities for personal and professional growth and advancement of medical education in underserved regions.

We are grateful for the collaboration with HVO, the Cambodian medical teams, and the students who made the volunteering experience so enriching. This initiative reinforced our commitment to improving access to dermatology care in underserved communities, both globally and in our own country. We hope our story inspires others to engage in similar initiatives and join the global effort to advance medical education in resource-limited settings.

Acknowledgements

We would like to express our heartfelt thanks to Dr. Beverly Roland, Project Director for HVO Cambodia; Dr. Sithach Mey, Head and Senior Consultant Dermatologist at the Department of Dermatology, Preah Kossamak Hospital, and Drs. Amb Bori and Siri Thida, Department Leads in Cambodia, for their invaluable guidance, expertise, and warm hospitality. Their support made our time in Cambodia unforgettable.

The psychosocial effect of tinea infection in patients

Authors: Daniel Henry, David Henry and Dennis Henry

Usha Memorial Skin, Eye and Dental Clinic, Bilaspur, Chhattisgarh, India

Dear Editor

As dermatologists in Southeast Asia, we frequently encounter patients suffering from tinea infection, often complicated by steroid modification or extensive presentation. We observe a significant lack of patient awareness regarding fungal infections, leading to the prolonged and indiscriminate use of over-the-counter topical preparations that combine steroids and antifungal agents. This practice, extending for a duration of two to three months or more, frequently results in adverse effects typical of topical steroid misuse, such as skin atrophy, hypertrichosis, and telangiectasia. Furthermore, any chronic dermatological condition invariably exerts profound psychosocial effects on the affected individual.1

Patients with extensive tinea corporis often exhibit a significantly diminished dermatological quality of life (QoL), consistent with findings by Henry D et al., which indicated that QoL is affected in patients with tinea infections.2 The application of steroids alters the typical clinical presentation of the disease, leading to diagnostic challenges.3 Such patients frequently experience considerable emotional distress, including depression, low self-esteem, social discrimination, and frustration due to their condition. Chronic extensive tinea infections can significantly disrupt daily routines, with symptoms such as itching in the workplace causing particular embarrassment, especially for female patients. The financial burden of treatment poses a substantial problem for economically disadvantaged patients and for households when multiple individuals are affected. Therefore, comprehensive patient counselling on tinea infection is crucial, alongside the provision of treatment options tailored to the patient’s financial capacity, given the frequently prolonged treatment duration. Educating patients about the ‘dos and don’ts’ of tinea management is essential. Successfully treating a case of tinea not only brings relief to patients but also immense satisfaction to the treating dermatologist.

References

1. Drucker AM, Wang AR, Li WQ et al. The burden of atopic dermatitis: Summary of a report for the National Eczema Association. J Invest Dermatol 2017; 137:26–30.
2. Henry D, Singh A, Madke B, Gandhi S. Effect of itch on quality of life. Abstracts. Int J Dermatol 2017; 56:1206. Available at: https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijd.13720?saml_referrer (accessed 4 September 2025).
3. Henry D, Singh A, Madke B, Kedia P. A case of altered clinical picture of extensive tinea corporis (tinea as a great mimicker). Iran J Dermatol 2019; 22:107–9.