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Spotlight

Spotlight on: Lorenzo Cerroni, MD

September 2017

In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe–others unsung heroes. All of these colleagues  have much to share, from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them.

Lorenzo Cerroni, MD, is an associate professor of dermatology and director of the research unit dermatopathology at the Medical University of Graz, Austria. He is past-president of the International Society of Dermatopathology and of the Austrian Society of Dermatopathology, secretary of the European Board Certification in Dermatopathology, and associate editor of the American Journal of Dermatopathology.

Dr Cerroni has authored 11 books and more than 350 scientific manuscripts. He is the recipient of the 2008 Ferdinand von Hebra Prize from the Austrian Society of Dermatology and the 2015 Founder’s Award from the American Society of Dermatopathology. He has delivered more than 700 invited lectures. Dr Cerroni has organized several congresses including 2 Symposia of the International Society of Dermatopathology (Graz 2000 and 2008), one Tutorial of Dermatopathology (Venice 2014), and 12 editions of the Summer Academy of Dermatopathology (Graz 2003-2017).

Q. What part of your work gives you the most pleasure?
A. Reading biopsies, that is, making histopathological diagnoses, sometimes gives me a feeling akin to opening a curtain and looking behind it, shedding light to a skin disorder that was unclear before. In addition, the sections of tissue observed under a microscope show a small universe: it’s our skin but it’s also a world of its own, and looking at it at through the microscope reveals some of its fascinating features.
 
Q. Are an understanding and appreciation of the humanities important in dermatology and why?
A. They are crucial for all men and women, even more so for a physician. With managing patients, we are dealing with the most fragile sphere of our fellow human beings, in a time of their life when uncertainty, worry, and anxiety reign. We need a deep understanding and appreciation of the humanities in order to help them in dealing with their fears, to take some of their apprehensions away, and to reduce the psychological burden of their disease.
 
Q. What is your greatest regret?    
A. To live my professional life in a time where the motto is “what can be cut?” rather than “where should we be invested?” In the world politicians are struggling to find a sustainable model for the health care system, yet many physicians share the impression that cuts are made in a detrimental and acritical way by people who may perhaps have some knowledge of economy, but no knowledge whatsoever of medicine. As a consequence, bureaucracy is devouring more and more of our time, and I still have yet to meet a colleague who thinks that we are heading in the right direction.

Q.Who was your hero/mentor and why?
A. Carl Sagan, an American astronomer and astrophysicist, has been one of the most influential people in my life. I wish I could have met him. Yet, reading his many books I have been impressed by the lucid and passionate explanation of complex systems such as the cosmos of our Earth, and by his rational, logical, and critical thinking. In his beautiful book Pale Blue Dot: A Vision of the Human Future in Space, he wrote: “The visions we offer our children shape the future: it matters what those visions are.” I try to live up to this sentence with my own children, and with the many younger colleagues who come to visit me for a fellowship.

Article continues on page 2

Q. Which patient had the most effect on your work and why?
A. One day I was on duty on the weekend and had to do the rounds in the entire department (at that time in Graz there were over 100 inpatients in the dermatology ward). In one room, there was a 17-year-old girl accompanied by her mother, who was allowed to stay with her during the night. She was a patient with terminal metastatic melanoma and died a few days later. There was nothing that they needed from me during that weekend beside normal routine, but there was much that they gave me during those 2 days: a lesson of dignity in the face of tragedy and death.

Q. What is the best piece of advice you have received and from whom?
A. When I was a boy I was racing in a rowing team on a coxless four. After coming second in a race, we were complaining with our trainer that the referee hadn’t sanctioned a false start of the winning team. Emilio Trivini, our trainer and a silver medalist in rowing at the Olympic Games in Tokyo in 1964, cut our complaints short and said to us: “If you want to win the next race, stop complaining and train harder.” We subsequently went on winning the Italian championship, and that short sentence pronounced in a harsh, almost rude tone has been one of the greatest lessons of my life. n

Q. Which medical figure in history would you want to have a drink with and why?
A. I would like to sit and have a chat with Louis-Ferdinand Céline. He graduated in medicine and wrote a PhD thesis on “The life and work of Philippe Ignace Semmelweis.” Dr Semmelweis was a Hungarian physician who demonstrated for the first time that hand-washing by attending physicians could dramatically reduce the number of women dying after childbirth. He met strong resistance by his colleagues and eventually had to leave his position at a Vienna hospital. In his doctoral thesis, Dr Céline tells this tragic story and uses it as a metaphor of the meanness of human beings. He was a controversial person, yet to my eyes he has been one of the most powerful writers of the last century, and The Journey to the End of the Night is one of the most impressive novels ever written. I cannot understand how a visionary artist like him could at the same time be so blinded on matters of politics and racism.

Q. What is the greatest political danger in the field of dermatology?
A. To my eyes, the greatest danger is the increasing, seemingly unstoppable growth of cosmetic dermatology. Cosmetic dermatology is not medicine and cannot be considered as a medical field. As a natural consequence, physicians and patients are increasingly seeing dermatologists as “nondoctors” (a perception which I fully share for those who are focusing on cosmetic procedures). As a second natural consequence, resources for traditional areas of medical and surgical dermatology are becoming scarce, and our specialty is losing important fields which are taken over by rheumatologists, immunologists, oncologists, and pathologists among others. In 2002 the British Medical Journal listed “ageing” as the No. 1 “nondisease” as voted by readers of the journal. A few years before, in 2000, I wrote an editorial for the millennium issue of the Archives of Dermatology (now JAMA Dermatology) titled “Not dark yet…”, pointing at the dangers posed to dermatology by focusing on management of cosmetic conditions. Almost 17 years have passed since the beginning of the new millennium, and the situation of dermatology as a true medical discipline has only become worse. Today, the words of the song by Bob Dylan that gave me the inspiration for the title of the Archives’ editorial are getting more and more true: “It’s not dark yet, but it’s getting there.” Bob Dylan won a Nobel prize, and that’s a great joy, yet dermatology is losing its heart, and that’s a great tragedy.

Dr Barankin is a dermatologist in Toronto, Ontario, Canada. He is author-editor of 7 books in dermatology and is widely published in the dermatology and humanities literature.

In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe–others unsung heroes. All of these colleagues  have much to share, from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them.

Lorenzo Cerroni, MD, is an associate professor of dermatology and director of the research unit dermatopathology at the Medical University of Graz, Austria. He is past-president of the International Society of Dermatopathology and of the Austrian Society of Dermatopathology, secretary of the European Board Certification in Dermatopathology, and associate editor of the American Journal of Dermatopathology.

Dr Cerroni has authored 11 books and more than 350 scientific manuscripts. He is the recipient of the 2008 Ferdinand von Hebra Prize from the Austrian Society of Dermatology and the 2015 Founder’s Award from the American Society of Dermatopathology. He has delivered more than 700 invited lectures. Dr Cerroni has organized several congresses including 2 Symposia of the International Society of Dermatopathology (Graz 2000 and 2008), one Tutorial of Dermatopathology (Venice 2014), and 12 editions of the Summer Academy of Dermatopathology (Graz 2003-2017).

Q. What part of your work gives you the most pleasure?
A. Reading biopsies, that is, making histopathological diagnoses, sometimes gives me a feeling akin to opening a curtain and looking behind it, shedding light to a skin disorder that was unclear before. In addition, the sections of tissue observed under a microscope show a small universe: it’s our skin but it’s also a world of its own, and looking at it at through the microscope reveals some of its fascinating features.
 
Q. Are an understanding and appreciation of the humanities important in dermatology and why?
A. They are crucial for all men and women, even more so for a physician. With managing patients, we are dealing with the most fragile sphere of our fellow human beings, in a time of their life when uncertainty, worry, and anxiety reign. We need a deep understanding and appreciation of the humanities in order to help them in dealing with their fears, to take some of their apprehensions away, and to reduce the psychological burden of their disease.
 
Q. What is your greatest regret?    
A. To live my professional life in a time where the motto is “what can be cut?” rather than “where should we be invested?” In the world politicians are struggling to find a sustainable model for the health care system, yet many physicians share the impression that cuts are made in a detrimental and acritical way by people who may perhaps have some knowledge of economy, but no knowledge whatsoever of medicine. As a consequence, bureaucracy is devouring more and more of our time, and I still have yet to meet a colleague who thinks that we are heading in the right direction.

Q.Who was your hero/mentor and why?
A. Carl Sagan, an American astronomer and astrophysicist, has been one of the most influential people in my life. I wish I could have met him. Yet, reading his many books I have been impressed by the lucid and passionate explanation of complex systems such as the cosmos of our Earth, and by his rational, logical, and critical thinking. In his beautiful book Pale Blue Dot: A Vision of the Human Future in Space, he wrote: “The visions we offer our children shape the future: it matters what those visions are.” I try to live up to this sentence with my own children, and with the many younger colleagues who come to visit me for a fellowship.

Article continues on page 2

Q. Which patient had the most effect on your work and why?
A. One day I was on duty on the weekend and had to do the rounds in the entire department (at that time in Graz there were over 100 inpatients in the dermatology ward). In one room, there was a 17-year-old girl accompanied by her mother, who was allowed to stay with her during the night. She was a patient with terminal metastatic melanoma and died a few days later. There was nothing that they needed from me during that weekend beside normal routine, but there was much that they gave me during those 2 days: a lesson of dignity in the face of tragedy and death.

Q. What is the best piece of advice you have received and from whom?
A. When I was a boy I was racing in a rowing team on a coxless four. After coming second in a race, we were complaining with our trainer that the referee hadn’t sanctioned a false start of the winning team. Emilio Trivini, our trainer and a silver medalist in rowing at the Olympic Games in Tokyo in 1964, cut our complaints short and said to us: “If you want to win the next race, stop complaining and train harder.” We subsequently went on winning the Italian championship, and that short sentence pronounced in a harsh, almost rude tone has been one of the greatest lessons of my life. n

Q. Which medical figure in history would you want to have a drink with and why?
A. I would like to sit and have a chat with Louis-Ferdinand Céline. He graduated in medicine and wrote a PhD thesis on “The life and work of Philippe Ignace Semmelweis.” Dr Semmelweis was a Hungarian physician who demonstrated for the first time that hand-washing by attending physicians could dramatically reduce the number of women dying after childbirth. He met strong resistance by his colleagues and eventually had to leave his position at a Vienna hospital. In his doctoral thesis, Dr Céline tells this tragic story and uses it as a metaphor of the meanness of human beings. He was a controversial person, yet to my eyes he has been one of the most powerful writers of the last century, and The Journey to the End of the Night is one of the most impressive novels ever written. I cannot understand how a visionary artist like him could at the same time be so blinded on matters of politics and racism.

Q. What is the greatest political danger in the field of dermatology?
A. To my eyes, the greatest danger is the increasing, seemingly unstoppable growth of cosmetic dermatology. Cosmetic dermatology is not medicine and cannot be considered as a medical field. As a natural consequence, physicians and patients are increasingly seeing dermatologists as “nondoctors” (a perception which I fully share for those who are focusing on cosmetic procedures). As a second natural consequence, resources for traditional areas of medical and surgical dermatology are becoming scarce, and our specialty is losing important fields which are taken over by rheumatologists, immunologists, oncologists, and pathologists among others. In 2002 the British Medical Journal listed “ageing” as the No. 1 “nondisease” as voted by readers of the journal. A few years before, in 2000, I wrote an editorial for the millennium issue of the Archives of Dermatology (now JAMA Dermatology) titled “Not dark yet…”, pointing at the dangers posed to dermatology by focusing on management of cosmetic conditions. Almost 17 years have passed since the beginning of the new millennium, and the situation of dermatology as a true medical discipline has only become worse. Today, the words of the song by Bob Dylan that gave me the inspiration for the title of the Archives’ editorial are getting more and more true: “It’s not dark yet, but it’s getting there.” Bob Dylan won a Nobel prize, and that’s a great joy, yet dermatology is losing its heart, and that’s a great tragedy.

Dr Barankin is a dermatologist in Toronto, Ontario, Canada. He is author-editor of 7 books in dermatology and is widely published in the dermatology and humanities literature.

In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe–others unsung heroes. All of these colleagues  have much to share, from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them.

Lorenzo Cerroni, MD, is an associate professor of dermatology and director of the research unit dermatopathology at the Medical University of Graz, Austria. He is past-president of the International Society of Dermatopathology and of the Austrian Society of Dermatopathology, secretary of the European Board Certification in Dermatopathology, and associate editor of the American Journal of Dermatopathology.

Dr Cerroni has authored 11 books and more than 350 scientific manuscripts. He is the recipient of the 2008 Ferdinand von Hebra Prize from the Austrian Society of Dermatology and the 2015 Founder’s Award from the American Society of Dermatopathology. He has delivered more than 700 invited lectures. Dr Cerroni has organized several congresses including 2 Symposia of the International Society of Dermatopathology (Graz 2000 and 2008), one Tutorial of Dermatopathology (Venice 2014), and 12 editions of the Summer Academy of Dermatopathology (Graz 2003-2017).

Q. What part of your work gives you the most pleasure?
A. Reading biopsies, that is, making histopathological diagnoses, sometimes gives me a feeling akin to opening a curtain and looking behind it, shedding light to a skin disorder that was unclear before. In addition, the sections of tissue observed under a microscope show a small universe: it’s our skin but it’s also a world of its own, and looking at it at through the microscope reveals some of its fascinating features.
 
Q. Are an understanding and appreciation of the humanities important in dermatology and why?
A. They are crucial for all men and women, even more so for a physician. With managing patients, we are dealing with the most fragile sphere of our fellow human beings, in a time of their life when uncertainty, worry, and anxiety reign. We need a deep understanding and appreciation of the humanities in order to help them in dealing with their fears, to take some of their apprehensions away, and to reduce the psychological burden of their disease.
 
Q. What is your greatest regret?    
A. To live my professional life in a time where the motto is “what can be cut?” rather than “where should we be invested?” In the world politicians are struggling to find a sustainable model for the health care system, yet many physicians share the impression that cuts are made in a detrimental and acritical way by people who may perhaps have some knowledge of economy, but no knowledge whatsoever of medicine. As a consequence, bureaucracy is devouring more and more of our time, and I still have yet to meet a colleague who thinks that we are heading in the right direction.

Q.Who was your hero/mentor and why?
A. Carl Sagan, an American astronomer and astrophysicist, has been one of the most influential people in my life. I wish I could have met him. Yet, reading his many books I have been impressed by the lucid and passionate explanation of complex systems such as the cosmos of our Earth, and by his rational, logical, and critical thinking. In his beautiful book Pale Blue Dot: A Vision of the Human Future in Space, he wrote: “The visions we offer our children shape the future: it matters what those visions are.” I try to live up to this sentence with my own children, and with the many younger colleagues who come to visit me for a fellowship.

Article continues on page 2

Q. Which patient had the most effect on your work and why?
A. One day I was on duty on the weekend and had to do the rounds in the entire department (at that time in Graz there were over 100 inpatients in the dermatology ward). In one room, there was a 17-year-old girl accompanied by her mother, who was allowed to stay with her during the night. She was a patient with terminal metastatic melanoma and died a few days later. There was nothing that they needed from me during that weekend beside normal routine, but there was much that they gave me during those 2 days: a lesson of dignity in the face of tragedy and death.

Q. What is the best piece of advice you have received and from whom?
A. When I was a boy I was racing in a rowing team on a coxless four. After coming second in a race, we were complaining with our trainer that the referee hadn’t sanctioned a false start of the winning team. Emilio Trivini, our trainer and a silver medalist in rowing at the Olympic Games in Tokyo in 1964, cut our complaints short and said to us: “If you want to win the next race, stop complaining and train harder.” We subsequently went on winning the Italian championship, and that short sentence pronounced in a harsh, almost rude tone has been one of the greatest lessons of my life. n

Q. Which medical figure in history would you want to have a drink with and why?
A. I would like to sit and have a chat with Louis-Ferdinand Céline. He graduated in medicine and wrote a PhD thesis on “The life and work of Philippe Ignace Semmelweis.” Dr Semmelweis was a Hungarian physician who demonstrated for the first time that hand-washing by attending physicians could dramatically reduce the number of women dying after childbirth. He met strong resistance by his colleagues and eventually had to leave his position at a Vienna hospital. In his doctoral thesis, Dr Céline tells this tragic story and uses it as a metaphor of the meanness of human beings. He was a controversial person, yet to my eyes he has been one of the most powerful writers of the last century, and The Journey to the End of the Night is one of the most impressive novels ever written. I cannot understand how a visionary artist like him could at the same time be so blinded on matters of politics and racism.

Q. What is the greatest political danger in the field of dermatology?
A. To my eyes, the greatest danger is the increasing, seemingly unstoppable growth of cosmetic dermatology. Cosmetic dermatology is not medicine and cannot be considered as a medical field. As a natural consequence, physicians and patients are increasingly seeing dermatologists as “nondoctors” (a perception which I fully share for those who are focusing on cosmetic procedures). As a second natural consequence, resources for traditional areas of medical and surgical dermatology are becoming scarce, and our specialty is losing important fields which are taken over by rheumatologists, immunologists, oncologists, and pathologists among others. In 2002 the British Medical Journal listed “ageing” as the No. 1 “nondisease” as voted by readers of the journal. A few years before, in 2000, I wrote an editorial for the millennium issue of the Archives of Dermatology (now JAMA Dermatology) titled “Not dark yet…”, pointing at the dangers posed to dermatology by focusing on management of cosmetic conditions. Almost 17 years have passed since the beginning of the new millennium, and the situation of dermatology as a true medical discipline has only become worse. Today, the words of the song by Bob Dylan that gave me the inspiration for the title of the Archives’ editorial are getting more and more true: “It’s not dark yet, but it’s getting there.” Bob Dylan won a Nobel prize, and that’s a great joy, yet dermatology is losing its heart, and that’s a great tragedy.

Dr Barankin is a dermatologist in Toronto, Ontario, Canada. He is author-editor of 7 books in dermatology and is widely published in the dermatology and humanities literature.