Classics in Clinical Dermatology with Biographical Sketches: 50th Anniversary 2nd Edition

Abstract

In 1953, two young American dermatologists, Shelley and Crissey, produced a work entitled Classics in Clinical Dermatology, containing the original descriptions of 143 dermatological disorders, with brief biographical notes on the ninety-four men and one woman who had written them. The chronology extended from Robert Willan's first descriptions of psoriasis and erythema nodosum in 1808, to Sophie Spitz's recognition of melanoma of childhood in 1948. This book has long been out of print, but after a lapse of half a century the same two authors, both now retired after long and distinguished careers, have produced a second edition, adding 46 original descriptions by a further thirty-one men and one woman. The choice of subjects is deliberately eclectic, encompassing the grave (Kaposi's sarcoma, Wegener's granulomatosis, mycosis fungoides), the commonplace (acne vulgaris, seborrhoeic dermatitis, pityriasis rosea) and the obscure (rhinoscleroma, hydroa vacciniforme). Likewise, some of those commemorated are very well known (Parkes Weber, Jonathan Hutchinson), others familiar only through the name of the disorder that they described (Behcet, Bowen, Paget, Darier). Many of the original descriptions are delightful to read, surpassing anything that would be written nowadays in both the elegance of the language and the precision of clinical observation. Erasmus Wilson, for example, in describing spider naevi, talks of a publican who had ‘yielded to the temptation of his calling’, whilst Willan's observation of the sequence of evolution of the morphological changes in chronic plaque psoriasis could not be improved upon. The modern additions offer reassurance that original clinical observations continue to be made by dermatologists in routine practice (Sweet, Wilkinson, Grover). It is also pleasing to discover that the fact that the original description of Kawasaki disease was in Japanese did not prevent its general recognition and the correct eponymous attribution. The inclusion of the biographical sketches is an important element of the work; an eponym becomes rather pointless if the person concerned has vanished into obscurity. A point of interest is that many original observations of skin disease were made by surgeons or physicians; in an age when clinical practice is becoming increasingly compartmentalized it is salutary to read of those such as Paget and Hutchinson whose clinical practice and contributions ranged over almost the entire spectrum of medicine. The earlier biographies, whilst brief, do not lack colour; one individual is said to have been ‘totally devoid of any sense of humour’, whilst another is said to have had ‘a certain abruptness of manner’. By contrast, those added to the second edition are in some instances overladen with sycophancy; no doubt Shelley and Crissey have mellowed with the passing of the years. The new edition of Classics in Dermatology will certainly appeal to anyone with an interest in how our understanding of skin disease has evolved. Nor is its appeal confined to the specialist. Many of the conditions described are of general medical importance—dermatomyositis, pyoderma gang-renosum, dermatitis herpetiformis. Perhaps most important of all, this splendid book will encourage readers, from whatever clinical specialty, to rediscover the dying art of precise clinical observation and clear description.