REMINISCENCE
HISTORY OF ARGENTINE DERMATOLOGY DAVID GRINSPAN, M.D.
Argentina is situated in the most southern part of America. It is bounded by Chile to the west; Bolivia, Paraguay, and Brazil to the north; and Brazil and Uruguay to the east. It has an area of 2^91,1)15 square kilometers and a population of 33,000,000 inhabitants. Buenos Aires is the capital city. Argentina has a variety of climates: warm in the north, cold in the south, and moderate, with seasonal changes, in the central area.
DAWN OF ARGENTINE DERMATOLOGY
Argentina was the first Latin American country to approach skin diseases scientifically. In 1835, Dr. Tiburcio Fonseca published a thesis on "Structure, function and relationship of the cutaneous organ with general pathology and therapeutics," which, in its 35 pages, demonstrated a sound knowledge of the subject at that time.' Dermatology began as a specialty in Argentina in the year 1874, when the Academy of Medicine included some new specialties, among which was "Clinical Aspects of Skin Diseases and Syphilis."^'^ A syphilology and dermatology service was organized for the first time in 1883 at the Hospital de Clinicas, which was the center of medical teaching in Buenos Aires. The professorship was created in 1892 with the name of "Venereal Diseases and Skin"; Dr. Baldomero Sommer was the first professor. He was the pioneer of dermatosyphilology in Argentina; he worked from 1892 to his death in 1918. He studied at the Viennese School of Dermatology created by Hebra (1816- 1880) and later continued by his disciples Kaposi (who was Sommer's teacher) and Neumann. This Viennese school was in fact the first important center of our specialty; it was influenced by famous French dermatologists such as Caucher, Fournier, Darier, Cougerot, and Civatte. Sommer always worked tirelessly; he taught not only with patients but also with pictures and "moulages." He founded the Museum of Wax Modelling, the only
Figure 1. School of Medicine of the Buenos Aires University.
one of its sort in Latin America at the time. He had many prominent disciples, such as Drs. Maximiliano Aberastury, Nicolas Creco, Pedro L. Baliiia, Neocle Ragusin, Carlos M. Seminario, Eduardo Jonquieres, Julio V. Uriburu, F. L. Nasio, Enrique Fidanza, and others. A decisive step forward for Argentine dermatology was the creation of the Sociedad Dermatologica Argentina (1907), with its seat at the Hospital San Roque (today Ramos Meji'a), in Buenos Aires. Professor Baldomero Sommer was its first president. Among the founders of the society were Sommer, Maximiliano Aberastury, Pacifico Diaz, Pedro L. Baliiia, Eudoro Cisneros, Nicolas Creco, Carlos M. Seminario, Julio V. Uriburu, and later Neocle Ragusin.
From the Department of Dermatology, Buenos Aires University, Buenos Aires, Argentina. Address for correspondence: Professor David Grinspan, M.D., Pacheco de Melo 1848 5° "A," (1126) Buenos Aires, Argentina. 881
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In 1908, the society started publishing a journal first called Revista Dermatologica Argentina, then Revista de la Asociacion Argentina de Dermatologia y Sifilologia, and since 1959 Revista Argentina de Dermatologia. This journal was the first publication of its kind in Latin America. When Professor Sommer died in 1918, Dr. Pacifico Diaz succeeded him as president of the society. In 1919, Dr. Maximiliano Aberastury, who had been teaching the subject since 1894, was appointed full professor of dermatology and also became president of the society. He stood out as a dermatologist, syphilologist, and as an eminent leprologist;'' he was the author of the Argentine law against leprosy (1926) that bears his name. He was a brilliant teacher; Drs. J. J. Puente, M. Fernandez Blanco, and E. Mazza, among others, learned from him. In 1927, the society changed its name to Asociacion Argentina de Dermatologia y Sifilologia. Dr. Pedro Balina, who was appointed full professor of dermatology that year, became its president until 1933, when he was succeeded by Dr. Neocle Ragusin. In 1934, a group of dermatologists headed by Dr. Nicolas Creco, a disciple of Sommer, decided to create a new entity, which they called Sociedad de Dermatologfa, Sifilograffa y Venereologia. Some other founding members were Drs. Ceferino Orol Arias, Miguel A. Mazzini, Antonio A. Fernandez, Alberto Bigatti, and Luis Trepat. This society became incorporated to the Asociacion Medica Argentina (AMA). Nowadays it is called Sociedad Argentina de Dermatologfa. Thus, since 1934 there have existed two societies representative of Argentine dermatology: Asociacion Argentina de Dermatologia y Sifilologia and Sociedad Argentina de Dermatologia, the latter being related to the Asociacion Medica Argentina.
BALINA AND GRECO
Of the two societies, the Asociacion Argentina de Dermatologia y Sifilologia prevailed because of a greater number of specialists, among whom were the professors of dermatosyphilology of the Buenos Aires University. The most outstanding figures of the time, when Dr. Pedro Baliiia was full professor, were Drs. Jose M. Puente, Juan Pessano, Ceferino Orol Arias, Milio Fernandez Blanco, Enrique Fidanza, Jose M. Carrera, Ludovico Facio, Luis F. Pierini, Marcial Quiroga, Miguel A. Mazzini, Cuillermo Basombrio, Fernando Noussitou, and Aaron Kaminsky, the majority of whom were, or later became, professors of the specialty. Professor Pedro L. Baliiia was the most outstanding personality of the time; he attracted some brilliant disciples, the most prominent of whom were Dr. Luis E. Pierini and Dr. Marcial Quiroga. The Asociacion Argentina de Dermatologia y Sifilologia established subsidiaries in Rosario in 1934, 882
and Cordoba in 1938, and in Mendoza in 1952; it continued with the publication of the Revista de la Asociacion Argentina de Dermatologia y Sifilologia and was already forming a library of unquestionable value. The Sociedad Argentina de Dermatologia, with its seat at the AMA, was presided over by Professor Nicolas Creco, who had been full professor of dermatology of the La Plata University (province of Buenos Aires); he gathered outstanding specialists around him. It published a bulletin informing about its scientific activities and organized monthly meetings where important papers were presented and discussed.
PIERINI AND QUIROGA
By the year 1947 some of Baliiia's disciples, such as Dr. Luis E. Pierini and Dr. Marcial I. Quiroga, formed their own schools. That was the most outstanding period of Argentine dermatology. Quiroga was full professor of medical students and chief of the service at the Hospital Ramos Mejia. Pierini was appointed professor of postgraduates (and afterwards the 2nd dermatology professorship) and chief of the service at the Hospital Rawson. The associate professors of Pierini were Drs. Luis M. Carrera, Aaron Kaminsky,and Julio Martin Borda; and those of Quiroga were, Drs. Miguel A. Mazzini, Alejandro Cordero, Cuillermo Basombrio, Fernando Noussitou, Arturo Mom, and Felix Ambrosseti. In 1946, Pierini and Quiroga published a book entitled Introduction to the Study of Dermatosyphilology, with a purified semiology, which constituted the basis for Argentine dermatologists to become great semiologists and highly capable of clinical diagnosis. Mycology was excellently performed by Dr. Pablo Negroni, a great help for dermatologists; R. Zapater and afterwards V. Madeo also cooperated in this field. In leprosy, a subspecialty naturally belonging to dermatologists, the most important figures were: Drs. Jose Maria Fernandez and Salomon Schujman, disciples of Fidanza, in Rosario (Santa Fe); Dr. Luis Argiiello Pitt in Cordoba; Dr. Olmos Castro in Tucuman; and Dr. Cuillermo Basombn'o in Buenos Aires. Thus all acquired talented followers: Jose Esteban Cardama, Juan C. Catti, Luis M. Baliiia, Carlos Consigli, Enrique Tello, Leonidas Llano, Ricardo Manzi, Ernesto T. Capurro, Pascual B. Arcuri, and A. J. Melamed. Dr. Enrique Jonquieres, one of Miguel A. Mazzini's disciples, and Professor Fernando Noussitou, who occupied important posts outside the country as representative of the World Health Organization, already stood out in this specialty. Syphilis was part of dermatology, to the point that societies and journals were of dermatosyphilology. All dermatologists had a thorough knowledge of this specialty; the most important names were Professor Jose M. Puente and Drs. Jose L. Carrera and Luis Caviiia Alvarado.
Argentine Dermatology Grinspan
Diaz, Gregorio Alvarez, and Luis Trepat had already made great progress. The author of this paper, another of Pierini's disciples, founded a center of skin tumors and stomatology at the Hospital Rawson in Buenos Aires, with an infrastructure of high regard. Following my teacher, I applied dermatologic semiology to the study of skin tumors and oral mucosa lesions. This study helped me in the publication of a Treatise of Stomatology of six volumes and in the creation of a stomatologic school, a first in Latin America. Dr. Jorge Abulafia was involved with the service almost from the beginning as an anatomopathologist; his knowledge allowed an exceptional anatomoclinical management of patients. The number and quality of the cases seen at the Hospital Rawson was surprising. The papers published were internationally acknowledged. Dr. Ismael Pomposiello also belonged to the school from the first years. Professor Julio Martin Borda gave postgraduate courses attended by many young Latin American doctors, who found in this teacher not only knowledge but also fatherly affection and encouragement. He created the Hospital Privado de Piel, together with the dermatologists of the Hospital Rawson, where he continued teaching for doctors from the provinces and from all of Latin America. Borda was of great importance to Argentinian clinical dermatology.
Dr. Pablo Bosq and later Dr. Eugenio Follman, with some other dermatologists and general anatomopathologists, were in charge of dermatopathology until the arrival of Professor Jorge Abulafia, whose activity is discussed below. One should also mention the outstanding dermatologist Carlos F. Guillot, who was also a medicine historian. With all these specialists and their corresponding subspecialties, Argentine dermatology occupied an important place in the medical world, based on clinical knowledge and a new and purified semiology. The majority of the dermatologists of the time learned at the French school, following Darier and later Degos. It is difficult to write a history of Argentine dermatology since 1950, because those who know it are part of it. But it is necessary to point out that those gathered in the Asociacion Argentina de Dermatologia y Sifilologia formed two groups; Pierini's school and Quiroga's school; both of which worked together in the development of Argentine dermatology. Pierini's School Pierini's school became internationally famous; Professor Julio Martin Borda, a man of great scientific, moral, and human values belonged to it. It held monthly meetings with exhibitions of patients; these were attended by a great number of dermatologists, especially from the provinces. It also organized an annual weeklong course during which participants could examine patients with many rare diseases and discuss them. Right from the beginning young Latin American doctors attended his school to learn the specialty. Luis E. Pierini is an internationally renowned dermatologist; he described diseases and techniques that bear his name. He was undoubtedly the most important representative of' Argentine dermatology of his time within and without our country. In 1950, Pierini's group founded Archivos Argentinos de Dermatologia, which became one of the most widespread Spanish language journals. They formed a specialized library, which has been the most important in Latin America since its inception. Luis E. Pierini, as president of the Colegio IberoLatino-Americano de Dermatologia, with my help as executive secretary, and the support of all Argentine dermatology organized the 5th congress of that institution in Buenos Aires (1963); it is still remembered as a great success. Professor Gay Prieto from Spain considered it the best he had attended during his long dermatologic career. This gave the country the respect and the opportunity necessary to organize other international dermatologic congresses. Among Pierini's nearest collaborators was Dr. Dagoberto Pierini, who devoted himself to pediatric dermatology. He became well-known in this subspecialty, in which the great Pierini and Drs. Pacifico
Other outstanding members of Pierini's school were Drs. Augusto M. Casala, Santiago J. Mosto, Sergio G. Stringa, Alberto I. Carvalho, Raul H. Mazzini, Norberto Grinspan Bozza, Andres Paz, and later Leon Jaimovich, who has just returned from New York where he was resident at the Skin and Cancer Center. Most of the physicians from those years are still working, although unfortunately Dagoberto Pierini and Ismael Pomposiello died young. From Pierini's school emerged associate professors of dermatology: David Grinspan, Dagoberto Pierini, Jorge Abulafia, and Augusto Casala. Dr. Raul Fleischmajer (Professor Aaron Kaminsky's disciple) belonged to the school for a short time. He is now an international expert in collagen physiopathology and chief of dermatology at the Mount Sinai Hospital of New York, an honor for Argentinian dermatology. Quiroga's School
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Quiroga's school also worked scientifically and attracted disciples who later became professors of dermatology, such as Drs. Luis Ambrosseti, Alejandro A. Cordero, Enrique Jonquieres, Arturo Mom, Pedro H. Magnin, and Rodolfo Corti. We should also remember Drs. E. Molina Leguizamon, N. Vivot, G. Duhm, C. F. Guillot, H. J. Sanchez Caballero, A. Woscoff, J. Avila, and M. Seoane. This school has monthly meetings with a large attendance of dermatologists. It continues with the medical students professorship and with the publication of the 883
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Table 1. Presidents of the Asociacion Argentina de Dermatologia since 1933
Revista Argentina de Dermatologia and has the oldest library in the country. Quiroga's professorship at the Hospital Ramos Meji'a was of great importance in Buenos Aires.
1933 Neocle Ragusin 1935 Jose M. Puente 1937 Juan Pessano 1939 Marcial Quiroga 1941 Luis E. Pierini 1943 Milio Fernandez Blanco 1945 Pablo Negroni 1947 Pedro L. Balifia 1950 Miguel A. Mazzini 1952 Guillermo Basomhri'o 1953 Fernando Noussitou 1955 Rafael Garzon 1957 Alejandro Cordero 1959 Aaron Kaminsky
Asociacion Argentina de Dermatologia and Sociedad Argentina de Dermatologia The Asociacion Argentina de Dermatologia had its seat at the Hospital Ramos Mejia. Table 1 shows the list of its presidents from 1933 to the present. The Sociedad Argentina de Dermatologia, (part of the Asociacion Medica Argentina) continued with its monthly sessions on theory for graduates. Professor Aaron Kaminsky had excellent associates such as his son Carlos, today associate professor of dermatology, his daughter-in-law Ana L. Jaimovich, today full professor of dermatology, and J. Kriner, S. Braunstein, H. Kaplan, A. Kaplan, B. Sevinsky, A. Aufgang, and A. Kohan. Dr. A. Segers was a surgical collaborator and a pioneer of dermatologic surgery. When in July 1978 the Hospital Rawson was closed due to a municipal resolution, Pierini's service (he had already retired) was destroyed. The work groups broke up, and their members were scattered to several hospitals. Then, the followers of Pierini and Borda with others such as Gatti and Gardama, consolidated the Sociedad Argentina de Dermatologia and made possible the organization of new monthly meetings and annual courses similar to those of the Hospital Rawson and the Hospital Privado de Piel. Table 2 shows the list of its presidents from 1934 to the present. Each executive commission of the Sociedad Argentina de Dermatologia improved what had been done by the previous one. The society was the foremost in Argentina as regards attendance of specialists to its meetings, exhibitions of patients, presentations of papers, and postgraduate courses.
1961 Jose Luis Carrera 1963 Felix Ambrossetti 1965 Enrique Jonquieres 1967 Marcial I. Quiroga 1968 Rodolfo N. Corti 1972 Miguel A. Mazzini 1976 Pablo Viglioglia 1978 Manuel Seoane 1980 Pedro Magnin 1982 Jose E. Cardama 1984 Hector Sanchez Caballero 1986 Luis M. Balifia 1988 Pedro Magnin 1990 Cristobal Parra
Argentine Dermatology in Cordoba The dermatosyphilologic activity in the learned city of Cordoba also began in the 19th century. The first dermatology professorship of Argentina was created in 1889 (even before that of Buenos Aires), and its first professor was Dr. Hugo Stemphelman, succeeded by Manuel Freyre (1890), Moises Tercera (1899), Tomas Garzon (1925), Domingo Tello (1926), and Rafael Garzon (1945). In 1938, a subsidiary of the Asociacion Argentina de Dermatologfa was created in Cordoba. Dr. Garzon was provisionally replaced by Ramon Argiiello until Luis Argiiello Pitt was appointed professor of dermatology in 1955. He was followed by Enrique Tello in 1972, a distinguished dermatologist. In 1973, Dr. Rafael Garzon (Jr) was appointed "in charge" of the professorship and has been full professor since 1983, when he won the open competition. The professorship has its seat at the Hospital de Glinicas. As well as being an important dermatologic center, Cordoba is the birthplace of papers on HACRE (endemic regional chronic hydroarsenicism) thanks to the work of Ramon Argiiello and Enrique Tello, now continued by Roberto Biagini from Salta. There were also papers on leprosy from Luis Argiiello Pitt and Garlos Gonsigli. Cordoba constitutes an advanced leprologic cen-
University of El Salvador It is necessary to remember the creation of the University of El Salvador in 1962 (9th in the country), where Dr. Luis M. Baliiia, an important dermatologist and leprologist, was appointed full professor of dermatology. His associate professor was Dr. Juan C. Gatti, and his collaborators were Drs. Juan J. Avila, Augusto Casala, Guillermo Grespi, Hugo N. Gabrera, Graciela Pizzariello, and Felix E. Wilkinson. Recently, Miguel de Herrera and Raul E. Valdez have been added to the list, as well as six assistant teachers. This professorship has worked with great enthusiasm and efficiency; it offers 3-year postgraduate and specialization courses. But the country does not begin and end in the city of Buenos Aires. 884
Argentine Dermatology Grinspan
Table 2. Presidents of the Sociedad Argentina de Dermatologfa since 1934 1934 Nicolas Greco 1936 Ceferino Orol Arias 1937 Roberto F. Wernicke 1938 Adolfo Muschietti 1939 Antonio A. Fernandez 1940 Eduardo Jonquieres 1941 Ernesto L. Othaz 1942 Gregorio Alvarez 1943 Felix F. Gunche 1944 Luis Trepat 1945 Adolfo Muschietti 1947 Ceferino Orol Arias 1948 Ernesto L. Othaz 1949 Felix F. Gunche 1950 Gregorio Alvarez 1951 Luis Trepat 1952 Jaime Spillzinger 1953 Alberto Bigatti 1954 Alcides Conti 1955 Antonio Fernandez 1957 Isaac Zelcer
The Reunion Dermatologica, which holds ordinary meetings and organizes national congresses and meetings, has been in existence for 50 years.
1959 Alcides Conti 1960 Simon Cohan 1961 Luis Trepat ^y 1962 Aaron Kaminsky 1963 Enrique Jonquieres 1965 Leon Jaimovich 1966 Aaron Kaminsky 1967 Pahlo Viglioglia 1969 Aaron Kaminsky 1971 Pahlo Viglioglia 1973 Jorge Abulafia 1975 Augusto Casala 1977 Osvaldo Mangano 1979 David Grinspan 1981 Alejandro A. Cordero 1983 Juan G. Gatti 1985 Sergio Stringa 1987 Jose E. Gardama 1989 Alberto Woscoff 1991 Hugo N. Cahrera
Argentine Dermatology in Rosario (Santa Fe) Its development began in 1922 with the creation of the Littoral National University. Enrique Eidanza was the first professor of dermatology and the founder of the dermatologic school. His work was brilliant and characterized by the stimulation of his young disciples, among whom were Jose Maria Eernandez (his successor at the professorship), Salomon Schujman, Pedro Scolari, Alberto Nudenberg, Francisco Carrillo, and Amadeo Campos. Jose M. Eernandez and Salomon Schujman became leprologists of international renown and participated in the creation of the South American Glassification of Lepra (La Habana, 1948). Eernandez will always be remembered because of the reaction that bears his name and also because of the use of BCG as a prophylaxis for leprosy. Although, it is considered that Schujman made possible the clinical understanding of the tuberculoid form of the disease. Both Eernandez and Schujman had disciples of great dermatologic and leprologic value: Eduardo Garboni, Augusto Mercau, Ignacio P. L. Astore, Augusto Serial (dermatopathologist), and Vicente Pecoraro, who was given the professorship in 1970 and was outstanding, along with J. M. Barman and I. Astore, for their contribution to the physiopathology of hair. In 1983, one of Pecoraro's disciples, Bernardo Nudenberg, was appointed full professor of dermatology. He shows a great integratory capacity and slants his professorship toward general medicine. The Asociacion Dermatologica of Rosario is the subsidiary of the Asociacion Argentina de Dermatologia created in 1935. It organizes several annual meetings. Dermatology in Rosario has always occupied an outstanding place in the teaching of leprology and nowadays in the relationship of dermatology with general medicine. Argentine Dermatology in Mendoza
ter. As a remote antecedent there already existed a leprosy lazaretto in 1621, another was founded in 1884, and in 1939 the Jose J. Puente Sanatorium and the Professor Guillermo Basombrio Clinic were inaugurated at San Francisco del Chafiar. Thanks to the help of the Leprosy Patronage, this clinic became a model, one of the best of its kind anywhere. Two new professorships were created in 1975. The Cordoba Catholic University also has a dermatology professorship that functions regularly and is one of the most renowned in the country. The first full professor was Dr. Ignacio Toledo (1961-1972), succeeded by Dr. Garlos Gonsigli, an outstanding dermatologist and leprologist.
Dermatology in the province of Mendoza was started in the 30s by Geronimo Lopez Gonzalez, who later won the open competition for the professorship of dermatosyphilology (1965). He had specialized with Professor Robert Degos at the Saint Louis Hospital in Paris. The School of Medical Sciences, belonging to the Cuyo National University, was founded in Mendoza in 1950. At that time, other outstanding dermatologists were Abdon Azar and Sebastian Pons and later Ricardo Billene, who had learned at Professor Garzon's school in Gordoba. Dr. Pons also attended Professor Vilanova's Catalan school in Barcelona (Spain). The 885
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inclusion of Anibal Ortiz Medina, Dr. Abulafia's disciple, was a great contribution to dermatopathology. In 1978, Sebastian Pons was appointed full professor of dermatology and was an excellent teacher, active in patient care and science. He became dean of the School of Medical Sciences of the Guyo National University. He died suddenly in 1983 at the peak of his scientific prowess. He was a brilliant specialist, who loved both dermatology and teaching. After his death, Alberto Torres Gortijo, who was the first associate professor from open competition, took over the professorship for 3 years; he followed the line of teaching received from his predecessors. He learned at the school of Professor Jose Gomez Orbaneja in Madrid (Spain) and at the Luis Pierini and Julio Martin Borda schools. Gristobal Parra has been full professor of dermatology since 1987.
Argentine Dermatology in Tucuman Dr. Norberto Olmos Castro was a great teacher, especially in leprology. Together with Dr. Pascual B. Arcuri, he established the importance of reading the "lepromino" reaction (known by their names) after a week. The present professor of dermatology at the Tucuman School of Medicine is Dr. Eudoro H. de los Rios. The Agrupacion Dermatologica de Tucuman, subsidiary of the Asociacion Argentina de Dermatologia, was created in 1970. Argentine Dermatology in Salta Dr. Andres Cornejo was one of the forerunners of specialists in the northwestern part of the country. He was a disciple of Mazza and gained great prestige thanks to his contribution to Ghagas and other tropical diseases. Dr. Gornejo helped in the preparation of "moulages" of dermatologic diseases. Also worth mentioning is Dr. Roberto Biagini, who updated several regional topics such as HACRF.
Argentine Dermatology in La Plata (Province of Buenos Aires) La Plata is an important dermatologic center. The specialty as such began in the year 1918 with Dr. Gamilo Cortelezzi, who was appointed to the professorship of dermatology at its creation in 1930. Professor Nicolas Greco was the next full professor from 1931 to 1947, succeeded by Professor Ernesto L. Othaz and Professor Alcides Conti (1953). Conti was the figure who contributed the most to the stature of La Plata dermatology. He was knowledgable and had many disciples. When he died. Professor Jorge Gueto was appointed to the professorship (1971), followed provisionally by Dr. Juan Fuertes (1986) and then by Raiil E. Balsa to the present. The Sociedad de Dermatologia de La Plata, nowadays a division of the Sociedad Argentina de Dermatologia (AMA), began its activities in 1973. We should also mention Dr. Luis Mirande and, as anatomopathologist. Dr. Roberto Gastelletto, Abulafia's disciple.
Argentine Dermatology in Entre Rios The first dermatologist of the province was Dr. Jose Maria Roque D'Angelo, who arrived in Parana in the year 1943 and started working at the Hospital San Martin. In 1985 Dr. Abraham Man was in charge of the specialty. The Sociedad Entrerriana de Dermatologia was founded in 1969, presided over by Dr. D'Angelo. Later the dermatologists of Santa Ee, Esperanza, Rafaela, and San Francisco (Cordoba) gathered and formed the Asociacion Dermatologica del Litoral, at which the first president was Dr. Ricardo Gusanelli. That same year (1980), the 5th Argentine Gongress of Dermatology was organized in Parana, headed by Dr. Abraham Man. Argentine Dermatology in Other Cities
Argentine Dermatology in Gorrientes The Asociacion Dermatologica para Chaco y Formosa, a subsidiary of the Asociacion Argentina de Dermatologia, was formed in 1983. Mar del Plata is a good dermatoloic center and has always kept close ties with Buenos Aires dermatology. The meetings and congresses celebrated in Mar del Plata are attended by many people, and those who visit this famous seaside resort are well looked after by these excellent dermatologists. We should remember Drs. Raul Rodeiro, Gelso Aldao (deceased), Juan F. Gaino, Garlos Gancio, Carlos de Natale, Jorge Brusco, Alfredo Amdur, Garlota Jaimovich, and Jorge Clara. In other places of the country new dermatologic societies are in formation. In Gomodoro Rivadavia, Dr. Eduardo Ghabeldin and Drs. Raiil and Glemente Jofre y Sotero Ojeda work with great enthusiasm. In Rfo Negro, Santiago del Estero and other provinces, there are derma-
The most important specialists of the province were Juan Felix Scappini, William Harvey, and Paulino L. Getzrow. Manuel Iglesias was full professor of dermatology and teacher of the above-mentioned doctors. He gave a great impulse to leprology together with Scappini, who is at present full professor of clinical dermatology at the School of Medicine of the Northeastern National University and also director of the dermatological dispensary and of the provincial program against leprosy. We should also remember that Professor Manuel Iglesias was one of the promoters of the law for the prophylaxis of leprosy, even before the promulgation of the national law named after Aberastury. Dr. Getzrow had the honor of being chief of dermatopathology at the Skin and Gancer Genter in New York, before the appointment of Dr. Ackerman. 886
Argentine Dermatology Grinspan
tologists who care about maintaining a high level of knowledge. In Santiago del Fstero there has been a Sociedad Santiagueiia de Dermatologia since 1983.
DERMATOLOGY NOWADAYS
At present there are 2,200 dermatologists in Argentina: that is 1 for every 15,000 inhabitants. Sociedad Argentina de Dermatologia Nowadays, the great majority of Argentine dermatologists are gathered in the Sociedad Argentina de Dermatologia. This entity gives 3-year courses for graduates, sponsored and recognized by the Ministry of Public Health, which gives the graduates the national degree of specialists. The Casa del Dermatologo is currently under construction on a recently acquired property. Archivos Argentinos de Dermatologia is its journal, and its library, to which physicians will have free access, will be installed in this new building. It has sections in La Plata, Mar del Plata, and the Cuyo area and still in formation in Cordoba and the Littoral area. The society awards several annual prizes and scholarships. The Sociedad Argentina de Leprologia forms part of it.
solidate our work. It is impossible to move forward without the good dermatopathologists, whom we are lucky to have in Argentina at present. In pediatric dermatology the most outstanding names are Professor Hector Crespi (Professor Alejandro Cordero's disciple), Drs. Adrian Pierini, Eva Mora, Rita Garcia Diaz, and Margarita Larralde de Luna, most of whom are new heads of dermatology services. This subspecialty is in very good hands. At the new children's hospital "Juan Garrahan" the dermatology service is directed by Dr. Adrian Pierini, a man of an unquestionable scientific knowledge and international renown. He is the present secretary of the Board of the International Society of Pediatric Dermatology, and he will preside over the VII International Congress of Pediatric Dermatology, to be celebrated in September 1994 in the city of Buenos Aires. The Sociedad Argentina de Dermatologia Pediatrica was founded on December 26, 1989. Argentine stomatology has always received international recognition. It was started by the author of this synopsis, who gathered all his experiences in a six-volume treatise. "Cosmiatry" (cosmetic dermatology), created by Professor Aaron Kaminsky, is at present supported by the work of Dr. Ana Kaminsky and Dr. Alejandro Cordero (Jr). The former is vice-president of the Colegio Ibero-Latino-Americano de Dermatologia and was elected chairwoman of the symposium Medical and Surgical Cosmetical Dermatology at the World Congress of Dermatology celebrated in 1992. She forms a first line team with Professor Carlos Kaminsky; they are working on the formation of an important school. In dermatologic surgery we can mention Dr. Norberto Grinspan Bozza and Professor Rafael Garzon (Jr) among others. Dr. Alfredo Segers was a pioneer in this subspecialty. The most outstanding names in cryosurgery (a ther^ apeutic technique now used more frequently by dermatologists) are E. Turjansky and G. Stolar, who started applying it to many dermatologic, particularly tumoral, diseases a long time ago in Argentina. Two other important specialists are Drs. Carlos Kaminsky and Alberto Torres Cortijo. Dr. Ricardo Negroni, the son of Pablo Negroni, stands out in mycology and collaborates with Argentine dermatologists in papers related to the specialty. His disciple Ricardo Galimberti is chief of dermatology at the Hospital Italiano. In leprology Professor Juan C. Gatti (deceased), Jose E. Cardama, and Luis Baliiia were the successors to Professor Basombrio in Buenos Aires. At the Hospital Mufiiz, currently directed by Dr. Juan J. Avila, Dr. Graciela Pizzariello together with Dr. Maria Elena Fariiia are in charge of virtually all leprosy patients. We should also remember that Professors Juan Carlos Gatti and Jose E. Cardama have published a treatise on leprology.
Asociacion Argentina de Dermatologia The Asociacion Argentina de Dermatologia continues with the periodical publication of the journal. In the year 1957, it edited an excellent and most helpful summary of the works published, called Blasi^ in honor of its author. Dr. Alfredo Blasi. This included everything since its creation and was complemented by another volume in 1987.* It has subsidiaries in Tucuman, Santiago del Estero, Chaco-Formosa, Rosario, Cordoba, and Cuyo. The Subspecialties Professor Abulafia is the father of dermatopathology, which is efficiently practised by Drs. Jose Casas, Oscar Bianchi, Ignacio Calb, Maria Cristina Kien, Graciela Sanchez, Eduardo Lacentre, Alicia Kowalczuk, Jorge A. Monti, Susana Romano, Florencio Castoldi and Roberto Schroh in Buenos Aires; Dr. Roberto Castelletto y Cueto (Jr.) in La Plata; Dr. Ani'bal Ortiz Medina in Mendoza; Dr. Adriana Bergero in Rosario; and Dr. Paulino Getzrow in Corrientes. Dr. Abulafia received the tutelage of Professor Hildebrando Portugal from Brazil. Fortunately, the Sociedad Argentina de Dermatopathologia (SADEPA) has just been founded (presided by Dr. Abulafia), which will surely contribute to the formation of a school of histopathologists, something very necessary to support our clinical findings and con887
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of several editions. With Dr. Luis Maria Balifia they published Temas de Leprologia. The last president of the Sociedad Argentina de Leprologia Professor Enrique Jonquieres, a prominent dermatologist and dermatopathologist, is a consultant for the subspecialty. The Sanatorio Sommer is still a place for the recovery and investigation of leprosy. As regards Dr. Meny Bergel from Rosario, his investigations on the subject have moved to other countries and have always given rise to interesting discussions within ours. We have already referred to leprology in other provinces. The STD (sexually transmitted diseases) are covered by Professor Alberto Woscoff, who was president of ULACETS (Union Latinoamericana contra ETS [STD]), and by Dr. Luis Belli. Dr. Juan Garlos Elichman is in charge of the laboratory analyses. We cannot fail to mention Dr. Sergio G. Stringa, who stands out in the field of collagenopathies and pediatric dermatology. He also formed a school with disciples such as Drs. Garlos Bianchi, Oscar Bianchi, Osvaldo Stringa, and Oscar Sanguinetti. Other important figures are Dr. Alberto 1. Garvalho, who was chief of the dermatology service at the Hospital Fiorito of Avellaneda and at the Hospital Aeronautico, and Dr. Santiago Mosto, who had the honor and great responsibility of replacing master Luis E. Pierini when he retired as chief of the service at the Hospital Rawson. Professor Augusto Gasala belonged to the same service; he was interim full professor at the Hospital de Gh'nicas General San Martfn. I would also like to mention some who excelled abroad. Dr. Leopoldo Montes was professor and director of dermatologic investigations at the University of Alabama (USA); Dr. Raiil Fleischmajer honorably represents us in the United States and all over the world; Dr. Paulino L. Getzrow; and Dr. Ricardo Mandojana. Dr. Fernando Stengel, current editor of Archivos Argentinos de Dermatologia., who was chief of the dermatology service at the Hospital de GIfnicas Jose de San Martin, was our worthy representative during his long stay in the USA. He is the necessary link whenever an English-speaking specialist visits Argentina. His versatility and mastery of the specialty are such that his synthesis is generally much clearer than the conference itself.
practical and useful (editor. Professor Leon Jaimovich; associate editor. Dr. Miguel Allevato); and Temas de Leprologia, which permanently updates the subject, directed at present by Dr. Julio G. Ocampo. The Manual de Dermatologia, written by Gatti and Gardama, first published in the year 1953, has already had 11 editions, which demonstrates its value and usefulness. Argentine and Latin American students, as well as graduates, study from it. There is also a Tratado de Enfermedades de la Boca, by the author of this synopsis, of six volumes. Professors Marcial Quiroga and Alejandro Gordero were members of the International Committee on Dermatology, and Professors Luis E. Pierini, David Grinspan and Jorge Abulafia were presidents of the Golegio Ibero-Latino-Americano de Dermatologia. Some dermatologic processes and different reactions bear the names of Argentine specialists; for example, Pasini-Pierini's idiopathic atrophoderma, Pierini-Borda's melanotic prurigo, Grinspan's syndrome, Fernandez' reaction, GrinspanAbulafia's atypical melanoacanthoma, Facio's "apodemic" prurigo, Quiroga-Gay Prieto's senile pseudoangioma, Quiroga-Noussitou-Agneta's "figured and persistent papulous erythema," Borda-Abulafia-Jaimovich's circumscribed scleroatrophy syndrome, Aaron Kaminsky's minimal digit-cutaneous syndrome, Puente-Acevedo's simple glandular cheilitis. Useful Addresses The addresses of contemporary Argentine dermatologists appear in the journals of the Asociacion Argentina de Dermatologia^ and in the Historia, Reglamentos, Directorio published by the Golegio Ibero- LatinoAmericano de Dermatologia in 1987.*
REFERENCES
1. 2.
3. 4.
Dermatology Books and Journals and Distinctions to Outstanding Argentine Specialists
5.
There are five dermatology journals: Archivos Argentinos de Dermatologia, started in 1951 and of international recognition; Revista Argentina de Dermatologia, the oldest in Latin America, which first appeared in 1908 and contributed enormously to the spreading of the Argentine dermatologic school, currently directed by Professor Pedro H. Magnin; Revista Argentina de Micologia, under the charge of Professor Ricardo Negroni; Actualizaciones Terapeuticas Dermatologicas,
6. 7.
8.
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Canton E. Historia de la Medicina en el Rio de la Plata. 1928. Volume IV. Madrid: 1928. Greco NV. Historia y desarrollo de la dermatologia y sifilografi'a en la Republica Argentina. Semana Medica 1945; 50:351-375. Quiroga Ml. Origenes de la Dermatologia Argentina. Semana Medica 1977; 85:436-439. Pierini LE. Cuarenta afios de Dermatologi'a. Arch Argent Dermatol 1973; 23:1-9. Blasi AA. Indice general de la Revista Argentina de Dermatosifilologia 1908-1955. Buenos Aires, 1957. Indice general 1963-1987. Rev Argent Dermatol 1987; 68:395-462. Asociacion Argentina de Dermatologi'a. Socios Titulares. Socios Adjuntos. Rev Argent Dermatol 1989; 70: 309-323. Colegio Ibero-Latino-Americano de Dermatologia. Historia, Reglamentos, Directorio. Listado del padron de socios del Colegio Ibero-Latino-Americano de Dermatologia. Buenos Aires; 1987:185.
HISTORY OF ARGENTINE DERMATOLOGY DAVID GRINSPAN, M.D.
Argentina is situated in the most southern part of America. It is bounded by Chile to the west; Bolivia, Paraguay, and Brazil to the north; and Brazil and Uruguay to the east. It has an area of 2^91,1)15 square kilometers and a population of 33,000,000 inhabitants. Buenos Aires is the capital city. Argentina has a variety of climates: warm in the north, cold in the south, and moderate, with seasonal changes, in the central area.
DAWN OF ARGENTINE DERMATOLOGY
Argentina was the first Latin American country to approach skin diseases scientifically. In 1835, Dr. Tiburcio Fonseca published a thesis on "Structure, function and relationship of the cutaneous organ with general pathology and therapeutics," which, in its 35 pages, demonstrated a sound knowledge of the subject at that time.' Dermatology began as a specialty in Argentina in the year 1874, when the Academy of Medicine included some new specialties, among which was "Clinical Aspects of Skin Diseases and Syphilis."^'^ A syphilology and dermatology service was organized for the first time in 1883 at the Hospital de Clinicas, which was the center of medical teaching in Buenos Aires. The professorship was created in 1892 with the name of "Venereal Diseases and Skin"; Dr. Baldomero Sommer was the first professor. He was the pioneer of dermatosyphilology in Argentina; he worked from 1892 to his death in 1918. He studied at the Viennese School of Dermatology created by Hebra (1816- 1880) and later continued by his disciples Kaposi (who was Sommer's teacher) and Neumann. This Viennese school was in fact the first important center of our specialty; it was influenced by famous French dermatologists such as Caucher, Fournier, Darier, Cougerot, and Civatte. Sommer always worked tirelessly; he taught not only with patients but also with pictures and "moulages." He founded the Museum of Wax Modelling, the only
Figure 1. School of Medicine of the Buenos Aires University.
one of its sort in Latin America at the time. He had many prominent disciples, such as Drs. Maximiliano Aberastury, Nicolas Creco, Pedro L. Baliiia, Neocle Ragusin, Carlos M. Seminario, Eduardo Jonquieres, Julio V. Uriburu, F. L. Nasio, Enrique Fidanza, and others. A decisive step forward for Argentine dermatology was the creation of the Sociedad Dermatologica Argentina (1907), with its seat at the Hospital San Roque (today Ramos Meji'a), in Buenos Aires. Professor Baldomero Sommer was its first president. Among the founders of the society were Sommer, Maximiliano Aberastury, Pacifico Diaz, Pedro L. Baliiia, Eudoro Cisneros, Nicolas Creco, Carlos M. Seminario, Julio V. Uriburu, and later Neocle Ragusin.
From the Department of Dermatology, Buenos Aires University, Buenos Aires, Argentina. Address for correspondence: Professor David Grinspan, M.D., Pacheco de Melo 1848 5° "A," (1126) Buenos Aires, Argentina. 881
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In 1908, the society started publishing a journal first called Revista Dermatologica Argentina, then Revista de la Asociacion Argentina de Dermatologia y Sifilologia, and since 1959 Revista Argentina de Dermatologia. This journal was the first publication of its kind in Latin America. When Professor Sommer died in 1918, Dr. Pacifico Diaz succeeded him as president of the society. In 1919, Dr. Maximiliano Aberastury, who had been teaching the subject since 1894, was appointed full professor of dermatology and also became president of the society. He stood out as a dermatologist, syphilologist, and as an eminent leprologist;'' he was the author of the Argentine law against leprosy (1926) that bears his name. He was a brilliant teacher; Drs. J. J. Puente, M. Fernandez Blanco, and E. Mazza, among others, learned from him. In 1927, the society changed its name to Asociacion Argentina de Dermatologia y Sifilologia. Dr. Pedro Balina, who was appointed full professor of dermatology that year, became its president until 1933, when he was succeeded by Dr. Neocle Ragusin. In 1934, a group of dermatologists headed by Dr. Nicolas Creco, a disciple of Sommer, decided to create a new entity, which they called Sociedad de Dermatologfa, Sifilograffa y Venereologia. Some other founding members were Drs. Ceferino Orol Arias, Miguel A. Mazzini, Antonio A. Fernandez, Alberto Bigatti, and Luis Trepat. This society became incorporated to the Asociacion Medica Argentina (AMA). Nowadays it is called Sociedad Argentina de Dermatologfa. Thus, since 1934 there have existed two societies representative of Argentine dermatology: Asociacion Argentina de Dermatologia y Sifilologia and Sociedad Argentina de Dermatologia, the latter being related to the Asociacion Medica Argentina.
BALINA AND GRECO
Of the two societies, the Asociacion Argentina de Dermatologia y Sifilologia prevailed because of a greater number of specialists, among whom were the professors of dermatosyphilology of the Buenos Aires University. The most outstanding figures of the time, when Dr. Pedro Baliiia was full professor, were Drs. Jose M. Puente, Juan Pessano, Ceferino Orol Arias, Milio Fernandez Blanco, Enrique Fidanza, Jose M. Carrera, Ludovico Facio, Luis F. Pierini, Marcial Quiroga, Miguel A. Mazzini, Cuillermo Basombrio, Fernando Noussitou, and Aaron Kaminsky, the majority of whom were, or later became, professors of the specialty. Professor Pedro L. Baliiia was the most outstanding personality of the time; he attracted some brilliant disciples, the most prominent of whom were Dr. Luis E. Pierini and Dr. Marcial Quiroga. The Asociacion Argentina de Dermatologia y Sifilologia established subsidiaries in Rosario in 1934, 882
and Cordoba in 1938, and in Mendoza in 1952; it continued with the publication of the Revista de la Asociacion Argentina de Dermatologia y Sifilologia and was already forming a library of unquestionable value. The Sociedad Argentina de Dermatologia, with its seat at the AMA, was presided over by Professor Nicolas Creco, who had been full professor of dermatology of the La Plata University (province of Buenos Aires); he gathered outstanding specialists around him. It published a bulletin informing about its scientific activities and organized monthly meetings where important papers were presented and discussed.
PIERINI AND QUIROGA
By the year 1947 some of Baliiia's disciples, such as Dr. Luis E. Pierini and Dr. Marcial I. Quiroga, formed their own schools. That was the most outstanding period of Argentine dermatology. Quiroga was full professor of medical students and chief of the service at the Hospital Ramos Mejia. Pierini was appointed professor of postgraduates (and afterwards the 2nd dermatology professorship) and chief of the service at the Hospital Rawson. The associate professors of Pierini were Drs. Luis M. Carrera, Aaron Kaminsky,and Julio Martin Borda; and those of Quiroga were, Drs. Miguel A. Mazzini, Alejandro Cordero, Cuillermo Basombrio, Fernando Noussitou, Arturo Mom, and Felix Ambrosseti. In 1946, Pierini and Quiroga published a book entitled Introduction to the Study of Dermatosyphilology, with a purified semiology, which constituted the basis for Argentine dermatologists to become great semiologists and highly capable of clinical diagnosis. Mycology was excellently performed by Dr. Pablo Negroni, a great help for dermatologists; R. Zapater and afterwards V. Madeo also cooperated in this field. In leprosy, a subspecialty naturally belonging to dermatologists, the most important figures were: Drs. Jose Maria Fernandez and Salomon Schujman, disciples of Fidanza, in Rosario (Santa Fe); Dr. Luis Argiiello Pitt in Cordoba; Dr. Olmos Castro in Tucuman; and Dr. Cuillermo Basombn'o in Buenos Aires. Thus all acquired talented followers: Jose Esteban Cardama, Juan C. Catti, Luis M. Baliiia, Carlos Consigli, Enrique Tello, Leonidas Llano, Ricardo Manzi, Ernesto T. Capurro, Pascual B. Arcuri, and A. J. Melamed. Dr. Enrique Jonquieres, one of Miguel A. Mazzini's disciples, and Professor Fernando Noussitou, who occupied important posts outside the country as representative of the World Health Organization, already stood out in this specialty. Syphilis was part of dermatology, to the point that societies and journals were of dermatosyphilology. All dermatologists had a thorough knowledge of this specialty; the most important names were Professor Jose M. Puente and Drs. Jose L. Carrera and Luis Caviiia Alvarado.
Argentine Dermatology Grinspan
Diaz, Gregorio Alvarez, and Luis Trepat had already made great progress. The author of this paper, another of Pierini's disciples, founded a center of skin tumors and stomatology at the Hospital Rawson in Buenos Aires, with an infrastructure of high regard. Following my teacher, I applied dermatologic semiology to the study of skin tumors and oral mucosa lesions. This study helped me in the publication of a Treatise of Stomatology of six volumes and in the creation of a stomatologic school, a first in Latin America. Dr. Jorge Abulafia was involved with the service almost from the beginning as an anatomopathologist; his knowledge allowed an exceptional anatomoclinical management of patients. The number and quality of the cases seen at the Hospital Rawson was surprising. The papers published were internationally acknowledged. Dr. Ismael Pomposiello also belonged to the school from the first years. Professor Julio Martin Borda gave postgraduate courses attended by many young Latin American doctors, who found in this teacher not only knowledge but also fatherly affection and encouragement. He created the Hospital Privado de Piel, together with the dermatologists of the Hospital Rawson, where he continued teaching for doctors from the provinces and from all of Latin America. Borda was of great importance to Argentinian clinical dermatology.
Dr. Pablo Bosq and later Dr. Eugenio Follman, with some other dermatologists and general anatomopathologists, were in charge of dermatopathology until the arrival of Professor Jorge Abulafia, whose activity is discussed below. One should also mention the outstanding dermatologist Carlos F. Guillot, who was also a medicine historian. With all these specialists and their corresponding subspecialties, Argentine dermatology occupied an important place in the medical world, based on clinical knowledge and a new and purified semiology. The majority of the dermatologists of the time learned at the French school, following Darier and later Degos. It is difficult to write a history of Argentine dermatology since 1950, because those who know it are part of it. But it is necessary to point out that those gathered in the Asociacion Argentina de Dermatologia y Sifilologia formed two groups; Pierini's school and Quiroga's school; both of which worked together in the development of Argentine dermatology. Pierini's School Pierini's school became internationally famous; Professor Julio Martin Borda, a man of great scientific, moral, and human values belonged to it. It held monthly meetings with exhibitions of patients; these were attended by a great number of dermatologists, especially from the provinces. It also organized an annual weeklong course during which participants could examine patients with many rare diseases and discuss them. Right from the beginning young Latin American doctors attended his school to learn the specialty. Luis E. Pierini is an internationally renowned dermatologist; he described diseases and techniques that bear his name. He was undoubtedly the most important representative of' Argentine dermatology of his time within and without our country. In 1950, Pierini's group founded Archivos Argentinos de Dermatologia, which became one of the most widespread Spanish language journals. They formed a specialized library, which has been the most important in Latin America since its inception. Luis E. Pierini, as president of the Colegio IberoLatino-Americano de Dermatologia, with my help as executive secretary, and the support of all Argentine dermatology organized the 5th congress of that institution in Buenos Aires (1963); it is still remembered as a great success. Professor Gay Prieto from Spain considered it the best he had attended during his long dermatologic career. This gave the country the respect and the opportunity necessary to organize other international dermatologic congresses. Among Pierini's nearest collaborators was Dr. Dagoberto Pierini, who devoted himself to pediatric dermatology. He became well-known in this subspecialty, in which the great Pierini and Drs. Pacifico
Other outstanding members of Pierini's school were Drs. Augusto M. Casala, Santiago J. Mosto, Sergio G. Stringa, Alberto I. Carvalho, Raul H. Mazzini, Norberto Grinspan Bozza, Andres Paz, and later Leon Jaimovich, who has just returned from New York where he was resident at the Skin and Cancer Center. Most of the physicians from those years are still working, although unfortunately Dagoberto Pierini and Ismael Pomposiello died young. From Pierini's school emerged associate professors of dermatology: David Grinspan, Dagoberto Pierini, Jorge Abulafia, and Augusto Casala. Dr. Raul Fleischmajer (Professor Aaron Kaminsky's disciple) belonged to the school for a short time. He is now an international expert in collagen physiopathology and chief of dermatology at the Mount Sinai Hospital of New York, an honor for Argentinian dermatology. Quiroga's School
'
Quiroga's school also worked scientifically and attracted disciples who later became professors of dermatology, such as Drs. Luis Ambrosseti, Alejandro A. Cordero, Enrique Jonquieres, Arturo Mom, Pedro H. Magnin, and Rodolfo Corti. We should also remember Drs. E. Molina Leguizamon, N. Vivot, G. Duhm, C. F. Guillot, H. J. Sanchez Caballero, A. Woscoff, J. Avila, and M. Seoane. This school has monthly meetings with a large attendance of dermatologists. It continues with the medical students professorship and with the publication of the 883
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Table 1. Presidents of the Asociacion Argentina de Dermatologia since 1933
Revista Argentina de Dermatologia and has the oldest library in the country. Quiroga's professorship at the Hospital Ramos Meji'a was of great importance in Buenos Aires.
1933 Neocle Ragusin 1935 Jose M. Puente 1937 Juan Pessano 1939 Marcial Quiroga 1941 Luis E. Pierini 1943 Milio Fernandez Blanco 1945 Pablo Negroni 1947 Pedro L. Balifia 1950 Miguel A. Mazzini 1952 Guillermo Basomhri'o 1953 Fernando Noussitou 1955 Rafael Garzon 1957 Alejandro Cordero 1959 Aaron Kaminsky
Asociacion Argentina de Dermatologia and Sociedad Argentina de Dermatologia The Asociacion Argentina de Dermatologia had its seat at the Hospital Ramos Mejia. Table 1 shows the list of its presidents from 1933 to the present. The Sociedad Argentina de Dermatologia, (part of the Asociacion Medica Argentina) continued with its monthly sessions on theory for graduates. Professor Aaron Kaminsky had excellent associates such as his son Carlos, today associate professor of dermatology, his daughter-in-law Ana L. Jaimovich, today full professor of dermatology, and J. Kriner, S. Braunstein, H. Kaplan, A. Kaplan, B. Sevinsky, A. Aufgang, and A. Kohan. Dr. A. Segers was a surgical collaborator and a pioneer of dermatologic surgery. When in July 1978 the Hospital Rawson was closed due to a municipal resolution, Pierini's service (he had already retired) was destroyed. The work groups broke up, and their members were scattered to several hospitals. Then, the followers of Pierini and Borda with others such as Gatti and Gardama, consolidated the Sociedad Argentina de Dermatologia and made possible the organization of new monthly meetings and annual courses similar to those of the Hospital Rawson and the Hospital Privado de Piel. Table 2 shows the list of its presidents from 1934 to the present. Each executive commission of the Sociedad Argentina de Dermatologia improved what had been done by the previous one. The society was the foremost in Argentina as regards attendance of specialists to its meetings, exhibitions of patients, presentations of papers, and postgraduate courses.
1961 Jose Luis Carrera 1963 Felix Ambrossetti 1965 Enrique Jonquieres 1967 Marcial I. Quiroga 1968 Rodolfo N. Corti 1972 Miguel A. Mazzini 1976 Pablo Viglioglia 1978 Manuel Seoane 1980 Pedro Magnin 1982 Jose E. Cardama 1984 Hector Sanchez Caballero 1986 Luis M. Balifia 1988 Pedro Magnin 1990 Cristobal Parra
Argentine Dermatology in Cordoba The dermatosyphilologic activity in the learned city of Cordoba also began in the 19th century. The first dermatology professorship of Argentina was created in 1889 (even before that of Buenos Aires), and its first professor was Dr. Hugo Stemphelman, succeeded by Manuel Freyre (1890), Moises Tercera (1899), Tomas Garzon (1925), Domingo Tello (1926), and Rafael Garzon (1945). In 1938, a subsidiary of the Asociacion Argentina de Dermatologfa was created in Cordoba. Dr. Garzon was provisionally replaced by Ramon Argiiello until Luis Argiiello Pitt was appointed professor of dermatology in 1955. He was followed by Enrique Tello in 1972, a distinguished dermatologist. In 1973, Dr. Rafael Garzon (Jr) was appointed "in charge" of the professorship and has been full professor since 1983, when he won the open competition. The professorship has its seat at the Hospital de Glinicas. As well as being an important dermatologic center, Cordoba is the birthplace of papers on HACRE (endemic regional chronic hydroarsenicism) thanks to the work of Ramon Argiiello and Enrique Tello, now continued by Roberto Biagini from Salta. There were also papers on leprosy from Luis Argiiello Pitt and Garlos Gonsigli. Cordoba constitutes an advanced leprologic cen-
University of El Salvador It is necessary to remember the creation of the University of El Salvador in 1962 (9th in the country), where Dr. Luis M. Baliiia, an important dermatologist and leprologist, was appointed full professor of dermatology. His associate professor was Dr. Juan C. Gatti, and his collaborators were Drs. Juan J. Avila, Augusto Casala, Guillermo Grespi, Hugo N. Gabrera, Graciela Pizzariello, and Felix E. Wilkinson. Recently, Miguel de Herrera and Raul E. Valdez have been added to the list, as well as six assistant teachers. This professorship has worked with great enthusiasm and efficiency; it offers 3-year postgraduate and specialization courses. But the country does not begin and end in the city of Buenos Aires. 884
Argentine Dermatology Grinspan
Table 2. Presidents of the Sociedad Argentina de Dermatologfa since 1934 1934 Nicolas Greco 1936 Ceferino Orol Arias 1937 Roberto F. Wernicke 1938 Adolfo Muschietti 1939 Antonio A. Fernandez 1940 Eduardo Jonquieres 1941 Ernesto L. Othaz 1942 Gregorio Alvarez 1943 Felix F. Gunche 1944 Luis Trepat 1945 Adolfo Muschietti 1947 Ceferino Orol Arias 1948 Ernesto L. Othaz 1949 Felix F. Gunche 1950 Gregorio Alvarez 1951 Luis Trepat 1952 Jaime Spillzinger 1953 Alberto Bigatti 1954 Alcides Conti 1955 Antonio Fernandez 1957 Isaac Zelcer
The Reunion Dermatologica, which holds ordinary meetings and organizes national congresses and meetings, has been in existence for 50 years.
1959 Alcides Conti 1960 Simon Cohan 1961 Luis Trepat ^y 1962 Aaron Kaminsky 1963 Enrique Jonquieres 1965 Leon Jaimovich 1966 Aaron Kaminsky 1967 Pahlo Viglioglia 1969 Aaron Kaminsky 1971 Pahlo Viglioglia 1973 Jorge Abulafia 1975 Augusto Casala 1977 Osvaldo Mangano 1979 David Grinspan 1981 Alejandro A. Cordero 1983 Juan G. Gatti 1985 Sergio Stringa 1987 Jose E. Gardama 1989 Alberto Woscoff 1991 Hugo N. Cahrera
Argentine Dermatology in Rosario (Santa Fe) Its development began in 1922 with the creation of the Littoral National University. Enrique Eidanza was the first professor of dermatology and the founder of the dermatologic school. His work was brilliant and characterized by the stimulation of his young disciples, among whom were Jose Maria Eernandez (his successor at the professorship), Salomon Schujman, Pedro Scolari, Alberto Nudenberg, Francisco Carrillo, and Amadeo Campos. Jose M. Eernandez and Salomon Schujman became leprologists of international renown and participated in the creation of the South American Glassification of Lepra (La Habana, 1948). Eernandez will always be remembered because of the reaction that bears his name and also because of the use of BCG as a prophylaxis for leprosy. Although, it is considered that Schujman made possible the clinical understanding of the tuberculoid form of the disease. Both Eernandez and Schujman had disciples of great dermatologic and leprologic value: Eduardo Garboni, Augusto Mercau, Ignacio P. L. Astore, Augusto Serial (dermatopathologist), and Vicente Pecoraro, who was given the professorship in 1970 and was outstanding, along with J. M. Barman and I. Astore, for their contribution to the physiopathology of hair. In 1983, one of Pecoraro's disciples, Bernardo Nudenberg, was appointed full professor of dermatology. He shows a great integratory capacity and slants his professorship toward general medicine. The Asociacion Dermatologica of Rosario is the subsidiary of the Asociacion Argentina de Dermatologia created in 1935. It organizes several annual meetings. Dermatology in Rosario has always occupied an outstanding place in the teaching of leprology and nowadays in the relationship of dermatology with general medicine. Argentine Dermatology in Mendoza
ter. As a remote antecedent there already existed a leprosy lazaretto in 1621, another was founded in 1884, and in 1939 the Jose J. Puente Sanatorium and the Professor Guillermo Basombrio Clinic were inaugurated at San Francisco del Chafiar. Thanks to the help of the Leprosy Patronage, this clinic became a model, one of the best of its kind anywhere. Two new professorships were created in 1975. The Cordoba Catholic University also has a dermatology professorship that functions regularly and is one of the most renowned in the country. The first full professor was Dr. Ignacio Toledo (1961-1972), succeeded by Dr. Garlos Gonsigli, an outstanding dermatologist and leprologist.
Dermatology in the province of Mendoza was started in the 30s by Geronimo Lopez Gonzalez, who later won the open competition for the professorship of dermatosyphilology (1965). He had specialized with Professor Robert Degos at the Saint Louis Hospital in Paris. The School of Medical Sciences, belonging to the Cuyo National University, was founded in Mendoza in 1950. At that time, other outstanding dermatologists were Abdon Azar and Sebastian Pons and later Ricardo Billene, who had learned at Professor Garzon's school in Gordoba. Dr. Pons also attended Professor Vilanova's Catalan school in Barcelona (Spain). The 885
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inclusion of Anibal Ortiz Medina, Dr. Abulafia's disciple, was a great contribution to dermatopathology. In 1978, Sebastian Pons was appointed full professor of dermatology and was an excellent teacher, active in patient care and science. He became dean of the School of Medical Sciences of the Guyo National University. He died suddenly in 1983 at the peak of his scientific prowess. He was a brilliant specialist, who loved both dermatology and teaching. After his death, Alberto Torres Gortijo, who was the first associate professor from open competition, took over the professorship for 3 years; he followed the line of teaching received from his predecessors. He learned at the school of Professor Jose Gomez Orbaneja in Madrid (Spain) and at the Luis Pierini and Julio Martin Borda schools. Gristobal Parra has been full professor of dermatology since 1987.
Argentine Dermatology in Tucuman Dr. Norberto Olmos Castro was a great teacher, especially in leprology. Together with Dr. Pascual B. Arcuri, he established the importance of reading the "lepromino" reaction (known by their names) after a week. The present professor of dermatology at the Tucuman School of Medicine is Dr. Eudoro H. de los Rios. The Agrupacion Dermatologica de Tucuman, subsidiary of the Asociacion Argentina de Dermatologia, was created in 1970. Argentine Dermatology in Salta Dr. Andres Cornejo was one of the forerunners of specialists in the northwestern part of the country. He was a disciple of Mazza and gained great prestige thanks to his contribution to Ghagas and other tropical diseases. Dr. Gornejo helped in the preparation of "moulages" of dermatologic diseases. Also worth mentioning is Dr. Roberto Biagini, who updated several regional topics such as HACRF.
Argentine Dermatology in La Plata (Province of Buenos Aires) La Plata is an important dermatologic center. The specialty as such began in the year 1918 with Dr. Gamilo Cortelezzi, who was appointed to the professorship of dermatology at its creation in 1930. Professor Nicolas Greco was the next full professor from 1931 to 1947, succeeded by Professor Ernesto L. Othaz and Professor Alcides Conti (1953). Conti was the figure who contributed the most to the stature of La Plata dermatology. He was knowledgable and had many disciples. When he died. Professor Jorge Gueto was appointed to the professorship (1971), followed provisionally by Dr. Juan Fuertes (1986) and then by Raiil E. Balsa to the present. The Sociedad de Dermatologia de La Plata, nowadays a division of the Sociedad Argentina de Dermatologia (AMA), began its activities in 1973. We should also mention Dr. Luis Mirande and, as anatomopathologist. Dr. Roberto Gastelletto, Abulafia's disciple.
Argentine Dermatology in Entre Rios The first dermatologist of the province was Dr. Jose Maria Roque D'Angelo, who arrived in Parana in the year 1943 and started working at the Hospital San Martin. In 1985 Dr. Abraham Man was in charge of the specialty. The Sociedad Entrerriana de Dermatologia was founded in 1969, presided over by Dr. D'Angelo. Later the dermatologists of Santa Ee, Esperanza, Rafaela, and San Francisco (Cordoba) gathered and formed the Asociacion Dermatologica del Litoral, at which the first president was Dr. Ricardo Gusanelli. That same year (1980), the 5th Argentine Gongress of Dermatology was organized in Parana, headed by Dr. Abraham Man. Argentine Dermatology in Other Cities
Argentine Dermatology in Gorrientes The Asociacion Dermatologica para Chaco y Formosa, a subsidiary of the Asociacion Argentina de Dermatologia, was formed in 1983. Mar del Plata is a good dermatoloic center and has always kept close ties with Buenos Aires dermatology. The meetings and congresses celebrated in Mar del Plata are attended by many people, and those who visit this famous seaside resort are well looked after by these excellent dermatologists. We should remember Drs. Raul Rodeiro, Gelso Aldao (deceased), Juan F. Gaino, Garlos Gancio, Carlos de Natale, Jorge Brusco, Alfredo Amdur, Garlota Jaimovich, and Jorge Clara. In other places of the country new dermatologic societies are in formation. In Gomodoro Rivadavia, Dr. Eduardo Ghabeldin and Drs. Raiil and Glemente Jofre y Sotero Ojeda work with great enthusiasm. In Rfo Negro, Santiago del Estero and other provinces, there are derma-
The most important specialists of the province were Juan Felix Scappini, William Harvey, and Paulino L. Getzrow. Manuel Iglesias was full professor of dermatology and teacher of the above-mentioned doctors. He gave a great impulse to leprology together with Scappini, who is at present full professor of clinical dermatology at the School of Medicine of the Northeastern National University and also director of the dermatological dispensary and of the provincial program against leprosy. We should also remember that Professor Manuel Iglesias was one of the promoters of the law for the prophylaxis of leprosy, even before the promulgation of the national law named after Aberastury. Dr. Getzrow had the honor of being chief of dermatopathology at the Skin and Gancer Genter in New York, before the appointment of Dr. Ackerman. 886
Argentine Dermatology Grinspan
tologists who care about maintaining a high level of knowledge. In Santiago del Fstero there has been a Sociedad Santiagueiia de Dermatologia since 1983.
DERMATOLOGY NOWADAYS
At present there are 2,200 dermatologists in Argentina: that is 1 for every 15,000 inhabitants. Sociedad Argentina de Dermatologia Nowadays, the great majority of Argentine dermatologists are gathered in the Sociedad Argentina de Dermatologia. This entity gives 3-year courses for graduates, sponsored and recognized by the Ministry of Public Health, which gives the graduates the national degree of specialists. The Casa del Dermatologo is currently under construction on a recently acquired property. Archivos Argentinos de Dermatologia is its journal, and its library, to which physicians will have free access, will be installed in this new building. It has sections in La Plata, Mar del Plata, and the Cuyo area and still in formation in Cordoba and the Littoral area. The society awards several annual prizes and scholarships. The Sociedad Argentina de Leprologia forms part of it.
solidate our work. It is impossible to move forward without the good dermatopathologists, whom we are lucky to have in Argentina at present. In pediatric dermatology the most outstanding names are Professor Hector Crespi (Professor Alejandro Cordero's disciple), Drs. Adrian Pierini, Eva Mora, Rita Garcia Diaz, and Margarita Larralde de Luna, most of whom are new heads of dermatology services. This subspecialty is in very good hands. At the new children's hospital "Juan Garrahan" the dermatology service is directed by Dr. Adrian Pierini, a man of an unquestionable scientific knowledge and international renown. He is the present secretary of the Board of the International Society of Pediatric Dermatology, and he will preside over the VII International Congress of Pediatric Dermatology, to be celebrated in September 1994 in the city of Buenos Aires. The Sociedad Argentina de Dermatologia Pediatrica was founded on December 26, 1989. Argentine stomatology has always received international recognition. It was started by the author of this synopsis, who gathered all his experiences in a six-volume treatise. "Cosmiatry" (cosmetic dermatology), created by Professor Aaron Kaminsky, is at present supported by the work of Dr. Ana Kaminsky and Dr. Alejandro Cordero (Jr). The former is vice-president of the Colegio Ibero-Latino-Americano de Dermatologia and was elected chairwoman of the symposium Medical and Surgical Cosmetical Dermatology at the World Congress of Dermatology celebrated in 1992. She forms a first line team with Professor Carlos Kaminsky; they are working on the formation of an important school. In dermatologic surgery we can mention Dr. Norberto Grinspan Bozza and Professor Rafael Garzon (Jr) among others. Dr. Alfredo Segers was a pioneer in this subspecialty. The most outstanding names in cryosurgery (a ther^ apeutic technique now used more frequently by dermatologists) are E. Turjansky and G. Stolar, who started applying it to many dermatologic, particularly tumoral, diseases a long time ago in Argentina. Two other important specialists are Drs. Carlos Kaminsky and Alberto Torres Cortijo. Dr. Ricardo Negroni, the son of Pablo Negroni, stands out in mycology and collaborates with Argentine dermatologists in papers related to the specialty. His disciple Ricardo Galimberti is chief of dermatology at the Hospital Italiano. In leprology Professor Juan C. Gatti (deceased), Jose E. Cardama, and Luis Baliiia were the successors to Professor Basombrio in Buenos Aires. At the Hospital Mufiiz, currently directed by Dr. Juan J. Avila, Dr. Graciela Pizzariello together with Dr. Maria Elena Fariiia are in charge of virtually all leprosy patients. We should also remember that Professors Juan Carlos Gatti and Jose E. Cardama have published a treatise on leprology.
Asociacion Argentina de Dermatologia The Asociacion Argentina de Dermatologia continues with the periodical publication of the journal. In the year 1957, it edited an excellent and most helpful summary of the works published, called Blasi^ in honor of its author. Dr. Alfredo Blasi. This included everything since its creation and was complemented by another volume in 1987.* It has subsidiaries in Tucuman, Santiago del Estero, Chaco-Formosa, Rosario, Cordoba, and Cuyo. The Subspecialties Professor Abulafia is the father of dermatopathology, which is efficiently practised by Drs. Jose Casas, Oscar Bianchi, Ignacio Calb, Maria Cristina Kien, Graciela Sanchez, Eduardo Lacentre, Alicia Kowalczuk, Jorge A. Monti, Susana Romano, Florencio Castoldi and Roberto Schroh in Buenos Aires; Dr. Roberto Castelletto y Cueto (Jr.) in La Plata; Dr. Ani'bal Ortiz Medina in Mendoza; Dr. Adriana Bergero in Rosario; and Dr. Paulino Getzrow in Corrientes. Dr. Abulafia received the tutelage of Professor Hildebrando Portugal from Brazil. Fortunately, the Sociedad Argentina de Dermatopathologia (SADEPA) has just been founded (presided by Dr. Abulafia), which will surely contribute to the formation of a school of histopathologists, something very necessary to support our clinical findings and con887
Internationai Journal of Dermatology Vol. 31, No. 12, December 1992
of several editions. With Dr. Luis Maria Balifia they published Temas de Leprologia. The last president of the Sociedad Argentina de Leprologia Professor Enrique Jonquieres, a prominent dermatologist and dermatopathologist, is a consultant for the subspecialty. The Sanatorio Sommer is still a place for the recovery and investigation of leprosy. As regards Dr. Meny Bergel from Rosario, his investigations on the subject have moved to other countries and have always given rise to interesting discussions within ours. We have already referred to leprology in other provinces. The STD (sexually transmitted diseases) are covered by Professor Alberto Woscoff, who was president of ULACETS (Union Latinoamericana contra ETS [STD]), and by Dr. Luis Belli. Dr. Juan Garlos Elichman is in charge of the laboratory analyses. We cannot fail to mention Dr. Sergio G. Stringa, who stands out in the field of collagenopathies and pediatric dermatology. He also formed a school with disciples such as Drs. Garlos Bianchi, Oscar Bianchi, Osvaldo Stringa, and Oscar Sanguinetti. Other important figures are Dr. Alberto 1. Garvalho, who was chief of the dermatology service at the Hospital Fiorito of Avellaneda and at the Hospital Aeronautico, and Dr. Santiago Mosto, who had the honor and great responsibility of replacing master Luis E. Pierini when he retired as chief of the service at the Hospital Rawson. Professor Augusto Gasala belonged to the same service; he was interim full professor at the Hospital de Gh'nicas General San Martfn. I would also like to mention some who excelled abroad. Dr. Leopoldo Montes was professor and director of dermatologic investigations at the University of Alabama (USA); Dr. Raiil Fleischmajer honorably represents us in the United States and all over the world; Dr. Paulino L. Getzrow; and Dr. Ricardo Mandojana. Dr. Fernando Stengel, current editor of Archivos Argentinos de Dermatologia., who was chief of the dermatology service at the Hospital de GIfnicas Jose de San Martin, was our worthy representative during his long stay in the USA. He is the necessary link whenever an English-speaking specialist visits Argentina. His versatility and mastery of the specialty are such that his synthesis is generally much clearer than the conference itself.
practical and useful (editor. Professor Leon Jaimovich; associate editor. Dr. Miguel Allevato); and Temas de Leprologia, which permanently updates the subject, directed at present by Dr. Julio G. Ocampo. The Manual de Dermatologia, written by Gatti and Gardama, first published in the year 1953, has already had 11 editions, which demonstrates its value and usefulness. Argentine and Latin American students, as well as graduates, study from it. There is also a Tratado de Enfermedades de la Boca, by the author of this synopsis, of six volumes. Professors Marcial Quiroga and Alejandro Gordero were members of the International Committee on Dermatology, and Professors Luis E. Pierini, David Grinspan and Jorge Abulafia were presidents of the Golegio Ibero-Latino-Americano de Dermatologia. Some dermatologic processes and different reactions bear the names of Argentine specialists; for example, Pasini-Pierini's idiopathic atrophoderma, Pierini-Borda's melanotic prurigo, Grinspan's syndrome, Fernandez' reaction, GrinspanAbulafia's atypical melanoacanthoma, Facio's "apodemic" prurigo, Quiroga-Gay Prieto's senile pseudoangioma, Quiroga-Noussitou-Agneta's "figured and persistent papulous erythema," Borda-Abulafia-Jaimovich's circumscribed scleroatrophy syndrome, Aaron Kaminsky's minimal digit-cutaneous syndrome, Puente-Acevedo's simple glandular cheilitis. Useful Addresses The addresses of contemporary Argentine dermatologists appear in the journals of the Asociacion Argentina de Dermatologia^ and in the Historia, Reglamentos, Directorio published by the Golegio Ibero- LatinoAmericano de Dermatologia in 1987.*
REFERENCES
1. 2.
3. 4.
Dermatology Books and Journals and Distinctions to Outstanding Argentine Specialists
5.
There are five dermatology journals: Archivos Argentinos de Dermatologia, started in 1951 and of international recognition; Revista Argentina de Dermatologia, the oldest in Latin America, which first appeared in 1908 and contributed enormously to the spreading of the Argentine dermatologic school, currently directed by Professor Pedro H. Magnin; Revista Argentina de Micologia, under the charge of Professor Ricardo Negroni; Actualizaciones Terapeuticas Dermatologicas,
6. 7.
8.
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Canton E. Historia de la Medicina en el Rio de la Plata. 1928. Volume IV. Madrid: 1928. Greco NV. Historia y desarrollo de la dermatologia y sifilografi'a en la Republica Argentina. Semana Medica 1945; 50:351-375. Quiroga Ml. Origenes de la Dermatologia Argentina. Semana Medica 1977; 85:436-439. Pierini LE. Cuarenta afios de Dermatologi'a. Arch Argent Dermatol 1973; 23:1-9. Blasi AA. Indice general de la Revista Argentina de Dermatosifilologia 1908-1955. Buenos Aires, 1957. Indice general 1963-1987. Rev Argent Dermatol 1987; 68:395-462. Asociacion Argentina de Dermatologi'a. Socios Titulares. Socios Adjuntos. Rev Argent Dermatol 1989; 70: 309-323. Colegio Ibero-Latino-Americano de Dermatologia. Historia, Reglamentos, Directorio. Listado del padron de socios del Colegio Ibero-Latino-Americano de Dermatologia. Buenos Aires; 1987:185.
