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Pioneers in Dermatology and Venereology: an interview with Professor Francisco Miguel Camacho Martinez

2021; Wiley; Volume: 35; Issue: 10 Linguagem: Inglês

10.1111/jdv.17602

1468-3083

Fiderman Machuca‐Martínez,

Medicine, History, and Philosophy

Francisco Camacho Martinez was born in Melilla, Spain, in 1945. More than 850 papers (594 in Spanish) and 22 books The most relevant would be: Medico Surgical Dermatology (1981); Dermatology (1988, 1998); Manual of Dermatology (2010, 2018); Ibero Latin American Practical Dermatology. Atlas, systemic associated diseases and therapy (2005, 2012); Sexually Transmitted Diseases (1986); Genodermatosis (1987), Surgical Dermatology (1995); Laser in Dermatology and Dermocosmetology (2000, 2008); Melanoma (1996, 2005); Nail diseases (2008); Tricología. Trichology. Trichologie (1981); Trichology (1996, 1997, 1998); Hair and its Disorders. Biology, Pathology and Management (2000); Montagna’s Trichology (2014, 2017). Chapters in books of Dermatology 162: The most relevant would be ‘Hypertrichosis and Hirsutism’ in the book of Jean Bolognia et al. (2003, 2008, 2012, 2018). At the time of my medical studies, I was an internal student in the Anatomy department for the first three years and in Endocrinology in the last three. Studying anatomy, I developed an interest in surgery, particularly in the minutious cutaneous surgery. As I studied endocrinology, I was fascinated by its importance in many dermatological conditions. And as the two schools (Plastic Surgery and Dermatology) were under the direction of Prof. Felipe de Dulanto, I obtained both specialities. Then, I was named Assistant Professor and placed in the Research Laboratory of the Hospital Clínico San Cecilio. My first and main teachers were Felipe de Dulanto (Granada), Joaquín Piñol (Barcelona), William Montagna (Oregon) and then I have had a ‘daily teacher’ as I call him, with whom I have worked and discussed almost daily since my arrival in Seville, Prof. José María Mascaró. From Felipe de Dulanto, I learned the relation of dermatology and internal medicine, as well as surgical dermatology, especially how to move in an operating room and apply all anatomical knowledge to our surgery. His hearing impairment allowed him to develop his other senses, not only to realize that there was something that was altering the surgical order but also to get into the cutaneous neurovascular crossroads by touch and go beyond dermatological surgery, masterfully reaching the complement of dissections lymph nodes of the neck, armpits or groin. From Joaquín Piñol, I learned immunology, cutaneous tumours, particularly melanoma, photobiology and many other cutaneous aspects because Piñol was an authentic dermatological encyclopaedia. And, he also helped me to interact with other European schools: French (Degos, Civatte, Duperrat), British (Ian Magnus for Phobiology), Austrian (Klaus Wolff) and American (Richard Winkelmann, Thomas Fitzpatrick, Stephen Katz). In addition, Piñol showed me how to organize sessions, library magazines, direct secretaries and teach daily lessons for students and postgraduates. From Bill Montagna, I not only learned research in the primates area but also dermatopathology, particularly related to trichology, without forgetting the constant lessons of friendship and humanity that such a high-level figure scientist kept with us. And from José María Mascaró, I still have a lot to learn, because if scientifically he is a leading figure, he is even more so in his social ability; having been the champion of Spanish Dermatology in the world both in the Spanish Academy and CILAD, as well as in the European or American Academies and the International League of Dermatological Societies. With José Mascaró, we established a deep friendship that still persists. He helped me in establishing new relations and links with foreign European and North American (particularly USA) schools, in scientific events organization, as he has extensive experience (I do consider him as another master) in solving many practical and sometimes difficult problems: he is what in Spain we call teacher at street level. I was Vice President of the EADV because Jean-Paul Ortonne asked me to participate in his Board in 1996. My collaboration lasted only for two years because I had been called to a service by College ILA of Dermatology in 1998. My achievements have been mostly related to the field of dermatological surgery. And of course, related to the particular knowledge of anatomy and the lessons of my teacher, I described surgical techniques that solve many of the patients’ problems. Thus, in Granada we described and performed the ‘Dulanto-Camacho flap’ whereby a modification of the lateral lingual flaps by an apical ‘sandwich’ lingual opening to replace the entire framework of the lower lip. Later in Seville, we described ‘Advancement flaps for vulvar reconstructions after vulvectomy’. And also, in Seville I directed and coordinated five surgical teams: dermatology, microsurgery, neurosurgery, abdominal surgery and plastic-vascular surgery to carry out a large excision of a malignant fibrous histiocytoma located in the scalp that reached the meninges and that we reconstructed with omentum. We published several surgical papers; the most important of them is referenced below: *Camacho F, Moreno JC, Murga M, Proaño J, Cantillana J, Naranjo M, Martínez Sahuquillo A, Macher G, Romero F. Malignant fibrous histiocytoma of the scalp. Multidisciplinary treatment. J Eur Acad Dermatol Venereol, 1999; 13:175-82 When I was Head of the Department of Medical & Surgical Dermatology, we had patients with high surgical difficulties. Many patients for whom everything possible was done and an extensive excisional and complementary surgery was performed, at the end of the intervention lasting many hours, which could be considered a success, died within days or months from metastasis. It is true that now we are able to keep many of them alive thanks to the ‘à la carte treatment’, but despite this, the survival rate is low. Nice episodes, many; funny, few. One of them was at the time when I was attending to the Saint Louis meeting as Dulanto's second in command from 1975 to 1980 and was responsible for another group of doctors from the Granada Service. One night in an official dinner, apart from the one that was held at Jean Civatte's house on the first night of the meeting, my wife and another couple from Granada were late. There were no more places but to my surprise, I saw one table where there were four free places, so we sat down. I did not know where to go when almost immediately Civatte and Belaich with their wives came and claimed their places. We were all disappointed by the situation but, as we are all good friends nobody was considered ‘usurper’. Another funny experience is in relation with my long-distance travels for a very short stay. In one occasion (April 1982), I was going to Stanford University with Professor Mascaró and his wife to attend a meeting organized by Eugene M. Farber and Paul H. Jacobs about ‘injectable collagen’, and as it was a one-day trip, I travelled only with a change of clothes and cosmetics. The customs officer did not believe that I would make such a long-distance trip to stay just for one day and without any bag. But they admitted that it was a ‘quick business trip’. That has happened to me several times and some of my close friends say that I know more airport hotels than cities where scientific meetings are held. Within medicine, endocrinology. From other areas of academic studies and degrees, I always liked, and when I can I practice it in an unprofessional way, architecture. And as related to the previous ones, painting in general. Giuseppe Verdi – ‘La traviata’. George Orwell - 1984. Diego Velázquez – ‘Las meninas’. Though I did not know him personally, Marion B. Sulzberger. He did very important work that remains to this day. The other 9 in alphabetical order: Ruggero Caputo, Jean Civatte, Felipe de Dulanto, Stephen Katz, Robin Marks, William Montagna, Joaquin Piñol Aguadé, George Popkin, and Richard K. Winkelmann, and if you will allow me to add an 11th name, I would not hesitate to say Otto Braun-Falco. This one is even more complicated, not only because to highlight only 10 is not easy, but also because friendship certainly brings them closer. Then, in alphabetical order I list 11, as in the previous list: Martin Black, Jean Bolognia, Rodney P.R. Dawber, Rudy Happle, Ana Kaminsky, José María Mascaró, Martin C. Mihm, Perry Robins, Vera H. Price and Antonella Tosti. The two most difficult questions to answer were the last two. Life turns and in the 1980s the awakening of Dermatology revealed its problematic relationship to and limits with the bordering specialties (uneasy or simply bad, what was then called ‘warfare frontiers’). These problems have not disappeared in the same way that sexually transmitted diseases are no longer considered to be in the field of Dermatology in many European countries. On the other hand, our specialty is being sub-sub-specialized. That will be useful for researchers in some specific fields, but not for the ‘classic’ specialty as a classically large medical and surgical specialty with venereology. On the other hand, dermatologists are and must be complete (or ‘total’) dermatologists, not cosmetologists or trichologists, or other subspecialties that border on aesthetic medicine that, certainly, is not a recognized medical speciality. I dare not answer. Ten years? When a colleague in a lecture presents his own research and concludes that they will be completed in 10 years, for example, I cannot see whether it will finally be fulfilled or not. Therefore, can we set dates for the development of gene therapy or stem cell transplantation? I dare not agree with. But we would be very glad if we could verify the experiences of our colleagues. *Note: The Pioneers in Dermatology and Venereology interview was conceived and conducted by Johannes Ring.