Pantheon of Dermatology

C. Löser, Klinikum Ludwigshafen, Germany; G. Plewig, Ludwig-Maximilians-Universität
München, Germany; W.H.C. Burgdorf, Ludwig-Maximilians-Universität München,
Germany
Pantheon of Dermatology
Outstanding Historical Figures
▶ 209 outstanding personages covering a span of six centuries
▶ biographical sketch and an assessment of the individual’s impact on
dermatology
▶ 2107 illustrations, including rare documents and portraits
Auspitz sign, Kaposi sarcoma or Herxheimer reaction: Who were the individuals who gave
their names to these terms? What was the impact on medicine during their lifetime? What
is the significance of their work today?
The authors introduce all who are interested in medical history and especially in the
development of dermatology as a specialty to 209 outstanding personages covering
a span of six centuries. Text and illustrations are combined to provide both a biographical
sketch and an assessment of the individual’s impact on dermatology. There are
2107 illustrations both from private collections and international libraries, including rare
documents, portraits and other impressive mementoes of past medical epochs.
Pantheon of Dermatology provides an exciting introduction to the history of dermatology
through the life stories of its most important protagonists. As Thomas Carlyle said:
History is the essence of innumerable biographies.
2013, Approx. 1250 p.,
2107 illustrations in color
Printed book
Hardcover
▶ 149,95 € | £135.00 | $209.00
▶ *160,45 € (D) | 164,94 € (A) | CHF 200.00
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Moriz Kaposi
Max Hundeiker
(1837–1902)
Die klinische Beobachtung,
die Beherrschung des klinischen
Materials ist das erste an unserer
Schule anzustrebende Ziel
Clinical observation, the mastery
of the clinical material is the ἀrst
major goal of our school
Fame is often bound with legend, but
there are few dermatologists associated with so many false stories as
Moriz Kaposi. For example, he was
alleged to have received his Habilitation in Erlangen. In fact he was never
there although Erlangen under the
leadership of Hugo ­Wilhelm von
Ziemssen (1829-1902) was a center
for syphilidology. Instead, Erlangen
1
was the city where his Habilitation
thesis was published. Similarly one
can find a number of dates when he is supposed to have
­received his Promotion, probably explained by a lack of uniformity in the university semesters in his time. Similarly the
unflattering comments on his conversion to Catholicism
and changing of name are contradicted by his own writings.
Kaposi was not an opportunist; he was already well-established in his career when he made these decisions.
Kaposi was a major factor in the development of our
specialty. He not only was the first to describe the sarcoma
named after him, but employed his skills of observation
and description to first report or best delineate many other
entities such as xeroderma pigmentosum, diabetic and
­leukemic skin changes, syringoma, gangrenous zoster and
with Juliusberg pustulosis varioliformis acuta, which later
became known as Kaposi varicelliform eruption or eczema
herpeticatum. He was very proud of the diseases he had
been first to describe: Frankl reported that he generally
­attached the word mihi (by me) to the name of the disease.
Moriz Kohn was born on 23 October 1837 (24 T ishri
5598 in the Jewish calendar) in Kaposvár. His first name is
written Moritz in the records of the Jewish community but
he almost always used Moriz. In some of his Hungarian
publications he used Moricz and Mór. The many versions
of his first name simply reflected the multiple languages
spoken by the educated classes in the Habsburg monarchy.
His parents Salamon Kohn and Rosa, née Krauss, were
poor. They put all their hopes in the education and advancement of their children. Moriz attended the Jewish grade
school and then the Gymnasium in Kaposvár for four years.
In 1856 he moved to Pressburg (today Bratislava, Slovakia)
where he got his Matura in 1856 and started medical school
in Vienna.
In 1861 he finished the essential
part of his medical school training;
in those days in V ienna separate
­examinations were required for
­surgery and obstetrics, which he
­finished in 1862 a nd 1866 r espectively. He then started his training
the in the syphilis clinic under Carl
Ludwig Sigmund (1810-1883), who
came from Schässburg in S ieben­
bürgen (today Sighişoara, Romania)
and was trained in Budapest. People
came from all corners of the AustroHungarian Empire to work in
­Vienna, as did t he pathologist
­Salomon Stricker from Waag-Neu­
stadtl (also then known as VágUjhely in H ungarian, today Nové
Mesto nad Váhom, Slovakia). He
introduced Kohn to histology which
played a m ajor role in his career.
Kohn got his Habilitation in Vienna in 1866 with a thesis on
Die Syphilis der Schleimhaut der Mund-, Rachen-, Nasen-
Key Dates
1837 Born on 23 October as Moriz Kohn in
Kaposvár, Hungary
1856 Matura in Pressburg (today Bratislava,
Slovakia)
Start of medical studies in Vienna
1861 Graduated in medicine; separate
examinations in sugary in 1862 and
­obstetrics in 1866
1866 Habilitation, named Privatdozent, started
working in the clinic of Hebra
1869 Converted to Catholicism and married
Martha Hebra
1871 Changed name to Kaposi based on his
birthplace
1875 Named Außerordentlicher Professor
1880 Acting Director of the clinic after the
death of von Hebra
1881 Professor and successor to von Hebra
1892 President of the 2nd International
­Congress of Dermatology in Vienna
1900 Festschrift of Archiv für Dermatologie
und Syphilis to celebrate his 25th year as
Professor
1900 Honorary President of the 4th International
Congress of Dermatology in Paris
1902 Died on 6 March in Vienna
572
Moriz Kaposi
2
3
K
4
5
573
Moriz Kaposi
6
7
und Kehlkopfhöhle (Syphilis of the mouth, throat, nose and
larynx) which was published by Verlag Ferdinand Enke in
Erlangen.
On 30 July 1866 Kohn was named Privatdozent. Hebra
knew how good he was and gave him a position in his­
clinic. Kohn later praised Hebra for his crucial role in the
scientific development of dermatology just as medicine was
started to be based on solid pathological principles, for his
contributions to the classification of diseases and for excellence as a clinical teacher. The two understood each other
well and Kohn soon became Hebra’s closest associate. He
devoted much energy to the time-consuming preparation
of the many volumes of Hebra’s books and wrote large sections himself. Primarily on the urging of Martha, Hebra’s
daughter, Kohn joined the Catholic church. The couple
married on 6 February 1869 and had five children who were
raised with loving care. The three sons all obtained university degrees. The oldest Richard was a min eralogist; the
second ­Hermann, a surgeon. The youngest Walther, died as
a cavalry officer in World War II. ­Martha Kaposi survived
her husband by 44 years and died well along in years in
Vienna in 1946.
In 1871 K ohn applied to have his name changed to
­Kaposi in honor of his home town of Kaposvár which in
8
K
9
11
turn was named after the Kapos River. In his application, he
explained that many physicians in Vienna were named
Kohn and he wanted to avoid confusion. In addition, he
published several important papers under his new name.
His application was approved on 8 N ovember 1871. H e
never tried to deny or hide his original name. Surprisingly,
in 1876 a contribution of his ­appeared in Hebra’s book
still under the name Kohn. The interpretation of Ingber that
­Kaposi changed his name to hide his Jewish identity and
advance his career is not plausible. Kaposi was already a
success and did not have to resort to such actions.
He had already published a great deal as Kohn. Nonetheless a s eries of even more i­ mportant papers appeared
after 1872, in cluding his first description of the sarcoma
now named after him. Through this paper and through his
10
Moriz Kaposi
12
13
14
15
great contributions to ­Hebra’s books, he became the Crown
Prince of the Hebra school and thus of Viennese dermatology. He overtook his brother-in-law Hans von Hebra, who
became a professor years later. In 1876 Kaposi was named
Außerordentlicher Professor in dermatology.
In 1877 Hebra was knighted for his ­contributions to the
­ erdinand Ritter von Hebra, a far cry
Empire and became F
from his humble beginnings as the son of an officer. Kaposi
assumed more and more of the daily work in the clinic. In
1880 his book Pathologie und Therapie der Hautkrankheiten
appeared; it was translated into many languages.
Von Hebra died on 5 A ugust 1880. K aposi became
­Acting Director of the clinic. In the competition to succeed
von Hebra he came out clearly on top competing with other
outstanding von Hebra Schüler such as Hans von Hebra
(1847-1902), Heinrich Auspitz (1835-1886), a nd Filipp
­Josef Pick (1834-1910), the founder in 1869 of the Archiv für
Dermatologie und Syphilis. Instead of preparing a list with
the names of three outstanding candidates, as was the usual
procedure, the search committee named only Kaposi –
­primo et unico loco (first and only). On 8 February 1991,
Kaiser Franz Joseph signed his certificate of appointment.
16
Just before his 44th birthday, on 19 O ctober1881, he
started the winter semester with a le cture honoring von
­Hebra. His appreciation and affection for his teacher was
apparent. After that day, he was the unquestioned chief of
the Wiener Schule. Many new diseases were described from
his clinic including in 1882 xeroderma pigmentosum. His
textbooks were translated into many languages. At every
meeting, he was a sought-after and critical discussant. His
remarkable skill with languages stood him in g ood stead;
he was fluent in Hungarian, German, French, all of which
he had spoken since his youth with literary pretensions. In
addition, he was versed in English and of course Latin, the
official language of the Empire.
An important factor in the rapidly increasing fame of
the Wiener Schule was the clear systemic approach to terminology, diagnosis and therapy. Kaposi wanted to see theories proven, not speculated upon. Some of his assessments
turned out to be wrong. For example, he was never convinced of the differences between syphilis and chancroid,
and was sure lupus vulgaris was unrelated to tuberculosis.
In his defense, at this time the dramatic advances bacteriology had not yet appeared. Kaposi was however a modern
K
579
Moriz Kaposi
Kaposi sarcoma
Moriz Kaposi described his sarcoma in 1870 und 1872
as idiopathisches multiples Pigmentsarcom (idiopathic
multiple pigmented sarcoma). After detailed histologic studies on the pigment and the underlying
­hemorrhage, in 1894 in a discussion at the 11th International Medical Congress in R ome he suggested
­replacing pigmentosum with haemorrhagicum to distinguish his sarcoma from a m elanosarcoma, the
­current name for malignant melanoma. In this way the
diagnosis of sarcoma idiopathicum multiplex haemorrhagicum Kaposi became established, but shifted over
time to Kaposi sarcoma.
In his first description, Kaposi had suggested
the relationship of the skin changes to an associated
­systemic disease. After over a century, the etiology
of Kaposi sarcoma is quite well understood. The
­association of Kaposi sarcoma with HIV/AIDS in
the 1980s p rovided an impetus for extensive research, showing that all forms of Kaposi sarcoma
­require the presence of human herpesvirus 8 and
that many are facilitated by immunosuppression.
Thus the term idiopathicum as used by Kaposi is
­finally obsolete, but the rest of his description still
completely relevant.
18
17
19
580
Moriz Kaposi
20
K
man, not at all afraid to re-assess concepts as newer methods of investigation, primarily histology, enhanced morphologic interpretations.
At the 1st International Congress of Dermatology in
Paris in 1889 h e served as Vice-President and gave the
opening lecture. At the next meeting in Vienna in 1892 he
was President. At the following meeting in London, he was
one of the foreign secretaries, and finally at the 4th International Congress of Dermatology in Paris in 1900, he was the
Honorary Chairman. He was overwhelmed with honors,
medals and titles and was an honorary member of virtually
every foreign dermatological society.
In October 1900 Kaposi celebrated his 25 year jubilee as
Professor. Best wishes and telegrams flooded in from
around the world. A Festschrift dedicated to him appeared
as a s upplement to Archiv für Dermatologie und Syphilis
containing contributions from his Schüler and friends. This
was the last great highlight of his career. A few days later he
had a stroke from which he recovered after weeks of hospitalization. He returned to work but in O ctober 1901, h e
suffered another stroke from which he only partially recovered. He tried again to present his lectures, but found himself quite short of breath. Kaposi died peacefully in his sleep
on 6 March 1902 in Vienna, only 65 years of age.
Figure Legends
Fig. 1. Portrait. Osterreichische Nationalbibliothek Wien,
­Bildarchiv with kind permission
Fig. 2–4. Series of undated portraits. Bildarchiv . Osterreichische Nationalbibliothek,, Vienna, with kind permission
Fig. 5. Hungarian commemorative stamp honoring Kaposi,
issued on the occasion of the 14th International Cancer
­Congress, Budapest 1986. Private collection
Fig. 6. Zur Nomenclatur des idiopathischen Pigmentsarcoms
Kaposi. From Kaposi 1894
Fig. 7–11. Plates. From Kaposi et al 1881
Fig. 12. Lichen ruber monileformis. Taf. XVIII. Vorderansicht
des Körpers. Chromolithographie nach einer Abbildung von
Dr. Henning. From Kaposi 1886
Fig. 13. Lichen ruber acuminatus u. planus Tafel I. Most today
would diagnose the patients in Fig. 12 and Fig. 13 as keratosis
lichenoides chronica or Nékám disease. The following text
shows just how aggressively a successful professor (an alpha
animal in wolf terms) can present his views: The reason why I
once again address the theme of lichen ruber acuminatus and
­lichen ruber planus in front of a knowledgeable group of specialists, something that I have addressed in some many instances
both in lectures and in writing, is the last report of our respected
colleague Prof. Neisser in his lecture at the 11th International
Medical Congress in Rome in 1894 on Ueber den gegenwärtigen
Stand der Lichenfrage (The current status of the lichen question)
(Archiv für Dermatologie und Syph. 1894. XXVIII. B. pag. 75–77).
As everyone knows, I said at the Congress in Paris in 1889 (1st
­International Congress of Dermatology ) that I considered what
besnier had describe din 1889 as pityriasis rubra pilaris to be
identical with lichen ruber Hebra or lichen ruber acuminatus, the
term which I proposed in 1876 for lichen ruber Hebra in instead
of lichen ruber planus. Then Unna, instead of clearly defining
the differences between pityriasis rubra pilaris and lichen ruber,
made the more funny than logical but nonetheless catchy
­statement that “since I consider pityriasis rubra pilaris and lichen
ruber acuminatus identical, then the latter cannot be lichen
­ruber Hebra” and furthermore Unna claimed to be the only real
disciple of Hebra’s teaching on lichen. Thus it seems opportune
since we have reopened the issue to clarify that point, not only
since my authorship has been questioned but much more in
­order to clarify the issue… Ignoring the last point, to which we
will return, Neisser suggests that I have given a new definition
of the disease I named lichen ruber acuminatus and that this
­disease, as I have defined it, is clearly different from lichen ruber,
as described by Hebra. From Kaposi 1895
Fig. 14. Lichen ruber acuminatus u. planus Tafel II. From Kaposi
1895
Fig. 15, 16. Lichen ruber acuminatus u. planus Tafel III, IV. From
Kaposi 1895
Fig. 17. Title page of the Festschrift: Zum fünfundzwanzigjährigen Professorenjubiläum. From Festschrift 1900
Fig. 18. Autograph Dr. Moriz Kaposi
Fig. 19. Prescription Dr. Kaposi
Fig. 20. Tombstone of Moriz Kaposi in the Döblinger Friedhof
in Vienna. Professor Dr. Karl Holubar, Vienna, with kind
permission
Publications
Hebra F, Kaposi M (1870) Ueber ein eigenthuemliches Neu­gebilde
an der Nase – Rhinosclerom. Von Prof. Hebra nebst histologischem Befunde vom Dozenten Dr. Moriz Kohn. Wien Med
Wochenschr 20: Spalte 1–5
Kohn M (1871) Das Keloid. Wien Med Wochenschr 24: 577–581
Kaposi (Moriz Kohn) M (1872) Neue Beitrage zur Kenntnis des
Lupus erythematosus. (Hierzu Tafel I.) Gez. u. lith. V. Dr. Jul.
U. C. H eitzmann Fig. 1–5. A rch Dermatol Syph (Prag) 4:
36–78
Kaposi M (1872) D er Tätowirte von Birma: eine Mittheilung.
Wien Med Wochenschr 2: 39–43
Kaposi M (1872) I diopathisches multiples Pigmentsarkom der
Haut. Arch Dermatol Syph (Prag) 4: 265–273
581
Moriz Kaposi
Hebra F, Kaposi M (1872) Lehrbuch der Hautkrankheiten. 2. Auf­
lage. Enke, Stuttgart
Kaposi M (1876) Sarcoma cutis. Sarcom der Haut. In: Handbuch
der speciellen Pathologie und Therapie, redig. v. Rud. Virchow,
Bd. 3/2. Enke, Stuttgart, pp 468–475
Hebra F, Kaposi M (1860, 1876) Lehrbuch der Hautkrankheiten.
1. Acute Exantheme und Hautkrankheiten (Hebra 1860)
2. (Hebra und Kaposi 1876). Enke, Stuttgart
Hebra F, Kaposi M, Fagge CH (Übersetzer), Tay W (Übersetzer)
(1876) On the Diseases of the Skin: including the Exanthemata.
The New Sydenham Society, London
Kaposi M (1880) Pathologie und Therapie der Hautkrankheiten.
In: Vorlesungen für Praktische Ärzte und Studirende. Erstauf­
lage. Urban & Schwarzenberg, Wien
Kaposi M (1880) Ferdinand Hebra, der Schöpfer der Wiener dermatologischen Schule. Einschlieslich ein Bericht über Hebras
Beerdigung. Wien Med Wochenschr 30: Spalte 927–931
Kaposi M, Besnier E, Doyon A (1881) Lecons sur les maladies de
la peau / Moritz (sic) Kaposi. Trad. et annot. par Ernest Besnier,
Adrien Doyon. Vol 1 und 2. Masson, Paris
Kaposi M (1881) R ede zum G edächtniss an Prof. Ferdinand v.
Hebra, gehalten anlässlich der Eröffnung seiner diesjährigen
Vorlesungen. Wien Med Wochenschr 41: 1207–1215
Kaposi M (1882) Ueber Xeroderma pigmentosum. Medizinische
Jahrbücher (Wien) 1882: 619–633
Kaposi M, Heitzmann C (1882) Die S yphilis der Haut und der
angrenzenden Schleimhaute. Von M. Kaposi. Mit 142 Figuren
in 76 chromlithographirten Tafeln und 13 Holzschnitten von
Carl Heitzmann. Braumüller, Wien
Kaposi M (1883) Pathologie und Therapie der Hautkrankheiten.
In: Vorlesungen für Praktische Ärzte und Studirende. Zweite
verbesserte und vermehrte Auflage. Urban & Schwarzenberg,
Wien
Kaposi M (1885) Xeroderma pigmentosum – Idiopathisches multiples Pigmentsarkom der Haut. Vortrag gehalten in der Sitzung
der k.k. Gesellschaft der Aerzte in Wien am 23. Oktober 1885.
Wien Med Wochenschr 35: Spalte 1333–1338
Kaposi M (1886) P rof. Heinrich Auspitz (Nachruf). Wien Med
Wochenschr 36: 797–798
Kaposi M (1886) L ichen ruber monileformis – Korallenschnur­
artiger Lichen ruber. (Hierzu Tafel XVIII, XIX, XX und XXI).
Vierteljahresschr Dermatol Syph (Der Reihenfolge XVIII. Jahr­
gang) Neue Folge des Archives fur Dermatologie und Syphilis
13: 571–582
Kaposi M (1891) P athologie und Therapie der S yphilis. Enke,
Stuttgart
Kaposi M (1894) Ueber die modernen Systematisierungsversuche
in der Dermatologie. Arch Dermatol Syph (Wien–Leipzig) 29:
73–91
Kaposi M (1894) Zur Nomenclatur des idiopathischen Pigmentsarcoms Kaposi. Arch Dermatol Syph (Wien–Leipzig) 29: 164
Kaposi M (1894) Zur Nomenclatur des primären idiopathischen
Pigmentsarcoms Kaposi. Wien Med Wochenschr 44: Spalte
977–982, 1027–1029
Kaposi M (1895) N och einmal: Lichen ruber acuminatus und
­Lichen ruber planus. (Hierzu Taf. I–IV) Arch Dermatol Syph
(Wien–Leipzig) 31: 1–32
Kaposi M (1898–1900) H andatlas der H autkrankheiten: fur
­Studirende und Ärzte. 1. A–H (Acne–Hypertrichosis) 1898.
2. I–M (I chthyosis–Myomata cutis) 1899. 3. N–Z (N aevus–­
Xeroderma pigmentosum) 1900. Braumuller, Wien
von Leyden E, Klemperer F (Hrsg) Unna PG, Kaposi M, Neisser
ALS (Mitarbeiter) (1903-1913) Die deu tsche Klinik am Eingange des Zwanzigsten Jahrhunderts: in a kademischen Vorlesungen. Urban & Schwarzenberg, Berlin
References
Festschrift (1900) g ewidmet Moriz Kaposi zum f ünfundzwanzigjährigen Professorenjubiläum: in V erehrung und Dankbarkeit von Collegen und Schülern. Ergänzungsband zum
„Archiv für Dermatologie und Syphilis“. Mit dreissig Tafeln.
Braumüller, Wien
Frankl J (1971) Geschichte der Dermatologie. Professor Moriz
Kaposi. Hautarzt 22: 448–449
Holubar K, Frankl J (1981) Moriz (Kohn) Kaposi. Am J Dermatopathol 3: 349–354
Hornstein OP (1993) Chronik der Dermatologischen Universitats­
klinik Erlangen (im Verlag der Klinik)
Ingber A (1983) Why Kaposi and not Kohn? Am J Dermatopathol
5: 103
King F (1983) Kaposi: Let’s pronounce it correctly. Am J Dermato­
pathol 5: 103–104
Marschalkó M, Kárpáti S (2004) Keratosis lichenoides chronica:
mimics, history, nomenclature. J Am Acad Dermatol 51: 1034–
1035
Rácz I (1987) Geschichte der Dermatologie. Moriz Kaposi: wieder
aktuell. Hautarzt 38: 168–169
Richter P (1928) G eschichte der D ermatologie. In: Jadassohn J
(ed): Handbuch der H aut- und Geschlechtskrankheiten,
Bd. 14/2. Springer, Berlin pp 1–252
Scholz A, Holubar K, Burg G (eds) (2009) Geschichte der deutschsprachigen Dermatologie. History of German Language Dermatology. Wiley- Blackwell, Weinheim pp 236-243, 654
Schönfeld W (1961) Zur Geschichte der Dermatologie, der Vene­
rologie, der G ewerbedermatosen, der der matologischen
Kosme­tik und der Andrologie im 19. und 20. Jahrhundert. In
Gottron HA, Schönfeld W (ed): Dermatologie und Venerologie, Bd 1/1. Thieme, Stuttgart pp 1–41
Shelley WB, Shelley ED (1992) A Century of International Congresses. An Illustrated History. Parthenon, Carnforth pp 15–18
Weidenfeld D (1981) Moriz Kaposi: In memoriam (Aus Wiener
Medizinische Presse 1902; 519–523; translated into English by
Rabson SM). Am J Dermatopathol 3: 355–358
Acknowledgment
Zita Battyani, head of the D ermatology Clinic a t the County
Hospital in Kaposvár provided assistance. The clinic she heads
was founded in 1899 by Anton Ullmann (1862-1938), a nephew
and Schüler of Kaposi
K
Helmut Kerl and
Lorenzo Cerroni
A. Bernard Ackerman
(1936–2008)
ἀ e single most crucial of all the
themes that permeate my philosophy of practice of surgical pathology
is capability for analytical, logical,
and incisive thinking – i.e. critical
thinking
A. Bernard Ackerman (Bernie) was
born on 22 November 1936 in Elizabeth, New Jersey, near New York.
­After a brilliant academic career at
Phillips Academy, Andover, and
1
Princeton University (where he majored in r eligion and literature), he
attended medical school at the College of Physicians and
Surgeons, Columbia University, where he graduated in
1962. Bernie did his training in dermatology at Columbia
University in New York, University of Pennsylvania in Philadelphia and Harvard University in Boston. He then spent
one year in 1968 working with Wallace H. Clark in Boston,
before becoming Director of Dermatopathology in the
­Department of Dermatology of the University of Miami.
In 1973 he left Miami and continued his career in New York
at the Department of Dermatology, New York University,
where he spent 20 productive years.
Early in this period in 1979 h e founded the International Society of Dermatopathology. From 1974 to 1984 he
organized the famous Annual Symposia on dermatopathology at New York University; they were without question the
most instructive dermatopathology meetings of the decade.
He also had students from all corners of the globe, establishing an international network of Ackerman Schüler.
After disagreements with Irwin M. Freedberg (19312005), who succeeded Rudi Baer (1910-1997) as Chairman
at New York University, Bernie moved in 1993 to Philadelphia and headed dermatopathology at Jefferson Medical
College. In 1999 he returned to New York and opened, in
cooperation with AmeriPath, a private institute, the Ackerman Academy of Dermatopathology. His retirement in 2004
was not a dramatic break, as he continued to work with
youthful enthusiasm.
Bernie published over 60 books and 700 scientific papers. He was certainly one of the most successful dermatologic scholars and no words can ever do justice to this impressive performance. His masterpiece Histologic Diagnosis
of Inflammatory Skin Diseases was published in 1978. With
that book he established algorithms for accurate histologic
diagnosis by identifying nine basic patterns of inflammatory skin diseases at scanning magnification. Bernie left his
mark on almost every major aspect of dermatopathology
ranging from Differential Diagnosis in Dermatopathology,
The Lives of Lesions, Pitfalls in Histopathologic Diagnosis of
Malignant Melanoma, and Clues to
Diagnosis (Sherlockian dermatopathology), to a series of books about
adnexal tumors as well as many other
topics. His essays in A Philosophy of
Practice of Surgical Pathology add a
new dimension to the study and nature of dermatopathology.
Other great accomplishments
were his publications on the early
­diagnosis of melanoma in si tu and
mycosis fungoides. Serendipitously,
his work establishing criteria for
­diagnosing the early stages of Kaposi
sarcoma became critically important
during the early days of the AIDS p andemic before the
causative HIV could be identified.
Key Dates
1936 Born 26 November in Elisabeth,
New Jersey
1958 Premedical Education, Princeton University,
A.B. (cum laude: Religion and Literature)
1962 Medical Education, Columbia University
of Physicians and Surgeons, MD
1963-1968 Residencies: Departments of Dermatology at Columbia Presbyterian Medical
Center, Hospital of the University of Pennsylvania and Harvard - Massachusetts
General Hospital
1964-1966 Military Service, Allergy and Dermatology Clinics, USAF Hospital, Andrews Air
Force Base, Washington DC
1968-1969 Fellowship in Dermatopathology,
Harvard, Massachusetts General Hospital
with Wallace H. Clark
1969-1973 Assistant and Associate Professor,
Departments of Dermatology and Pathology, University of Miami, School of Medicine, Miami, Florida
1973-1993 Director of Dermatopathology,
­Professor of Dermatology and Pathology,
New York University School of Medicine,
New York
1993-1999 Director, Institute for Dermato­
pathology, Jefferson Medical College,
Philadelphia
1999-2004 Director, Ackerman Academy of
­Dermatopathology, New York
2008 Died 5 December in New York
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A key part of Bernie’s intellectual approach was an unrelenting appeal for precision in writing and speaking. He
wrote with emotion, artistry and love, care and intellectual
brilliance, searching for new ideas, always producing new
concepts and setting standards of incomparable quality.
A different mirror of his talent is found in his playful
and creative book for early school-age children, Your Skin is
Showing. Another academic endeavor in hi s professional
life was founding his own publishing house Ardor Scribendi
in 1997 with the goal of changing the publication culture in
medicine. His ideas reverberated beyond dermatology, extending to the history of medicine, academic freedom and
moral values in medicine.
He also established two dermatopathologic journals –
The American Journal of Dermatopathology in 1979 a nd
later in 2000, Dermatopathology: Practical & Conceptual –
both of which revealed him as a visionary force in medical
publishing. He was a s uperb Editor-in-Chief who had a
nose for the essence of a paper and was always eager to present new or unconventional ideas.
If one asks what Bernie’s most important contribution
was – what was really the heart of his academic life, our
answer would be his total commitment to teaching and
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training. He should be remembered as a s uperb teacher,
who cared about his students.
He succeeded in twice in New York and once in Philadelphia in creating the leading dermatopathology centers,
where legions of students from all around the globe received
the best training in the world. Bernie transmitted not only
his endless energy, his incredible knowledge, and the principles of dermatopathology, but also much, much more –
his sparkling passion, his intellectual and moral maturity,
his enthusiasm and above all his love and respect for our
specialty of dermatology.
We would not truly do justice to Bernie if we did not
discuss other aspects of his personality. If anything was foreign to him, it was fear. He had no fear of loss of face, disagreements or even frank arguments. He had the strength
and intellectual skill to challenge dogmas which enjoyed
worldwide approval. Examples include his writings and lectures about sentinel lymph node biopsy and UV-irradiation
as the main cause of melanoma, as well as his long-standing
disagreement with his teacher Wallace H. Clark about the
concept of dysplastic nevi. Bernie was such a skilled speaker that he could easily insult or hurt those who tried to argue
with him. His razor-like criticism and confrontational rhet-
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oric caused many colleagues to feel hurt. Bernie was almost
always a m aster is separating professional and personal
criticism, although on some occasions his scientific rhetoric
unfortunately led to personal vendettas.
In special moments, Bernie undoubtedly identified
himself with Henry David Thoreau’s thinking:
If a man does not keep pace with his companions,
perhaps it is because he hears a different drummer.
Let him step to the music which he hears ….
Henry David Thoreau (1817-1862)
His favorite physician role models were Sir William B. Osler
and Carl T. Nelson (1908-1978), Chairman of the Department of Dermatology at Columbia Presbyterian Medical
Center in New York. He practiced medicine in their spirit
realizing that intellectual honesty and human caring, and
not just the cutting edge of research lies in the heart of our
profession.
Bernie had sensationally fast eyes, comparable to perfect pitch in musicians. When he looked at glass microscope
slides, no one could come close his amazing diagnostic
skills and his rational morphologic interpretation of images.
His lectures were among the best ever given and made him
an icon of dermatopathology. Bernie transmitted not only
incredible knowledge but also his enthusiasm and love of
our specialty.
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The ethics of our profession were especially important
to him. He was distressed by what he perceived as unconscionable behavior and fraudulent expert witness statements in medical-legal proceedings over mistakes in dermatopathologic diagnoses. Here he set a warning signal, as
one can read in A Trial in Philadelphia.
Another monumental effort of Bernie’s showing the
depth of his convictions was the creation of the internet
portal derm101.com a teaching resource which illuminates
various aspects of dermatology and matters that transcend
them. In 2007 he founded the A. Bernard Ackerman Endowment for the Culture of Medicine at Harvard Medical School.
This donation supports a professorship in the humanistic,
ethical, artistic and literary aspects of medicine, as well as a
reading room at Massachusetts General Hospital which
harbors his extensive collection of microscopes.
In Central Park in New York, where he often walked
alone, he donated a bench near the statue of Alice in Wonderland. Perhaps his spirit continues to visit this site that he
so loved.
The once-in-a-lifetime Dermatopathologist
If a single term could capture the essence of the career
of A. Bernard Ackerman, it is originality. His distinctive form of pedagogy has revolutionized thinking not
only in dermatopathology, but also clinical dermatology and general pathology.
The Teacher
His unique mode of teaching has been delivered
through lectures and books, and at a multi-headed microscope to which thousands of eager students from
all over the world have flocked.
The Author
In his writings Ackerman challenged the conventional
and generally accepted, thereby enabling present and
future generations of students to critically engage and
build on his work.
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When the final history of dermatology is written, one
likely sentence might be:
Ackerman’s charismatic personality, his creative and
ground-breaking publications and above all his mastery
of the art and science of lecturing made him the leading
and most creative dermatopathologist of the 20th century –
one who transformed the world of dermatopathology.
Figure Legends
Fig. 1. Portrait. Undated photograph. Private collection
Fig. 2. Home of the Ackerman family, undated. 963 Park
­Avenue, Elizabeth, New Jersey. Pirvate collection
Fig. 3. Graduation photo, Princeton University, 1958. Private
collection
Fig. 4. With residents in dermatology at the University of
­Miami (seated on left Paul Bergstresser and seated all the way
on the right Paul Kechijian, middle back is Richard Feinstein).
Standing from left: Jim Cosmides, Bill Dobes, Joel Bamford,
Richard Kornberg, Dick Stone, Richard Feinstein, Jim Plemmons, Richard Childers, Jay Walther, Al Marsico. Sitting, From
left: Paul Bergstresser, Alam Fahrzad Berke, Bernie Ackerman,
Tom Breeza, and Paul Kejechian. Private collection
Fig. 5. Bernie and his father (a dentist and car-freak), 1976 in
238 Oceana, Loveladies Habour, Long Beach Island, New Jersey. Private collection
Fig. 6. Albert M. Kligman, Bernie Ackerman and Helga LinkePlewig (called Little Linke by Bernie), admiring the engine of
the fancy British car of Bernies father. 1976 in 238 Oceana, Loveladies Habour, Long Beach Island, New Jersey. Private ­collection
Fig. 7-9. Bernie in Munich 1976. Preparation for the First
­International Dermatopathology Symposium.Bernie in front
of the city hall Munich, Marienplatz. Bernie joking with
Helmut H. Wolff in a traditional beer-garden before and after.
Private collection
Fig. 10-13. First International Dermatopathology Symposium
in Munich, 16-18 June 1978. Arrival at theAirport Munich Riem
with Ed Gomez, Willi Meigel, Anna Ragaz, Bernie Ackerman, his
secretary Joyce, Helmut Wolff, Arthur Rywlin. Inter­national
speakers at the Sheraton Hotel Munich: Helmut H. Wolff, Otto
Braun-Falco, Bernie Ackerman, Richard K.Winkelmann and
­Edgar Wilson Jones. Certificate of Attendance with caricature
of a microscope incorporating the landmark-steeples of the
Munich Liebfrauen-Dom. By Mark Podwal. Private collection
Fig. 14, 15. Cover and text with three illustrations of the nine
basic patterns of inflammatory skin diseases by silhouette.
Histologic Diagnosis of Inflammatory Skin Diseases 1978.
­Private collection
Fig. 16. Bernie at the multiheaded microscope to teach
­dermatopathology to students from all over the world. Private
collection
Fig. 17. Bernie on top of the Hohenpeißenberg, Bavaria, 1976.
Private collection
Fig. 18. Bernie Ackerman established two dermatopathologic journals The American Journal of Dermatopathology (1979)
and Dermatopathology: Practical & Conceptional (2000). Private collection
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A. Bernard Ackerman
Fig. 19. Ackerman in his study, by his own words Joyfully
playing alone at age 63. Private collection
Fig. 20. With trainees in dermatopathology at New York University. In the year 2000 Bernie founded the Ackerman Academy of Dermatopathology, New York with the unique 27-headed microscope to teach dermatopathology. Private collection
Fig. 21. An article on Kaposi’s varicelliform eruption reviewed
by Ackerman. These corrections reveal his incisive precision in
language and writing. Private collection
Fig. 22. Reading room at Massachusetts General Hospital
which was donated by Ackerman and harbors his collection of
antique microscopes. Private collection
Publications
Ackerman AB (1978) Histologic Diagnosis of Inflammatory Skin
Diseases. Lea & Febiger, Philadelphia
Sanchez JL, Ackerman AB (1979) The patch stage of mycosis fungoides. Am J Dermatopathol 1: 5-26
Ackerman AB (1980) Malignant melanoma: a unifying concept.
Human Pathol 11: 591-597
Gottlieb GJ, Ackerman AB (1988) Kaposi’s Sarcoma A Text and
Atlas. Lea & Febiger, Phialdelphia
Ackerman AB, Dubow B (1990) Malignant melanoma in situ: the
evolution of a concept. Modern Pathol 3: 734-744
Ackerman AB, Cerroni L, Kerl H (1994) P itfalls in Histopathologic Diagnosis of Malignant Melanoma. Lea & Febiger, Philadelphia
Ackerman AB (1999) A Philosophy of Practice of Surgical Pathology: Dermatopathology as Model. Ardor Scribendi, Philadelphia [Source for opening quote]
Ackerman AB, Massi D, Nielsen TA (1999) Dysplastic Nevus. Ardor Scribendi, Philadelphia
Ackerman AB, Kerl H, Sanchez JL et al (2000) A Clinical Atlas of
101 Skin Diseases with Histopathologic Correlation. Ardor
Scribendi, New York
Ackerman AB (2000) A t rial in P hiladelphia. Dermatopathol
Pract & Concept 6: 238-242
Ackerman AB (2006) Autobiography: L’Chaim – To Life! Dermatopathol Pract & Concept 12: 20-….
Ackerman AB, Miller RC (2007) A Year without Peer: 1963 – 1964
in the Department of Dermatology of Columbia Presbyterian
Medical Center. Ardor Scribendi, New York
Ackerman AB (2008) The Sun and the ‘Epidemic’ of Melanoma:
Myth on Myth! Ardor Scribendi, New York
References
Barankin B (2004) A. Bernard Ackerman, MD. In: Dermographies. Autobiographies in D ermatology. Vol 1. C ommunity
books, Lockeport pp 11-13
Kerl H (2009) A. B ernard Ackerman, 22 November 1936 – 5.
Dezember 2008. An once-in-a-lifetime dermatologist. J Dtsch
Dermatol Ges 7: 385-389
Kerl H, Burgdorf W (2010) A. Bernard Ackerman (1936 – 2008).
The most important dermatopathologist of the 20th century,
who transformed the world of dermatopathology. Am J Dermatopathol 31: 734-739
Thoreau HD (1854) W alden; or, life in t he woods. Ticknor &
Fields, Boston
Weyers W (1999) The International Society of Dermatopathology. Ardor Scribendi, New York
Weyers W (2006) A. Bernard Ackerman – the ‘Legend’ turns 70.
J Am Acad Dermatol: 55: 862-866
Weyers W (2009) In memoriam A. Bernard Ackerman 19362008. Hautarzt 60: 165-166
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