E. del Río

Los comienzos de la Dermatopatología y de la Microbiología dermatológica en España

Crisóstomo Martínez from Valencia was a pioneering microscopist in 17th-century Europe. The first microscopic representations of skin in Spain appeared in an 18th-century work by Martín Martínez. Microbiology and histopathology progressed considerably in the late 19th century thanks to anatomists like Maestre de San Juan and surgeons like Federico Rubio Galí. The first Spanish pathologist to specialize in dermatology was Antonio Mendoza, a colleague of José Eugenio de Olavide at the Hospital San Juan de Dios in Madrid. Claudio Sala and Juan de Azúa also made significant contributions, including the description of pseudoepithelioma. Several disciples of Santiago Ramón y Cajal and Jorge FranciscoTello, such as Lorenzo Ruiz de Arcaute and Guillermo de la Rosa King, consolidated the dermatology laboratory, but the Civil War sent many into exile or deprived them of their professional status. Juan Rubió in Barcelona and Julio Rodríguez Puchol in Madrid were the immediate predecessors of todays dermatopathologists.

Potholing: Skin and Stone

be treated alongside illnesses of all kinds. But also, caves have always had their other dark and mysterious side, as the lairs of witches and dragons. Some of these rock shelters or caves were assimilated into the Christian tradition and have become sanctuaries, as is the case at Covadonga. Caving, like dermatology, has its own language. Some of the common terms include: stalactites, stalagmites, columns. Others are less well known but easy to interpret: crawl holes, chambers, flowstones, potholes. Some are more exotic: gours, cave pearls, cone karsts, etc. Also the kit and The incident involving the Belgian caver Annette van Houtte in early August last year, in the Navarre region of the western Pyrenees, had enormous repercussions in the media and brought public attention to a hobby both little known and discrete: speleology or caving. This science is, simultaneously, a hobby, a sport, an adventure, and, above all, a passion. Caves may be naturally or artificially formed. The former are more common in areas of limestone rock formed at the bottom of seas in the Mesozoic and Paleozoic eras and pushed up by tectonic forces to form the highest mountain ranges on the planet. Rainwater dissolves the calcium carbonate in the rocks and deposits it again, shaping the most capricious cavities. Spain has a rich limestone heritage, including the Pyrenees and the Picos de Europa, which are both peppered with caves and potholes. Many are extremely well-known: El Soplao in Cantabria, Valporquero in Leon, the Drach cave in Majorca, Las Grutas de las Maravillas in the Onuba mountains of Aracena, or the Nerja caves in Malaga. Some caves were formed by volcanic action, like the famous Los Verdes cave in Lanzarote, and there are caves in granite areas produced by the direct erosion of subterranean rivers, like the Folon system in Pontevedra province, north-western Spain. The conquest and study of caves has no objective other than knowledge itself—geological, topographical and mineralogical—and the personal challenge. Now that people have reached both poles and all the highest peaks in the world, the only unknown territories left for our adventurous spirit to explore and master are the ocean depths and bowels of the earth. Entering a space previously untouched by any human being is a magical, almost mystical, event. The human relationship with caves dates back to prehistory. For thousands of years they were home to our distant ancestors, providing shelter against the cold and inclement weather, and protection from animals and enemy clans. In fact, only a few decades ago, some Spaniards still lived in caves carved out of the rock itself. It is more than likely that, at some point in time, an inhabited cave or rock shelter formed the first rudimentary hospital, in conjunction with huts in surrounding camps where injured hunters could Potholing: Skin and Stone

Pioners of Spanish Dermatologia Surgery

Even before dermatology was born as a specialty at the beginning of the 19th century, most skin lesions and dermatoses tended to be treated by surgeons rather than physicians. After medicine and surgery were unified into a single discipline and dermatology emerged as a modern specialty, this relationship became blurred and Spanish dermatologists leaned more towards medicine than surgery. Then improvements in surgical techniques, knowledge of antiseptic and aseptic procedures, the development and introduction of anesthesia, and the greater interest in micrographic approaches led to the rediscovery and almost complete rebirth of this old surgical tradition in the second half of the 19th century. In Spain, dermatologic surgery as such did not really exist until the first third of the 20th century, when Enrique Alvarez Sainz de Aja and Vicente Gimeno emerged as the main exponents of this discipline. Of these 2, Alvarez Sainz de Aja—drawing on his previous experience as a general surgeon and obstetrician—was the better practitioner of the incipient dermatologic surgery. The other, Gimeno, wrote an interesting booklet on dermatologic surgery that was published in 1923 and that formed the basis of his inaugural speech to the Spanish Royal National Academy of Medicine.

Mucosal plaques on the tongue and pillars of the fauces

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Dry gangrene of the foot

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