Von Hebra – Legend in dermatology

INTRODUCTION

Ferdinand Karl Franz Schwarzmann, Ritter Von Hebra was one of the founders of the New Vienna School of Dermatology which became the basis of modern dermatology. He was an Austrian physician and dermatologist.

EARLY LIFE

He was born on September 7, 1816, in Brno, Moravia, approximately 60 miles North of Vienna.^[1] It was then a part of the Austrian empire and now a place of historical importance in Czech Republic.

His father Johannes was a military official with the rank of officer in the imperial army.^[2] He started his premedical education in Graz, the second-largest city in Austria, later graduated in medicine (1841) at the University of Vienna. After graduation in medicine, he was posted as assistant at the Lehrkanzel fur Staatsarzneikunde.^[3] Later, he joined Joseph Skoda’s clinic at Allgemeines Krankenhaus (General hospital).^[4] This job was a turning point in his life. He was posted in the “Rash room” the section of the hospital packed with skin diseases.^[3] There he developed interest in dermatology and his observational power and skill made him an expert in this field. His work was deeply influenced by Karl Von Rokitansky (1804–1878), one of the founders of modern pathological anatomy.

CAREER IN DERMATOLOGY

In 1845, he was made the director – ordinarius – of an independent department of dermatology. Later, in 1848, he was appointed as Primarius at the Allgemeines Krankenhaus in Vienna, in 1849 extraordinary professor in Dermatology and in 1869 full-time professor.^[3] He climbed up the ladder of fame in a short period. He popularized dermatology when it was a neglected subject in all general hospitals.

CONTRIBUTIONS TO DERMATOLOGY

Hebra put forward the concept that all skin problems are due to local irritation and suggested local remedies to it. In 1841, Hebra described how to differentiate between psoriasis and leprosy.

In 1844, he concluded that scabies is caused by a mite and there is no humoral pathology involved in it.^[3] He made a classification of skin diseases based on pathological anatomy, which was used for almost a century. He published the first treatise on classification Hautkrankheiten (skin diseases) in 1845.^[4] In 1860, Hebra described “erythema exudativum multiforme” which is now called Herpes associated Erythema Multiforme. In 1862, crusted scabies is named “Scabies Norwegi Boecki” by Von Hebra.^[5] His other contributions include inunctions of mercury in the treatment of syphilis, coining the term seborrhea congestiva which he later concluded to be a form of lupus erythematosus and reporting the first case of rhinoscleroma.^[4]

In the second half of the 19^th century, Hebra introduced restoring and resurfacing of skin by chemical peels. Agents such as phenol, croton oil, and nitric acid were used as exfoliative agents in various combinations for peels. This was used to treat pigmentary abnormalities like freckles.^[6]

His book “Lehrbuch der Hautkrankheiten” (Textbook of skin diseases) was accepted all over Europe for its unique presentation. His another important book was “On disease of the skin, including the exanthemata” that was published by the New Sydenham Society, London. His aptitude for knowledge and teaching was evident in the “Atlas der Hautkrankheiten” (Atlas of skin diseases) with illustrations by two leading medical illustrators of Austria, Anton Elfinger and Carl Heitzmann.

He died on August 5, 1880, at the age of 64. However, Hebra’s era did not end. It was taken over by his son-in-law, Moritz Kaposi who also made valuable contributions to the field of dermatology. His son Hans Von Hebra also became a professor of dermatology. Von Hebra was buried in the same cemetery as Rokitanski and Skoda. Hence, all three legends remain together for eternity.

CONCLUSION

Von Hebra played an important role in shaping modern day dermatology and rightly deserves his place among the legends of the specialty.