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History of dermatology in China

The history of Dermatology in China can be traced back to about 3600 years ago, when archeologists found the descriptive terms of skin or skin disease on oracle. Dermatology, albeit not regarded as a specialty at the time, is an important part of Traditional Chinese Medicine (TCM). Ancient Chinese people described dozens of specific skin conditions, a portion of which has parallel with modern terms. The ancestors regarded that the skin problems was not only a problem of the skin alone, but a reflection of internal problems as well. By thousands of year of empirical practicing, TCM practitioners developed strategies to classify the disease spectrum, mostly with philosophical exercise; and also developed different mixes of herbal medicine, either topical or systemic, to manage different skin conditions. In addition, physical methods were also developed, such as acupuncture or maxibustion, massage. A couple of distinguished TCM practitioners in Chinese history were recognized, though none of them, strictly speaking, was specialized in skin diseases. Shizhen Li, Simiao Sun, Tuo Hua, to name a few. They produced a couple of volumes covering collections and classifications of herbs, or methodology of diagnosis and treatment in general.

Modern medicine was introduced to China in the middle of 19^th century when missionary doctors from America and Europe came to China. They then established several hospitals where dermatology either as a division or as a group in department of medicine. At that time the infectious skin diseases such as syphilis, leprosy and tinea capitis were most common diseases. It was reported that 50.6% men had had venereal diseases (Liande Wu, 1926). During those time, dermatology disciplines were named departments of dermato-venereology （皮肤花柳科）.

The most famous figures playing important roles in dermatology in China

• Dr. John Glasgow Kerr (1824-1901): John Glasgow Kerr was the first dermatologist working in China who established the earliest hospital in Guangzhou city in 1859 and trained many Chinese medical doctors. He wrote the first Chinese textbook of dermatology- “Manual of Cutaneous Diseases” - in 1874.
• Dr. Maxwell JL（1873-1951）: Maxwell JL was another pioneer dermatologist. He came to China in 1901 and worked in hospitals in Shanghai, Xiamen, Wuhan and several other cities. He published an English textbook of Dermatology in 1929 in Shanghai. He contributed a lot to the control of leprosy in China.
• Dr. Hongkang Chen: Hongkang Chen was the first Chinese dermatologist working in Peking Union Hospital (established in 1921) and also the first president of Chinese Society of Dermatology.
• Dr. Xianqi Jian: Xianqi Jian established the department of dermatology in Peking University Medical School in 1915 and later on he became the president of Peking University Medical School Hospital. He translated a Japanese Textbook of Dermatology and Venereology into Chinese and contributed a lot to the establishment of Chinese dermatology.
• Prof. Chuan-kuei Hu: Chuan-kuei Hu devoted all his life to Chinese dermatology. He published world-famous article “Cutaneous lesions associated with deficiency in vitamin A in man” that was included in several English textbooks of dermatology until now [1]. It was the skin disease first reported from China. For more than 30 years Dr. Hu was the key leader of the Chinese Society of Dermatology and was actively involved in many achievements of Chinese dermatology including the control of venereal diseases, leprosy and tinea capitis, the founding of ”the Chinese Journal of Dermatology” (in Chinese) in 1953, the founding of Central Institute of Dermatology and Venereology in1954. In 1964 he declared the complete control of venereal diseases in China that was regarded a great achievement of new public [2]. He died in 1986 and donated most his personal savings to set-up a foundation for dermatological research in Peking University and his skeleton, as he decided in his will, was kept in Peking University School of Medicine for medical education.
• Dr. Haide Ma (George Hatem) (1910-1988): Haide Ma was a famous dermatologist in China. He was born in United States and came to China soon after graduation from Geneva Medical College in 1933. He joined the Chinese Red Army in 1936 and actively participated in the Anti-Japanese War. After the establishment of the People’s Republic of China，he was deeply involved in establishment of institutes of leprosy control and he played a very important part in leprosy control in China. Because of his contribution, he was awarded several national and international prize for leprosy control.
• Dr. Hongjiong Li: Hongjiong Li worked in Peking Union Hospital all his life and was the president of Chinese Society of Dermatology from 1982 to 1986. He contributed a lot to Chinese dermatology. He died in 1993.
• Dr. Guoliang Yang: Guoliang Yang founded the department of Dermatology of Huashan Hospital, Shanghai Medical University and trained hundreds of Chinese dermatologists. He died in 2004 at the age of 105 years old.
• Dr. Hong-duo Chen: Hong-duo Chen in China Medical University made important findings about the role of Langerhan’s cell in the biophysiology of the skin [3,4]. He was the president of Chinese Society of Dermatology from 1994 through 2006.
• Dr. Xuejun Zhang: Xuejun Zhang from Anhui Medical University identified the cylindromatosis gene responsible for multiple familial trichoepithelioma and some candidate genes or loci for psoriasis and other geneodermatosis [5-7].
• Dr. Young Yang: Young Yang et al. from Peking University identified two missense mutations in SCN9A in a family and the sporadic patient with primary erythermalgia [8].
• Dr. Cheng Zhou: Cheng Zhou et al. from Peking University identified mutation in ribosomal protein L21 in patients from two families with hereditary hypotrichosis simplex [9].

There are also many famous dermatologists who contributed to the founding of Chinese dermatology. Although it is impossible to write down all their names, we should remember Dr. Xinde Diao, Dr. Ruimu Wu, Dr. Weitong Liu，Dr. Zuoliang Qin，Dr. Guangyuan Yu, Dr. Guoquan Dong, Dr. Guangchao Wang and others pioneer dermatologists.

The Chinese Society of Dermatology

The Chinese Society of Dermatology was established in April of 1937 and the first president was Dr. Hongkang Chen. Soon after that, the second world war broke-out and doctors all over the China were involved in the 8-year anti-Japanese war and subsequent 3-year civil war.

After the birth of the People’s Republic of China in 1949, the Chinese dermatology began to develop rapidly. Dermatologists helped Chinese people in their struggle against skin diseases and venereal diseases. Great achievements were made, including control of venereal diseases, leprosy and tinea capitis. In 1952, the Chinese Society of Dermatology had its 2^nd congress and elected board member. Prof. Chuan-kuei Hu was elected as president. He worked at that position until 1982. For more than 30 years he was the key leader of Chinese Society of Dermatology. Dr. Hongjiong Li and Dr. Guoliang Yang were also two respected leaders of Chinese dermatology at that time.

In 1978, China opened its door to the outside world again and academic activities returned to normal. From 1978 until now, the Chinese Society of Dermatology had its regular board member meetings and re-elected its new board members. The presidents of the CSD board members were as follow: Hongjiong Li (1982-1986), Dr. Guangchao Wang (1986-1990), Dr. Xitang Chen (1990-1994), Dr. Hongduo Chen (1994-2006) , Dr. Xuejun Zhang (2006-2012) and Dr. Jianzhong Zhang (2012-2015).

Today the Chinese Society of Dermatology (www.csdnet.org) is among the most active societies under the Chinese Medical Association. It plays important roles in medical education, national and international academic exchange, advisory consultation for the government and other functions. It has more than 20,000 members. Dermatology is now a thriving discipline in China.

At present, most investigative dermatologists are from university hospitals. The grants for dermatological research are available at different level. We are happy to see that the level of dermatological research had grown immensely and more and more SCI papers have been published during past five years. Some findings made by Chinese dermatologists have shown a global impact; for example, the function of Langerhan’s cells, the findings of new genes for skin diseases and mechanisms of some skin diseases by Dr. Hong-duo Chen. Additionally, Chinese dermatologists made some discoveries on the pathogenesis of psoriasis [10], lupus erythematosus [11,12], pemphigus [13] and unusual skin infections [14]. Some papers were published in top journals such as “Nature Genetics”，”Lancet “, “J Immunol”, etc.

Academic exchange is one of the important functions of CSD. In recent 30 years, more and more Chinese dermatologists studied abroad and attended various international meetings such as American Academy of Dermatology annual meeting, European Academy of Dermatology and Venereology annual meeting and other international meetings. Also, more and more international colleagues were invited to Chinese dermatological meetings. CSD had hosted the 5^th Asian Congress of Dermatology in 1998 and the 9^th international Congress of Dermatology in 2004. In 2007, CSD again successfully held the 8^th International Congress of International Society of Cosmetic Dermatology. In 2007, CSD became a member of ILDS.

CSD also had very close relationship with dermatological societies of neighbor countries. “China-Japan Joint Meeting of Dermatology” is a good example, which started in 1988 and totally 10 joint meetings have been held during past 20 years [15]. In 2008, the Chinese Society of Dermatology, Japanese Dermatological Association and Korean Dermatological Association agreed to merge the China-Japan Joint Meeting of Dermatology and the Japan-Korea Joint Meeting of Dermatology into one meeting-‘Eastern Asia Dermatology Congress (EADC)’. So far, three EADC have been held (2010 in Fukuoka Japan, 2012 in Beijing China, 2014 in Jeju Korea). In 2013, the 9^th Asian Congress of Dermatology was held in Hong Kong. In 2014, the 11^th international Congress of Cosmetic Dermatology was held in Beijing. In 2015, the 23^rd World Congress of Dermatology was held in Vancouver Canada and CSD organized more than 450 participants to attend this meeting. All these suggest that Chinese dermatology plays more and more roles in international dermatology.

China is now on its way of rapid development. We believe that Chinese dermatology will also develop more rapidly in the future and will contribute more to the development of global dermatological science.

References

1. Frazier CN, Hu CK (1931) Cutaneous lesions associated with deficiency in vitamin A in man. Arch Int Med 48: 507.
2. Hu CK, Ye GY, Chen XT (1965) Control and clearance of syphilis in China (in Chinese). Bulletin Science 6: 503-510.
3. Chen HD, Raab S, Silvers WK (1985) Influence of major-histocompatibility- complex-compatible and incompatible Langerhans cells on the survival of H-Y-incompatible skin grafts in rats. Transplantation 40: 194-197. [Crossref]
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4. Chen HD, Ma CL, Yuan JT, Wang YK, Silvers WK (1986) Occurrence of donor Langerhans cells in mouse and rat chimeras and their replacement in skin grafts. J Invest Dermatol 86: 630-633. [Crossref]
5. Zhang XJ, Huang W, Yang S, Sun LD, Zhang FY, et al. (2009) Psoriasis genome-wide association study identifies susceptibility variants within LCE gene cluster at 1q21. Nat Genet 41: 205-210. [Crossref]
6. Zhang XJ1, Liang YH, He PP, Yang S, Wang HY, et al. (2004) Identification of the cylindromatosis tumor-suppressor gene responsible for multiple familial trichoepithelioma. J Invest Dermatol 122: 658-664. [Crossref]
7. Wen Y, Liu Y, Xu Y, Zhao Y, Hua R, et al. (2009) Loss-of-function mutations of an inhibitory upstream ORF in the human hairless transcript cause Marie Unna hereditary hypotrichosis. Nat Genet 41: 762. [Crossref]
8. Yang Y, Wang Y, Li S, Xu Z, Li H, et al. (2004) Mutations in SCN9A, encoding a sodium channel alpha subunit, in patients with primary erythermalgia. J Med Genet 41: 171-174. [Crossref]
9. Zhou C1, Zang D, Jin Y, Wu H, Liu Z, et al. (2011) Mutation in ribosomal protein L21 underlies hereditary hypotrichosis simplex. Hum Mutat 32: 710-714. [Crossref]
10. Man XY, Yang XH, Yao YG, Zheng M (2006) Immunolocalization and expression of vascular endothelial growth factor receptors (VEGFRs) and neuropilins (NRPs) on keratinocytes in human epidermis. Mol Med 12: 127-136. [Crossref]
11. Ding M, Zhang JZ (2008) SSB peptide and DNA co-immunization induces inhibition of anti-dsDNA antibody production in rabbits. Chin Med J (Engl) 121: 227-230. [Crossref]
12. Lu Q, Wu A, Tesmer L, Ray D, Yousif N, et al. (2007) Demethylation of CD40LG on the inactive X in T cells from women with lupus. J Immunol 179: 6352-6358. [Crossref]
13. Wang L, Bu D, Yang Y, Chen X, Zhu X, et al. (2004) Castleman's tumours and production of autoantibody in paraneoplastic pemphigus. Lancet 363: 525-531. [Crossref]
14. Gao TW, Li CY, Zhao XD, Liu YF (2002) Fatal bacteria granuloma after trauma: a new entity. Br J Dermatol 147: 985-993. [Crossref]
15. CSD, JDA (2008) History of friendship – In celebration of the 20^th anniversary of China-Japan Joint Meeting of Dermatology. Beijing.