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5[ Rockefeller THE ROCKEFELLER UNIVERSITY
University 1230 YORK AVENUE NEW YORK, NY 10021
Dy e April 29, 1980

JOSHUA LEDERBERG

PRESIDENT

Dr. George F. Odland

Professor of Medicine and
Biological Structure

Head, Division of Dermatology

University of Washington
Seattle, Washington 98195

Dear Dr. Odland:

Thank you for your letter of February 22nd and for
the report on Analysis of Research Needs and Priorities
in Dermatology. I read this with great interest and am
happy to respond to your request for comments.

This was certainly an illuminating and broad per-
spective on research accomplishments and opportunities
in dermatology. I am sure that it is a landmark for the
field and it stands high in relation to similar efforts
that have been attempted in some of the other categorical
areas.

I have to say that it likewise bears the earmarks of
the usual mode of preparation, namely @ committee attempt-
ing to refine a consensus of disparate interests. Recog-~
nizing that pressures of time may have predominated, I
share some impressions with you about some of the limita-
tions of the report. This is with the hope that these
might be kept in mind in the event of some future reinitia-
tion of a like effort.

Perhaps most wanting is an overall framework of skin
biology, as the foundation on which other specialized per-
spectives would have to rest. Such a preface might consume
a considerable fraction of the entire work; but without it
there is a real loss of integration from dealing primarily
with the diverse pathologies.

Another disparity of perspective, which is perhaps
inevitable in a committee-based monograph is the contrast
of the chapter on "prevalence, morbidity and cost," with
the rest of the document. For example, the top two entries
Dr. George F. Odland
April 29, 1980

-2-

of Table 5 at page 398 are diseases of sebaceous glands
and pilonidal cysts, respectively: these together account
for a significant portion of the diagnoses ,;but as far as

I could tell were mentioned nowhere else in the report.
"Other cellulitis and abscess"is the remaining major
diagnostic category and accounts for even more of the days
of hospitalization for listed skin conditions: of course
these present problems that are by no means unique to skin
although an exploration of that very question, (the ways
in which skin microbiology differs from that of other
organs) would. be of some fundamental interest. One may
well object to such indices of appropriate attention;. but
the asserted rationale for more attention to dermatological
research is precisely the health burden.-'

Finally, I note the total, and I assume intended, lack
of reference to thermal injury, other than sunburn! This
is, of course, consistent with the boundaries of dermatology
as a medical specialty in the United States; there is an
obvious incongruity about the exclusion of such an important
health problem which does have roots in research on the skin
that are at least comparable to those of the other areas
represented.

In any event, these are all small points compared with
the urgency of promoting research in this area. The con-
nections of dermatology with basic cell biology are so self-
evident that I hardly need to belabor them; and not only do
I wish for success in this field but J] will certainly lend
my own efforts toward it.

 

Jpshua Lederberg

cc: Dr. Attallah Kappas
Dr. David Carter