Remembering the Pioneers of Topical Agents.

Abstract

While everyone remembers seeing a traveling salesman pushing “Dr Smith’s Wonder Pills” or something similar in a Class B Western movie, many have forgotten that several serious dermatologic preparations carry the name of a colleague of the past. These former mainstays of dermatologic therapy are disappearing because proof of efficacy is lacking, a declining interest in compounding them, and the inclusion of ingredients no longer deemed suitable for topical use. We recall a few examples that, a generation ago, were prescribed daily by almost every dermatologist. Burowsolution is an aluminumacetate solutionwith astringent and antibacterial properties thatwasprimarily usedwithwetdressings.Karl AugustBurow (1809-1874)was anophthalmologist inKonigsberg, East Prussia. Castellani paint is a carbol fuchsin solution that is an effective antifungal and antimicrobial agent. It discolors the skin so badly that colorless formsweredeveloped.AldoCastellani (1877-1971wasan Italianphysicianwith abroad rangeof interests, especially in tropicalmedicine.He was an enthusiastic Italian royalist and also supporter of BenitoMussolini as well as a peripatetic physician who practiced around the world, including NewOrleans, Louisiana. Lassar paste is a zinc oxide paste, still in use to treat diaper dermatitis. It was also one of the early vehicles used for anthralin in treating psoriasis.OscarLassar (1849-1907)wasa flamboyantpractitioner inBerlin, Germany, who had a flourishing private clinic, had an earlymoulage collection,andwasa leader indevelopingpublicbaths.Hemayhavebeen the first dermatologist to die in an automobile accident. Schamberg lotion is an inexpensive antipruritic formulation of zinc oxide with menthol and phenol. Because of the latter ingredient, it fell into disrepute. Jay Schamberg (1870-1934) established the Dermatological Research Laboratories at the University of Pennsylvania, which was theonlyAmericansupplierofaneo-arsphenamineduringWorldWar I. He plowed the considerable profits back into further research, helping establish Pennsylvania as a leading dermatologic center. The Unna boot is a gauze bandage impregnated with calamine and zinc oxide paste used to treat stasis dermatitis and leg ulcers. Paul Gerson Unna (1850-1929) was a pioneer histopathologist whoworked out ofhisown institute, theDermatologicum, inHamburg,Germany.Hewas also an innovative therapist who trained a number of prominent dermatologists. Whitfield ointment is an inexpensive antifungal agent still in use. It contains 3% salicylic acid and 6%benzoic acid in a lanolin base. Arthur Whitfield (1868-1947) was a pioneer British dermatologist who started the program at King’s College, authored a widely used small textbook, and was a founder of the British Association of Dermatology. Even as their compounds gradually fall victim tomodernization,we should be thankful to these individuals for their highly personal contributions to the dermatologic treatment armamentarium.