Editor of the American Journal of Tropical Medicine
Dear Dr. Boyd:
On occasion of the Fifth International Congress of Microbiology, I had the opportunity to visit a hospital in the city of São Paulo, Brazil which is entirely devoted to pemphigus foliaceus cases. The hospital (Instituto Adhemar de Barros) houses 170 patients, that is, more cases of pemphigus foliaceus than the hospitals of the United States and Europe altogether. In 10 years, more than 1,000 cases from the state of São Paulo (population 10,000,000) have been registered by the Pemphigus Foliaceus Service of the State Secretary of Health. This disease is also endemic in 3 adjacent states of Southern Brazil while sporadic cases are observed in the other states. Apparently there are now about 400 cases of the disease in Brazil. The organisation of the Pemphigus Foliaceus Service includes a Field Service and a Hospital. In the latter, emphasis is put on the social aspect of the disease as well as on research on its etiology.