In 1981, a New York Times medical reporter wrote about a rare illness found in 41 homosexual men. A year later the newly labeled AIDS was impacting most of Europe. In 1983, Roy Colven began medical school at the UW.

“We were curious what this new thing was,” he said. “I’ve sort of grown up with the pandemic.”

It wasn’t until 1984 that doctors discovered the infection strand and labeled it HIV. Researchers thought it’d take about two years to find a vaccine.

When Colven was working an internship at Harborview Medical Center, he said he’d admit three to four patients a night with AIDS.

“They were dying,” he said. The disease had likely been spreading since the late ‘50s, and the patients coming in had had it for at least 10 years. “[The outbreak] was a silent event; it wasn’t an explosion.”

He said about 80 to 100 percent of the patients exhibit signs of HIV and AIDS through skin diseases.

“The obvious things are the opportunistic things when the immune system is weak,” he said.

With AIDS, something as simple as warts can take over an infected person’s skin, to the point of disfiguration. Other problems that commonly get out of hand are psoriasis and eczema.

Rare diseases, such as Kaposi’s sarcoma (KS), a tumor that used to only be found in older Mediterranean men, started showing up in young American men in 1981, Colven said. Eventually the presence of KS became almost a sure sign of AIDS.

“The roots of dermatology are in sexually transmitted diseases,” Colven said. He said dermatology was started in response to syphilis in Europe. During a sabbatical in Cape Town, South Africa, Colven diagnosed three to four men with AIDS after looking at their skin.

He first grew interest in focusing on HIV and AIDS dermatology, and decided to specialize in it while studying at Duke University.

“It was probably that year as an intern … watching it progress and watching the public response to it,” Colven said.

Sarah Myers, an associate professor at Duke University who worked with Colven, said in an e-mail: “Dr. Colven had great skill and empathy in caring for the dermatology patients who had other medical problems and were often sicker than many of the relatively healthy patients we generally see in our outpatient clinics.”

In 1996, Colven graduated. During the same time, scientists created a retroviral medicine, which dealt with most of the dermatological outcomes of the HIV and AIDS epidemic.

“There was a sense that after effective treatments came in there was no longer a need,” he said.

Colven still ran three open clinics for HIV and AIDS dermatology at the Harborview Madison Clinic, but it didn’t take much time for those clinics to narrow down to opening one day a week.

“He concentrated much of his patient care in HIV clinics and soon became recognized as an expert in his field, both in the U.S. and abroad,” Myers said.

Colven said the retroviral medicine requires a rigorous schedule. So he sees a fair amount of drug abusers and alcoholics, because they find it difficult to keep to an exact schedule. There are also some who aren’t compliant with the drug for whatever reason.

“We now have a patient population with skin reactions to any one of the multitude of drugs they are on, chronic common inflammatory conditions seen in non-immunocompromised patients and increased incidence of skin cancer. The dermatologist’s role is still very important, as a long-term caregiver and part of the patient’s healthcare team,” Myers said.

Colven began studying medicine with the foresight that it could take him anywhere in the world.

After graduating high school, Colven’s father took him on a two-year boating trip from Honolulu to New Zealand. While in the South Pacific, Colven met Jim and Lucile Parker, who would become his father and mother in-law.

He said for the most part they made the trip in parallel, meeting up at destination points after crossing a length of water. However, during one crossing he stayed on the Parker’s boat. “I got to be very close with them,” he said. “There was nothing they didn’t know about me.”

Jim Parker, a psychologist, became a mentor to Colven, and encouraged him to go to medical school. He pointed out that Colven could practice medicine in any country he wanted.

“I had this vision that medical school was such a long road, and he shifted my vision about it,” Colven said.

Then his future wife, Darcy Parker, joined them, but her parents pressured her to return to classes at the UW. However, during her time on the boat, Colven and Darcy grew an attachment.

“A lot of our relationship is built on having adventures together,” he said.

Colven’s love of traveling and interest in AIDS led him to take a year-long sabbatical with his two children and Darcy.

Researchers think HIV and AIDS originated in the Congo River Basin, which is in Central Africa. Colven originally wanted to work with a program in Tanzania that trains medical assistants. “I wanted to go to hard time Africa,” he said.

He gave up that ideal, when he realized the UW wouldn’t pay him to leave. “I had a naïve idea about a sabbatical,” he said. He was eventually offered a position in Cape Town, and awarded a Fulbright scholarship. Setting up a teledermatology system, which uses the Internet to diagnose patients, became his new focus.

When it came to Africa, Darcy gave Colven full support. “I didn’t have to drag her anywhere; she was pushing me,” he said. “There would be no way I could not go and stay married.”

He said he was also happy his children could have similar experiences. “It was nice for them to see what they had in the U.S. was pretty cushy,” he said.

While in Cape Town, Colven’s children, ages 12 and 8, attended an international school, where they befriended students from all over the world, including Iraq.

“Cape Town is the most incredibly beautiful place I’ve [been],” Colven said. It was colonized by the British Empire, and has according amenities. “When you first arrive, it feels like a European city,” he said. However, one doesn’t have to go far to realize the city’s anomaly. “In the rural areas, the life is pretty bleak.”

After arriving, he decided to expand his sabbatical by a year, because many projects started by foreigners fizzle when they leave. “I needed another year to get the staff … interested and trained in telemedicine,” he said.

While in Africa, they traveled to Nimibia and went on a safari in Tanzania. Colven also took a couple-month-long position in Madagascar, where he took care of deep-sea divers studying the pristine shorelines.

While in Madagascar, Colven treated a few of the local villagers who made connections with the staff. He restocked the medical supplies and even worked in an open hut made from local materials.

Not having a lab made it difficult to diagnose illnesses. He said as a result, he had to try his best to guess, and when a treatment didn’t work, he’d try again. “I think that’s how medicine is done in most parts of the world,” he said.

Colven introduced teledermatology to Cape Town. He visited small clinics in rural areas and help them set up a system where they could send in photographs of the patients with their medical backgrounds. He’d reply to the inquiries within three to four days.

He wasn’t used to seeing so much black skin, nor had he worked with some of the tropical-related skin disorders. He said he “couldn’t see skin conditions in South Africa without first seeing them in person.”

Since Colven’s return to the United States, he has been able to set up a teledermatology system for rural areas in Washington state.

Colven also started doing “grand rounds” with doctors in countries throughout Africa. He answers questions using a headset, and the doctors communicate over the instant messaging system Adobe Connects. Together the doctors analyze about five to six cases in a few hours.

“If I didn’t know what was going on [with the patient], there was bound to be someone else who knew,” Colven said. “It takes me back to Africa, in a virtual sort of way.”

[Reach reporter Celeste Flint at features@thedaily.washington.edu.]