The history of the organization is best described in the following article:
Reprinted from the Journal of Cutaneous Pathology with permission from the publisher, Munksgaard. J Cutan Pathol 1993: 279-287, © Munksgaard 1993
In Memoriam: The author of this article, Robert G. Freeman, MD, passed away October 19, 2007, in Dallas, at age 80. Dr. Freeman was an honorary member of ASDP, and served as president in 1979. He spent his career teaching in the departments of dermatology and pathology at the University of Texas Southwestern Medical School, and Baylor University College of Medicine, where he also earned his MD. Later, Dr. Freeman served as ASDP historian. He is survived by sons David and Mark, daughters Angie and Sara, and six grandchildren.
The American Society of Dermatopathology. The First 30 Years
By: Robert G. Freeman, MD*
*Historian, American Society of Dermatopathology, on the occasion of the thirtieth anniversary of the society.
The American Society of Dermatopathology (ASD) is 30 years old!! The original group of nine men, consisting of members of the Committee on Pathology of the American Academy of Dermatology (AAD) and a few invited dermatopathologists met to organize a society exclusively for dermatopathology on a Tuesday afternoon, December 2, 1962, while at the annual meeting of the AAD. The members of the Committee on Pathology and others elected as the first Officers and committee chairmen of the new ASD became the founding members. Two days later, they met again and adopted a constitution and bylaws establishing the ASD. During 1963 other interested persons were added as charter members. The first scientific meeting with 45 attending was held on Tuesday evening during the 1963 AAD meeting. This was a small but significant beginning.
Prior to the establishment of the ASD, the major forum for the presentation and discussion of anything new in dermatopathology was in the dermatopathology courses and the Clinicopathologic conference (CPC) of the AAD. These are still significant forums for discussion of dermatopathology topics, but, increasingly, discussion of new topics and innovations shifted to the ASD. Initially the two societies remained closely linked and the programs were held concurrently. However, the AAD administration at that time was not enthusiastic about concurrent society programs that might detract from their own meeting; and the ASD was allowed to meet only in the evening and only at a time that did not interfere with scheduled AAD scientific or social functions – thus the initial meetings on Tuesday evenings preceding the Wednesday CPC.
Roots of the Society
Dermatology and pathology have always been linked closely. Some of the earliest treaters of skin disease were pathologists who had already learned the skills of careful observation and analysis of morphological data that make up the core of work of both specialties. Discovery of aniline dyes and development of histological techniques allowed the application of histopathology to the study of skin diseases at an early period in the evolution of dermatology. In fact, dermatopathology was, for a period, the "cutting edge" of dermatology, much as immunology, and now molecular biology are today. Dermatopathology as an early area of interest to dermatologists is also attested to by the textbooks on the subject such as those written by Simon (1848), Unna (1894), McCarthy (1931), Lever (1949; through eight editions), and others. Topics in dermatopathology were presented at various meetings such as the American Dermatological Association (ADA) from its inception in 1876. With the establishment of the AAD in 1938, regular sessions on dermatopathology were held in the form of Courses and the CPC. The major dermatological teaching centers often had dermatopathologists on their staff. But at this point, it is not intended to review all the dermatopathologists who contributed to our early teaching and knowledge. They built a foundation for dermatopathology but most did not make a direct impact on the ASD.
|Table 1. Past Presidents.
|Hamilton Montgomery, M.D.
|Hermann Pinkus, M.D.
|Elson B. Helwig, M.D.
|Herman Beerman, M.D.
|Herbert Z. Lund, M.D.
|Francis Ellis, M.D.
|Walter F. Lever, M.D.
|Daniel F. Richfield, M.D.
|Walter R. Nickel, M.D.
|Louis H. Winer, M.D.
|John R. Haserick, M.D.
|Alvin J. Co, M.D.
|Edward P. Cawley, M.D.
|James H. Graham, M.D.
|Richard K. Winkelmann, M.D.
|George Ioannides, M.D.
|Robert G. Freeman, M.D.
|Mark Allen Everett, M.D.
|Robert W. Goltz, M.D.
|Amir H. Mehregan, M.D.
|John T. Headington, M.D.
|Martin H. Brownstein, M.D.
|A. Bernard Ackerman, M.D.
|Kurt S. Stenn, M.D.
|Ken Hashimoto, M.D.
|Waine C. Johnson, M.D.
|Ronald J. Barr, M.D.
|Loren E. Golitz, M.D.
|Evan R. Farmer, M.D.
|Beno Michel, M.D.
Some of the more notable dermatopathologists who were active in the AAD just preceding the founding of the ASD were men like Dr. Fred Weidman of Philadelphia, Dr. Marcus Caro of Chicago, and the founding members. Dr. Herman Beerman of Philadelphia then, and for 17 years, was chairman of the CPC. During this era anything new and significant in dermatopathology would almost certainly be presented at the CPC. Dr. Montgomery was still active at the time of initiation of plans for a society of dermatopathology. In fact he was the chairman of the Committee on Pathology of the AAD that initiated the discussion of such a society; he was very active in the organization of the organizational meetings in 1962 and was elected as its first president. I clearly recall Dr. Montgomery standing in the foyer of the 4th floor of the Palmer House in 1963 with the master list in his hand discussing and adding names of potential charter members.
The first official meeting of the ASD took place December 2, 1962, at a meeting of the committee on Pathology in which Dr. Montgomery presided. Other members of that committee were Drs. Herman Beerman, John R. Haserick, Arthur B. Hyman, Walter F. Lever, Walter R. Nickel, Louis H. Winer, and Marcus R. Caro. However, Dr. Caro had died in May 1962. Drs. Beerman and Haserick were recorded as absent from this first meeting; and Dr. Elson Helwig and Dr. Hermann Pinkus were invited to attend. At this meeting the decision was made to establish a society of dermatopathology, and a second meeting was scheduled two days later.
Prior to this first meeting of the ASD, there must have been informal discussions about the organization of a society for dermatopathology to prompt the calling of such a meeting. At the second meeting two days later a constitution and bylaws already were prepared for approval, indicating prior preparation. Between 1975 and 1984, I attempted to interview as many of the founding members as possible about the source of the idea and the planning for the ASD. Very few details about the origin of the idea were forthcoming; and most of those interviewed said they did not recall whose idea it was or how the planning came about. Dr. John Haserick, who did not attend the first meeting, distinctly recalls suggesting the idea of a society. Perhaps his suggestion was made a year or two prior to the first meeting in 1962.
There is little doubt, however, that Dr. Montgomery was the key organizer, supported by the other members of the AAD Committee on Pathology and other founding members, all of whom were active in AAD teaching of dermatopathology. The Committee on Pathology in 1961 included Drs. Montgomery, Beerman, Caro, Haserick, Lever and Winer. The Instructors in the Histopathology Special Course in 1961 were Drs. Winer, Nickel, Helwig, Beerman, Lever, Samuel W. Becker Jr., and David W. Kersting. At the CPC, Dr. Beerman was the moderator, and Drs. George W. Binkley, Grier F. Starr, Hyman, and Lever were presenters. Consulting panel members included Drs. Becker, Cawley, Ellis, Fasal, Ginsberg, Goltz, Helwig, Kersting, Knox, Lockwood, Lund, Mescon, Montgomery, Nickel Pinkus, Richfield, Stoughton, Szymanski, Wilson, Winer, and Wood. This list includes most of the names of prominent dermatopathologists of that era on which a new society could depend and from which its membership developed.
The decision to organize a society of dermatopathology was not unanimous. At least one, and probably two individuals attending the first two meetings expressed the idea that such a society was not necessary and would likely fail. But once the decision was made to organize, all of the attendees supported the action, and those early objectors later served as presidents of the new society (Table 1).
The dermatopathology activities in the AAD during this era consisted primarily of the courses in dermatopathology, given on the weekend of the annual meeting, and the CPC, held on Wednesday each year. These were the main forums for the presentation of anything new or different in dermatopathology. The only other existing regular forums in dermatopathology at that time were the Zola Cooper Seminar, organized in 1953 by Dr. James Burks to meet annually with the Southern Medical Association, and the Dermatopathology Seminar, held annually at the meeting of the Pacific Dermatological Association. These sessions still are held regularly, but with the organization of the ASD, the shift of emphasis and prestige to this new forum began and has increased steadily since.
|Table 2. Past secretary-treasurers.
|Walter F. Nickel, M.D.
|James H. Graham, M.D.
|Robert G. Freeman, M.D.
|John T. Headington, M.D.
|Kurt S. Stenn, M.D.
|Loren E. Golitz, M.D.
|Antoinette F. Hood, M.D.
Initially, the governing body of the ASD, as specified in the bylaws, was the Executive Committee composed of the AAD Committee on Pathology and the chairmen of standing ASD committees. Thus the ASD grew out of and was sustained by the existing leadership in dermatopathology. It became clear, however, that this composition of the Executive Committee was improper, creating a conflict of interest between the two organizations, and putting the ASD at the mercy of the officers of the AAD by virtue of appointment powers of the AAD President to the Committee on Pathology. This error was recognized by 1970 and was corrected by changes in the bylaws approved in 1974 at the time of the incorporation of the ASD as a non-profit educational corporation. Dr. James H. Graham, the second secretary-treasurer (Table 2), was the prime mover for these changes and for the incorporation. Since 1974, the Executive Committee, still the governing body of the ASD, has consisted of the elected officers, chairmen of the standing committees, and the three past presidents, with no relationship to the AAD.
Although the ASD grew out of the AAD, and its leaders often were also leaders in the AAD, the relationship between the two was not always harmonious. The AAD administration was not at that time enthusiastic about any societies associating themselves with their annual meeting, apparently because they felt this would detract from the meeting and divert interest and support from the AAD. Perhaps this protective attitude derives from the same source that had the academy meet in Chicago each December where there would be nothing else to do and no other place to go but to the meeting. At any rate, for about the first 15 years of its life, the ASD was not allowed to meet in conflict with any scientific or social functions of the AAD.
When the ASD decided to meet on Friday beforehand, the AAD would not change the time of the Wednesday CPC meeting to coordinate with the ASD meeting. Thus dermatopathologists had to stay at the meeting from Thursday thorough the following Wednesday to participate in both sessions. Very few dermatopathologists could stay away from their teaching and diagnostic work for that long. This condition, as much as anything else, probably led to the decline of the CPC in the 1960s and 1970s. Moreover, the ASD was frequently excluded from the major hotels reserved by the AAD. As a result, the ASD meeting initially was held on Tuesday evenings prior to the Wednesday CPC, or on Thursday afternoon after the end of the AAD meeting. At these early meetings, the attendance was poor, some people had already gone home, everyone was tired after a week of meetings and the discussion was not very active.
Later, the meetings were moved to the Friday preceding the AAD meeting, with better results, except that some members still could not arrive early for the meeting and stay for the AAD meetings too. Often the meetings were in other hotels, such as the Balmoral Hotel adjacent to the Americana Hotel in Bal Harbour, Fla., or near the Palmer House at the University Club in Chicago, courtesy of Dr. Fred Szymanski. Twice the meeting was held in separate cities.
Growth of the Society
After a few lean years, the significance of and support for the ASD began to be recognized. The need for an identity for dermatopathologists was increasingly obvious as an academic forum as well as a need for definition of the subspecialty for certification, relicensure, and accreditation and other intrusions by third parties; which need also prompted the establishment of the special competency Board Examination for Dermatopathology in 1973.
The Initial Concept
The initial concept of the ASD, as explained by Dr. Walter Nickel, its secretary-treasurer for the first seven years, was to maintain a small relatively exclusive group of physicians who were intensely interested in and actively practicing the subspecialty. The concept of a small group was to encourage free discussion at the meetings at which everyone was known. This was a format dear to the heart of Dr. Nickel and others; although it may not have been shared by all the early members. It is clear that these ideas were incorporated in the organizational structure of the society in the form of (1) mandatory attendance at least once every three years to maintain membership in the society, and (2) a limit of 125 fellows in the society, creating an exclusive category of membership. The attendance requirement was unpopular with some members, especially pathologists, who might not plan to attend the academy meeting. Before his death, Dr. Nickel told me that he was disappointed that these principles had not been maintained, and that he thought the organization had grown to be too big and was no longer any fun. By this time, there was pressure to shorten the time of presentation and discussion of papers in order to include as many papers as possible on the Friday program, and free discussion was inhibited. At any rate, Dr. Nickel served the society well, and deserves a major share of the credit for its survival and early growth and for initiating innovative programs. Later, bylaw changes eliminated these restricting principles after it became obvious that the specialty was growing rapidly and that the ASD would need to grow and change to meet the needs of a membership of more than 700 plus the trainees wishing to attend the meeting. Today the membership totals 909, including 106 international members.
American Academy of Dermatology
The AAD has established relationships with several related organizations. The growth of the ASD out of the AAD already has been recounted, as has the administrative separation of the ASD from the Committee on Pathology of the AAD. As the AAD developed a permanent staff and offices, affiliated organizations were welcomed to meet at the time of the annual meeting of the AAD, and in the early 1980s, their offer to provide administrative services for the ASD was considered but was declined. The annual meeting of the ASD has been held with the AAD meeting every year except 1975 when the ASD met at the Hotel Del Coronado in California, and 1976, at the Mayo Clinic, Rochester, MN. These 20 separate meetings which I helped arrange as secretary-treasurer were the result of thinking among some of the members that the ASD might better serve both dermatology and pathology members and might grow stronger and more independent with separate meetings. But separate meetings were not universally popular, and in 1976 a poll of the members showed that most favored meeting with the AAD for convenience, economy of travel and the opportunity for trainees to attend both meetings. The only other recorded suggestion for a separate meeting was made in 1968 by Dr. Nickel, the secretary-treasurer, whose proposal to meet in the Bahamas was rejected.
International Academy of Pathology
At the suggestion of Dr. James Graham, one of my first actions as secretary-treasurer in 1975 was to contact the officers of the International Academy of Pathology (IAP) to inquire about the possibility of establishing a relationship with that organization by holding an annual joint session on dermatopathology at the time of their annual meeting in March. They first proposed joint sponsorship of a dermatopathology session at the International Congress of Pathology. This session, organized and moderated by Dr. Waine Johnson, was held in Washington, D.C., in October 1976. The first combined meeting with the IAP consisted of an afternoon session on "Cutaneous Vasculitis" organized by Dr. Richard K. Winkelmann and myself and held in Toronto in March 1977 with about 250 pathologists in attendance. This was considered highly successful, and joint meetings with the IAP have been continued since. Later, a group of pathologist-dermatopathologists meeting as the Dermatopathology Club at the same time as other pathology organizations held joint meetings with the society and the IAP for several years in the 1970s and eventually merged, with the group meeting with the IAP.
Intersociety Pathology Council
In 1973, the ASD agreed to send a representative to meet with representatives of other pathology organizations at the meetings of the Intersociety Pathology Council, recognition by pathologists that the ASD represented a significant segment of pathology. At this time negotiations were ongoing to establish a mechanism for board certification in dermatopathology. The ASD secretaries or other designated pathologist representatives have attended many of the biannual meetings, and report back to the ASD Executive Committee on any events of interest to dermatopathologists.
American Medical Association
In 1975, the annual meeting of the ASD was the site of inspection by AMA representatives with a view to approving the program for Continuing Medical Education. This meeting was held at the Hotel Del Coronado, Calif. It was the first two-day meeting of the society and the meeting at which the first self-assessment course was held under direction of Dr. Walter Nickel and his colleagues from Southern California. The application was approved by the AMA, and the ASD has been accredited for CME ever since. Incidentally, one of the AMA representatives applied for membership in the ASD the next year.
American Registry of Pathology
The American Registry of Pathology (ARP) was established by Congress as a civilian organization to interface with the Armed Forces Institute of Pathology (AFIP) and the various registries of pathology maintained there. In 1976, the ASD voted to make an annual donation of $1,000 to the ARP and to join the AAD as co-sponsor of Dermatopathology Registry since 1938, a relationship fostered by Drs. Weidman, Montgomery and Col. J. Ash of the AFIP. Through this relationship the AFIP established a repository for dermatopathology slide sets, and provided these sets for enrollees in the AAD courses on histopathology of the skin. These courses and slide sets were organized in four courses: Course 1, Inflammatory Dermatoses; Course 2, Granulomatous Dermatoses; Course 3, Nevi and Neoplasmas; and Course 4, Reticulo-endothelial and Alterative Dermatoses. Anyone teaching dermatopathology at the AAD in the 1950s and 1960s probably used this course material. Such sets are still available, and the AFIP later also became a repository for slide sets generated in conjunction with the self-assessment courses initiated by the ASD in 1975, and incorporated for the first time in the AAD program by Dr. James Graham in 1976. In 1950, the Osborne Fellowship was assigned to the AFIP under the supervision of Dr. Elson B. Helwig, director of the Dermatopathology Registry. In 1977, the Osborne Fellowship was transferred by the AAD to the Dermatology Foundation to support research projects, but the AAD continues its support of the Dermatopathology Registry.
American Board of Dermatology and American Board of Pathology
In 1970, the society approved a resolution to request the two above-named boards to consider provision for Subspecialization in Dermatopathology. In 1971, Dr. Robert Goltz reported that the American Board of Dermatology had proposed such a move to the American Board of Pathology but had received a cool reception. Negotiations were continued, however, and by 1972 a joint Committee for Special Competence in Dermatopathology had been established with three members from each Board. In 1973, an agreement was reached for joint certification, and it was approved by the American Board of Medical Specialties.
The first examination for Special Competence in Dermatopathology was held in 1974 in Washington D.C., and in the same year a Residency Review Committee for Dermatopathology was organized to review and accredit training programs in Dermatopathology. Initially formal fellowship training in dermatopathology was not required to qualify for the examination. Dermatopathologists already in practice were permitted to claim practice time to qualify, but everyone was required to take the examination to receive this certification. The occasion of the first examination was an impressive sight with names such as Lever, Pinkus, Nickel, Winer, Helwig, etc., on the list. Even the members of the Test Committee were required to take an examination, which they did by quizzing each other in a separate room. This examination went uneventfully for most, although quite a few people were nervous about being embarrassed by taking the examination. A few individuals had problems; for example, Dr. Winer was assigned alphabetically to sit at the back of the large meeting room, He could not see the screen when Kodachromes were projected, but he was not allowed to move closer to the screen. Instructions had been sent out that one might need binoculars to see the screen!
In 1982, it was announced that a candidate for certification in dermatopathology must complete a residency in either pathology or dermatology before taking a fellowship in dermatopathology and that at least one year of fellowship training in an accredited program in dermatopathology would henceforth be mandatory before the candidate would be allowed to sit for the examination for Special Competence in Dermatopathology. These committees for dermatopathology examination and for residency review remain active to the present time. They are assisted in the preparation of questions by a test committee for dermatopathology with three members from each specialty. Dermatopathology board certification became a requirement for membership in the ASD.
The Scientific Program
The first scientific program of the American Society of Dermatopathology met December 3, 1963, at 4:30 p.m. for two hours with four speakers, all on the subject of "Melanoma." There were 45 attendees. The printed program covered half a page of paper, triple spaced. In 1991, the scientific program extended over 2–1/2 days with 15 sessions lasting a full day or a half-day, with as many as five sessions running simultaneously, and with more people attending any one session than had attended the first session in 1963. The printed program was a slick preprinted bound booklet with 166 pages and a multicolored cover. Many changes have occurred in the past 30 years!
The first scientific program of the society was held on Tuesday afternoon, 4:30 p.m. to 6:30 p.m., December 3, 1963, in Private Dining Room #18 of the Palmer House in Chicago. Dr. Herbert Lund was appointed the first chairman of the Committee on Program and Research; however, since he was committed to a heavy workload at homes, the next committee member in line, Dr. Richard K. Winkelmann, planned the first program and is listed as the moderator. The program began with a short presidential address by Dr. Montgomery, then the subject of the rest of the program was "Melanoma" and the speakers were Drs. Helwig, Haserick, T. Fitzpatrick and A. S. Zelickson.
The same format was followed in 1964 on "Epidermal Malignancy" and in 1965, with presentations by five different speakers on subjects of their choice. The Tuesday afternoon format with invited speakers continued through 1967. In the 1967 program, Dr. Winkelmann reviewed the highlights of the 78 cases presented at the Pacific Dermatological Association's dermatopathology Seminar. In 1968, the meeting was held at the University Club, Chicago, and it included five speakers and a review of Pacific dermatological cases by Dr. Herbert Lund and Zola Cooper and seminar cases by Dr. James Graham. For the first 15 years of the society, most of the details were dealt with by the secretaries, their personal secretaries, and their spouses. The society is indebted to Mona Nickel, Helen Winer, Ann Graham, Lila Freeman and others for their assistance with registration, record keeping, planning for banquets, prevention of gate crashing at the banquets, and endless other details required to make the meetings as successful as possible.
From 1969 through 1972, the meeting was held on the Friday preceding the academy meeting, allowing more time for the session. The program was composed of about 15 submitted papers by different speakers. All papers submitted were accepted. In 1973 and 1974, the meeting was moved back to the Palmer House and held on Wednesday evening and Thursday afternoon after the academy meeting. During these years, the scientific program consisted of a presidential address and submitted papers entirely. A business meeting was held, usually after lunch, and then the papers resumed. An evening banquet was being held by this time. Also by 1973, the program, for the first time, had expanded beyond one page; it consisted of six mimeographed pages stapled together giving the meeting schedule, the agenda for the business meeting, and a listing of the committees and the past presidents. By 1974, enough papers were submitted to the Program committee to fill the program time and allow selection of topics, with rejection of two or three papers. The abstracts were always reviewed anonymously by the committee members, and their ratings were compiled by the Secretary. Rejections at that time had been unheard of and some of the rejections led to protests and even a proposal that each member be required to present a paper every three years. During these years, many of the abstracts submitted were single ones by individuals, but the program was supported strongly by four or five abstracts every year from the training programs of Dr. Winkelmann and Dr. Bernie Ackerman.
The Self-Assessment Course
In 1975, the scientific meeting was moved permanently to Friday preceding the academy meeting. In this year the first major expansion of the scientific program to two days was achieved with the presentation on Thursday of the first self-assessment course and with submitted papers and business meeting on Friday. The self-assessment course was conceived by Dr. Walter Nickel who also helped arrange for the meeting to be held in the Hotel Del Coronado in Southern California, preceding the AAD in San Francisco. The format for the first self-assessment course was essentially the same as today. Participants reviewed unknown microscopic slides using individual microscopes in the morning, and those same cases are discussed by several discussants in the afternoon. At the first course, Dr. Nickel was assisted by Dr. Louis Winer, Dr. James Graham, Dr. William Reed, Dr. James Nickel, and Dr. Joe Wood. Mr. Gary Nickel of Micro-Optics Co. provided 75 Olympus microscopes for the session. The cases selected were randomly chosen to include a variety of cases from daily practice, with no topical emphasis. Thus the participants were able to gauge their individual performance against the panel of experts. The 75 available microscopes were fully utilized, and a few individuals, including a contingent of Australian dermatologists, were only allowed to sit in on the afternoon discussion.
This program was very successful, and this format has remained extremely popular. It has remained a regular feature of the annual meeting for 17 years, and recently three sessions have been required. It was adapted for the AAD meeting in 1976 by Dr. Graham and the format has been adapted for other dermatopathology courses since.
The similarity of the formatting of this program to the formatting of the 1974 examination for Special Competence in Dermatopathology is striking. That examination was conducted according to the standard format of the microscopic practical examinations given each year by the American Board of Pathology. It was first experienced by dermatologists at the 1974 examination. It is almost certainly the source of Dr. Nickel's idea for the session.
The Special Courses
The Friday scientific session of submitted papers has continued to be well attended, and the Self-Assessment Course on Thursdays has always been fully subscribed. Even in 1975, it was obvious that an interest existed for even more scientific sessions. Some members were interested in a two-day meeting but they did not care to repeat the Self-assessment Course, so plans were begun for a simultaneous scientific session on Thursday. Since then, research-oriented Special Courses have been a regular part of the program, on topics such as Advances in Dermatopathology (1980); From Subjectivity to Objectivity (1981); Nevi and Melanoma (1982); Adnesal Neoplasms and Histiocytic Disorders (1983); Soft Tissue Tumors and Basement Membrane Zone Symposium (1984); Dermatopathologic Clues to Systemic Disease, Dysplastic Nevi, and Ichthyosis (1985); Coetaneous Lymphomas (1986); Silver Anniversary: Landmarks in Dermatopathology, Unconventional Diagnostic Approaches, and Pediatric Dermatopathology (1987); Computer Utilization, Disorders of the Melanocyte, and Dermatopathology in AIDS (1988); Comparative Dermatopathology, Political and Economic Issues, and Eosinophils in Dermatopathology (1989); Molecular Genetics, Mast Cells and Basophils, Lymphohistiocytic Infiltrations, and Historical Perspectives (1990); and Pediatric Dermatopathology Imports (1991).
Poster exhibits were first presented as a part of the program in New Orleans in 1982. This was supervised by Dr. Clark Lambert. The idea was encouraged to allow more members and trainees to participate in the program by presenting data in poster form when they were not allotted a space on the regular program of scientific presentations. This reflects the large number of projects being completed in dermatopathology, in contrast to a decade earlier, when anyone submitting an abstract for the program could get it accepted.
In the early years of the society, nearly all the papers were presentations of descriptive pathology, and at that time, such subjects reflected the interest of the members and were generally preferred by the Program Committee. By 1982, newer techniques, such as immunofluorescence and immunoperoxidase, were being applied to problems in dermatopathology, and these subjects were increasingly included in the programs. Some complained that the program was composed of basic techniques and that it was virtually impossible to get a descriptive pathology paper accepted for floor presentation. For several years, special sessions were held in which poster presenters were allowed to give a brief presentation of their material, but this became too difficult and was discontinued.
Seminal Cases and Slide Sessions
In 1983, the first session of Seminal Cases was scheduled to allow individuals to present a case of interest that was thought-provoking and a subject for discussion. This initially was a three-hour session held on Thursday afternoon, concurrently with the Special Courses. It has been extended to six hours and in 1991 was held as a Wednesday evening session. In 1985, an evening slide session, with viewing and discussion of microscopic slides, was instituted for Friday evening. Thus, there were still opportunities for those interested to present and discuss descriptive pathology, the main basis for the dermatopathologist's daily work. In 1989, a new feature of the program was the presentation of interesting cases from the society's Slide Reference Library, which is maintained under the supervision of Dr. Arthur Balin.
The President's Address has been a part of the society's scientific program from the beginning. The first program lasted only two hours, but Dr. Montgomery, the first president, made a few brief remarks to begin the first meeting in 1963. And, ever since, the Presidential Address has begun the scientific session; it has not been open for discussion from the floor, as are all other papers.
One of the more significant changes in the scientific program is the institution of a special lecture honoring one of the founding members, Dr. Hermann Pinkus. The Pinkus Lecture is given during the scientific session by an invited scientist on a subject of general interest. The Pinkus Lecturers and their topics have been Dr. Tung-Tien Sun, "Pathways of Epidermal Differentiation from Skin to Black Hairy Tongue" (1986); Dr. Clive Taylor, "Immunohistologic Approaches to Tumor Diagnosis" (1987); Dr. Join Ooita, "Molecular Pathology of Collagen in the Skin" (1988); Dr. John R. Stanley, "Examination of Pemphigus and Pemphigoid Under Higher Magnification: Autoantibodies Against Adhesion Junction Molecules" (1989); Dr. Lance Liotta, "Molecular Mechanisms of Cancer Invasion Metastasis" (1990); and Dr. S. Katz, "The Skin Immune System: Allergic Contact Dermatitis as a Paradigm" (1991). This was instituted by the society at the urging of Dr. Kurt Stenn, then secretary-treasurer.
A society dinner or banquet was initiated early in the history of the society. Initially, a speaker was not featured at the banquet. Later, speakers were included, but the records available do not consistently document who these speakers were or the subjects on which they spoke.
Consultations in Dermatopathology
In 1990 and 1991, the newest feature of the program was Consultations in Dermatopathology, a series of informal sessions allowing a small group of participants to review glass slides directly using a multiheaded microscope and discuss topics of interest with one of the "real experts (Masters) in dermatopathology. Such "masters" have included Drs. Ackerman, Barr, Cooper, Headington, McNutt, Mihm, Santa Cruz, Wick and Winkelmann.
The Founders Award
As the society grew and expanded its program and activities, several awards and lectureships were considered, and it was agreed that the society was now able to support such activities. In 1980, the society elected to acknowledge the contributions of the Founding Members by elevating each to the category of honorary member, a designation reserved for those members giving dedicated and meritorious service to dermatopathology. Also, under the guidance of Dr. Kurt Stenn, the secretary-treasurer, a Founder's Award was instituted to recognize those members for long and distinguished service to the society. To date, the following members have received the Founder's Award:
1984 - Dr. Hermann Pinkus
1985 - Dr. Elson B. Helwig
1986 - Dr. Walter Lever
1987 - Dr. Richard K. Winkelmann
1988 - Dr. Wallace Clark
1989 - Dr. A. Bernard Ackerman
1990 - Dr. James H. Graham
1991 - Dr. Robert G. Freeman
Quality Control and Proficiency Testing
The regulation of laboratories became an issue for all laboratories including dermatopathologists with the passage of the Clinical Laboratories Improvement Act of 1967. By 1971, the implementation of the provisions of this act had become a major concern for any laboratory doing business in interstate commerce. In addition, some state governments were becoming involved in laboratory regulation and in making requirements more stringent for relicensure. In 1971, a report on licensure of dermatopathology laboratories engaged in interstate commerce was given at the annual meeting. In 1972, the society approved the establishment of a standing Committee on Peer Review to report on the possibility of establishing a Laboratory Proficiency Testing program, and this report was given in 1973. The society approved the establishment of a program for Quality Control, Proficiency Testing, and Laboratory Inspection at the meeting in 1974, to be implemented beginning in 1975. Dr. James H. Graham was secretary-treasurer and Dr. George Ioannides was the main organizer and first director of the program. The program was to provide a means whereby enrolled members could receive tissues for processing in their laboratory with the slides being reviewed by the committee members to determine proficiency in slide preparation. Second, a set of prepared slides was circulated to participants for their interpretation and evaluation of their diagnostic ability. Third, a laboratory inspection comparable to that given by the CLIA inspectors was offered to individuals who desired an on-site inspection by a society member.
In 1975, 42 subscribers were enrolled. In 1976, 42 enrolled and 17 laboratories were inspected. In 1981, laboratory inspection was discontinued due to lack of interest and the development of alternate accreditation mechanisms. Quality Control and Proficiency Testing programs are still active, and represent the only such program specifically for dermatopathology. A suggestion was considered, but declined, to add a program for quality control for immunofluorescence.
In 1982, a committee was appointed, on the recommendation of Dr. Kurt Stenn, secretary-treasurer, for the collection and archival storage of dermatopathology slides that could serve as a reference collection for the members. This was implemented, and the collection has been maintained since by Dr. Arthur Balin. These slides are available for study and review, and selected cases have been presented at the annual meeting. Contribution of new cases to add to the collection is encouraged.
A Society Journal
As early as 1973, a suggestion was made and an ad hoc committee was appointed to evaluate the feasibility of establishing a society journal. Sentiment was expressed in favor of a Society journal because of difficulty some members had experienced in getting manuscripts accepted in established journals. At the 1974 meeting, Dr. Herbert Lund, committee chairman, reported that the committee did not feel that a journal was feasible at that time and recommended an affiliation with an established journal as an alternative. After this, I was unable to arrange an affiliation with any journal, but Dr. John Epstein, editor of the Archives of Dermatology, agreed to publish the abstracts of the annual meeting of the ASD in the December issue of the Archives that was circulated just prior to the annual meeting in December. This practice was continued until the ASD succeeded in establishing its official journal through Munksgaard.
Later, during the tenure of Dr. Terry Headington as secretary-treasurer, the matter of a society journal was again raised. An ad hoc committee chaired by Dr. Martin Brownstein was appointed to investigate this question. A recommendation was made that the existing Journal of Cutaneous Pathology (Munksgaard) become the official journal, but the decision was delayed a year in order to investigate other alternatives such as a link with the existing American Journal of Dermatopathology or with another publisher to establish a new journal. In the interim, Drs. Brownstein and Mehregan assumed the editorship of the Journal of Cutaneous Pathology. Then on approval of the agreement with Munksgaard, Dr. Evan Farmer became the society's first editor. The second and current editor is Dr. Philip Cooper.
The growth and development of the ASD has been spectacular in its relatively short 30-year existence. I have been privileged to attend every meeting and to be a part of this growth. It was established with a great deal of optimism by its founders at a time when many wondered "Why a society for dermatopathology?" But they correctly judged that the subspecialty of dermatopathology was coming into its own and was beginning to grow. Following Dr. Nickel as secretary-treasurer, Dr. Jim Graham succeeded in putting the society on a firm foundation with new bylaws and incorporation, expanding the meeting to accommodate rising attendance, and instituting new programs such as the quality control and proficiency testing program. The momentum was already mounting when I took over the secretary's job in 1975, and we were able to continue to expand these programs, increase the membership, and increase attendance and double the program to two full days.
During the tenure of Dr. Terry Headington, the membership more than doubled, the program was expanded and ties with pathology groups were strengthened. International interest was stimulated with the result that dermatopathologists in other countries have now established their own national societies while many still attend our meetings. Also, the mechanism for a journal was set in motion. And other troublesome problems for the society were resolved. While he was secretary-treasurer, Dr. Stenn further enhanced recruiting and membership, and also initiated several society activities such as the Pinkus Lectures, the Founder's Award, the Reference Library, a society logo, and a banquet speaker. Dr. Loren Golitz further expanded the program, accommodated a growing membership, guided the society toward greater maturity and initiated discussion of common problems among teachers of dermatopathology. Dr. Toni Hood has overseen a veritable explosion of activity with expansion of the meeting to two and one-half days with 15 different sessions, as many as five of which ran simultaneously, and many of which are still crowded. Along with this, there has been board of directors retreats, establishment of criteria for selecting the founder's awardee, audiotaping of lectures and a resident appreciation award, consultants tutorials, and overall a more polished professional operation than ever before.
I do not think that Dr. Montgomery or Dr. Nickel, or others who did not live to see it, would believe what has grown out of their little huddle late one Tuesday afternoon in 1962 in the Red Lacquer room of the Palmer House. It is amazing to see the interest, attendance and enthusiasm shown by this group when they get together. It is unparalleled. It is time to look back for a moment and thank those who made it possible. It is also time to look forward and resolve to carry on with the dedication, selflessness and enthusiasm it will take to maintain the momentum and achievement for the public good.