Moritz Kaposi, MD

Moritz Kaposi – Photo credit: Unknown – Images from the History of Medicine (NLM), Public Domain; Wikipedia Commons

 

According to his biographer, Dr. J.D. Oriel, “in his lifetime, Moritz Kaposi, MD, was acknowledged as one of the great masters of the Vienna School of Dermatology, a superb clinician and renowned teacher“. While his mentor, Ferdinand von Hebra, is considered the “father of dermatology“, Kaposi was one of the first to establish dermatology on its anatomical pathology scientific basis. He became the chairman of the Vienna School of Dermatology, after Hebra’s death in 1880.

 

Moritz Kaposi, a Hungarian physician, was born on 23 October 1837 in Kaposvar, Austria-Hungary and died on 6 March 1902 in Vienna. This well-known physician is best known as the dermatologist who discovered the skin tumor that received his name (Kaposi’s sarcoma). Kaposi was born to a Jewish family, whose original surname was Kohn. But with his conversion to the Catholic faith, he changed it to Kaposi in 1871, in reference to his town of birth. One purported reason behind this is that he wanted to marry a daughter of current dermatology chairman, Ferdinand Ritter von Hebra, and advance in the society, which he could not have done being of Jewish faith. This seems unlikely because he married Martha Hebra and converted to Catholicism several years prior to changing his name, by which time he was already well established in the Vienna University faculty and a close associate of von Hebra. A more plausible explanation is based on his own comments to colleagues that he changed his name to avoid confusion with five other similarly named physicians on the Vienna faculty. Rumors about the sincerity of both his marriage and his concerns about his Jewish ancestry may have arisen through professional jealousy. According to William Dubreuilh (1857-1935), first professor and chairman of dermatology in Bordeaux: “On disait de Kaposi qu’il avait pris la fille de Hebra, sa maison, sa chaire et sa clientele, laissant le reste a son beau-frere Hans Hebra.“ – “It was said of Kaposi that he had taken the daughter of Hebra, his home, his chair and his clientele, leaving the rest to his brother-in-law, Hans Hebra.“

 

In 1855, Kaposi began to study medicine at the University of Vienna and attained a doctorate in 1861. In his dissertation, titled Dermatologie und Syphilis (1866), he made an important contribution to the field. Kaposi was appointed as professor at the University of Vienna in 1875, and in 1881 he became a member of the board of the Vienna General Hospital and director of its clinic of skin diseases. Together with his mentor, Ferdinand Ritter von Hebra, he authored the book Lehrbuch der Hautkrankheiten (Textbook of Skin Diseases) in 1878. Kaposi’s main work, however, was Pathologie und Therapie der Hautkrankheiten in Vorlesungen fur praktische Arzte und Studierende (Pathology and Therapy of the Skin Diseases in Lectures for Practical Physicians and Students), published in 1880, which became one of the most significant books in the history of dermatology, being translated to several languages. Kaposi is credited with the description of xeroderma pigmentosum, a rare genetic disorder now known to be caused by defects in nucleotide excision repair (“Ueber Xeroderma pigmentosum. Medizinische Jahrbucher, Wien, 1882: 619-633“). Among other diseases, Kaposi was the first to study Lichen scrofolosorum and Lupus erythematosus. In all, he published over 150 books and papers and is widely credited with advancing the use of pathologic examination in the diagnosis of dermatologic diseases.

 

Kaposi’s name entered into the history of medicine in 1872, when he described for the first time Kaposi’s sarcoma, a cancer of the skin, which he had discovered in five elderly male patients and which he initially named “idiopathic multiple pigmented sarcoma“. More than a century later, the appearance of this disease in young gay men in New York City, San Francisco and other coastal cities in the United States was one of the first indications that a new disease, now called AIDS, had appeared. In 1993, the discovery that Kaposi’s sarcoma was associated with the herpesvirus, sparked considerable controversy and scientific in-fighting until sufficient data had been collected to show that indeed KSHV was the causative agent of Kaposi’s sarcoma. The virus is now known to be a widespread infection of people living in sub-Saharan Africa; intermediate levels of infection occur in Mediterranean populations (including Israel, Saudi Arabia, Italy and Greece) and low levels of infection occur in most Northern European and North American populations. Kaposi’s sarcoma is now the most commonly reported cancer in parts of sub-Saharan Africa. Kaposi’s sarcoma is usually a localized tumor that can be treated either surgically or through local irradiation. Chemotherapy with drugs such as liposomal anthracyclines or paclitaxel may be used, particularly for invasive disease. Antiviral drugs, such as ganciclovir, that target the replication of herpesviruses such as KSHV have been used to successfully prevent development of Kaposi’s sarcoma, although once the tumor develops these drugs are of little or no use.

 

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