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Anais Brasileiros de Dermatologia

Print version ISSN 0365-0596On-line version ISSN 1806-4841

An. Bras. Dermatol. vol.80 no.1 Rio de Janeiro Jan./Feb. 2005 



The pioneers of dermatology - Part 2 - The life and works of Paul Gerson Unna



Ney Romiti

Emeritus Professor. Titular Professor of the Discipline of Dermatological Clinics and Pathology, UNILUS





It is necessary to introduce the life of Dr. Paul Gerson Unna to the new generation of dermatologists. He is well known almost only for the revolutionary Unna boot, which has a minor significance when compared to his extensive and outstanding contribution to the formation and pioneering spirit in Dermatology, both in terms of his research and educational performance. This gaining further merit by not benefiting, over the years, from the shelter afforded by an university.

Paul Unna was born in Hamburg (09/08/1850) and later, in homage to his mother's family of traditional Hamburg doctors, dating back to the 17th century, he incorporated her maiden name Gerson to that he was baptized with and become Paul Gerson Unna. His father was a respectable general practitioner, as were three of his children (Karl, Paul Jr. and Georg Wilhelm) who were dermatologists, and the fourth, Eugen, a pharmacist. He studied for medical graduation at the universities of Heidelberg, Leipzig and Strasbourg, but it was in Vienna, attracted by the fame of this School (Hebra, Kaposi and Auspitz), that he completed his Masters degree in Dermatology. His interest in the specialty was already defined at his inaugural dissertation when, under the tutorship of the anatomist Waldeyer, he presented the thesis "Contribution to Histology and Formation of the Dermis and its Annexes". The originality of this meticulous researcher was delineated when he detailed the structure of the skin, characterizing its differentiation into four layers and indicating the basal layer as responsible for regeneration of the epidermis.

It was in 1894, that he published "Histopathology of the Skin Diseases". This work was the result of exhaustive research on the anatomicopathological findings consecrated at that time, and also original concepts that were opposed to many of the pre-established doctrines. That book became the basis for all those who were attracted to Dermatology. Even today, the chapter on "Nevi" is a classic. Pathological complementation, enhanced with clinical details and therapeutic orientations, deserve special mention. At this time, he developed the original staining methods to reveal and differentiate the structures and composition of the skin. In this manner, he identified the plasmatic, nevus cells, the composition of collagen and elastin, spongiosis, the balloon and reticular degeneration of the spinous layer in chickenpox, zoster and other bullae. He also dedicated special attention to bacteriology, pathology and therapy for leprosy. On 1884, he visited Armauer Hansen, in Norway. For these patients, originating from all parts of the world, he built an infirmary in the garden of his clinic. Special and original staining methods for the leprosy bacillus were described. He affirmed that the disease denominated zaraath, as described in the third book of Moses, was only the denomination for a wide collection of different dermatoses, and therefore not only leprosy. Various other dermatoses were the object of his descriptions and he characterized in details and denominated that which we know today as seborrheic dermatitis.

He was always attentive to therapeutic advances, many of these were original and deserved several monographs entitled "The diagnosis and therapy of dermatoses¨. The indication of cygnoline, derived from anthraline, for psoriasis therapy dates back to 1916. The plaster, plaster of Paris and similar, containing or not salicylic acid became important therapeutic resources. Soaps with ichthyol, salicylic acid, sulfur, tar, resorcinol with moisturizing vehicles belong to this era and even today products commercially known as Nivea are part of the current therapeutic arsenal. He was pioneering in research into the bio- and histochemistry of the skin; keratin, chromolysis, oxireduction and proteins all belong to this harvest. He was also responsible for the introduction of thermocautery and the comedos expressor as therapeutic resources in surgical procedures.

His bibliographical production was extensive, in it includes over 500 publications, notably the Atlas of Histology and Pathology of the Skin, that merited several editions between 1896 and 1910. Jointly with Morris (London), Duhring (Philadelphia) and Leloir (France), he edited the famous International Atlas of Rare Skin Diseases, written in French, English and German, which exemplifies the important exchange of knowledge and updating in the concepts of the dermatoses.

It was later, in 1907, when he was 57 years of age, that the senate of Hamburg conferred him the title of Professor and directorship of two infirmaries in the Eppendorfer Hospital, and in 1919, the recently inaugurated University of Hamburg granted him the title of Honorary Professor.

Together with two other dermatologists, Hans v. Hebra and Oscar Lassar, he edited the monthly journal Monatshefte fuer praktische Dermatogie (1882), that was re-baptized Dermatologisch Wochenschrifte and soon after Dermatologisch Monatsschrifte.

He recognized the special need for medical recycling and already in 1888, he organized theoretical and practical courses for doctors, among whom various foreigners were included.

Dedication to and love of music were a constant presence in his life, as reflected by the weekly concerts held at his house, in which he performed as an eminent cellist.

The bibliographical references are part of A. Hollander's article (his last disciple): Monatsschrift 1974. Band 160, Heft 1. q



Ney Romiti
Rua Machado de Assis, 303
11050 - 060 Santos SP

Received on October 04, 2004.
Approved by the Consultive Council and accepted for publication on October 04, 2004.

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