History of Latin American Dermatology

PAULO R. CUNHABahia’s Tropical Dermatology SchoolThe Dermatology course was created at the Bahia Medical School at a time when thisschool competed with that of Rio de Janeiro School for first place in the study of skin diseases.Alexandre Cerqueira, its head, who had been professor of the high and secondaryschool in 1865, and university lecturer a year later, identified Tinea Nigra in 1891. Hisobservations on the topic were not published. It would be his son, Antônio Gentil de CastroCerqueira Pinto, who used them in 1916 in his graduation thesis titled KeratomycoseNigricans Palmar. In it, he described the way in which his father obtained the experimentalreproduction of the disease, through the inoculation of a volunteer with scalestaken from a lesion.Both dermatologists, father and son, were linked to a famous school that introducedthe study of tropical pathology in the country. According to F. E. Rabello, “it was preciselyJ. Adeodato, in 1888, and Juliano Moreira, in 1896, who were the first to make the clinicalidentification of the Bahia Button of Tegumentary Leishmaniasis, known in the MiddleEast under various names” 2 .We owe to what was in all justice called the Bahia Medical School, the emergence ofa growing interest in our problems of tropical nosology. It was also a citizen of Bahia,Silva Lima (1826-1910), who for the first time provided a classical description of the curiousailment called Ainhum. Silva Lima was in a privileged position to do it, since Bahiawas for a long time the capital of the country and the major center for the inflow ofAfrican slaves. It is one of the rare truly racial diseases, peculiar to the full-blood black,generally associated with a certain degree of plantar hyperkeratosis.The Bahia Tropical Dermatology School emerged and developed despite the relativedifficulties of official education, provided at the time by the University of Salvador. Atany rate, the capital of Bahia favoured the specialized branch of medicine for its interestin cutaneous medicine. For that reason, physicians from abroad or those related tothe university met in study groups, thus becoming the true national and foreign forerunnersof the scientific phase of Brazilian medicine. Among them were: Silva Lima ofPortugal, John Patterson of Britain, Otto Wucherer of Germany and several Brazilians,such as Maria Pires Caldas, Ludgero Ferreira, Antônio José Alves and Antônio Januáriode Faria.João Francisco da Silva Lima, who graduated from the Salvador Medical Schoolwhere he worked all his life as a tireless researcher, enriched the Brazilian scientificlegacy with valuable contributions on issues of tropical pathology, his works on buboesand ainhum standing out.Otto Wucherer had settled in 1843 as clinician in the capital of Bahia and began tosystematically examine the feces of the constipated, finding in them the eggs of Ancylostomumduodenale and thus determining the etiology of the disease caused by that parasite.Later, he identified the microfilariae responsible for elephantiasis, of which theagent, in his honor, was given the name Wuchereria.John Patterson, from Edinburgh, arriving in Salvador in 1842, promptly stood outwith his work on yellow fever and cholera morbus, which at that time was endemic.The work by Silva Araújo, another member of the Bahia School, that achieved thegreatest repercussion was the Study of the Demodex folliculorum, for which he was selectedto become a member of the Imperial Academy of Medicine. For this, he moved toRio de Janeiro, where he would later be appointed to head the first Service of Skin Diseasesat the newly created General Polyclinic, where, in the future, other masters suchas Parreiras Horta and Ramos e Silva would stand out.72