Roberto Núñez Andrade (1905-1979) was a prominent Mexican dermatologist who focused a big part of his clinical practice to the treatment and knowledge of cutaneous disorders of children. Due to his scientific contributions, he is considered a pioneer of pediatric dermatology in Mexico.
Roberto Núñez Andrade (1905-1979), fue un destacado dermatólogo mexicano interesado en las enfermedades de la piel de los niños, quien por sus aportaciones científicas y por haber enfocado una parte de su práctica clínica a las dermatosis infantiles, debe ser considerado un precursor de la dermatología pediátrica en México.
The Hospital Infantil de Mexico (HIM) was inaugurated in 1943, with the objectives of providing healthcare to sick children, promoting education in pediatrics and conducting research concerning health and social issues affecting the Mexican population1. Since then, it has been an institution of great importance for the development of pediatrics in Mexico and the place where a division of activities, or subspecialties, was established from its early days in our country. This division was done with the goal to carry out appropriate assistential duties, which were not limited to only the grouping of diseases according to their nature but also considered other aspects, such as the differences between the care of a child and an adult and the need to study in greater depth certain disorders2.
Nonetheless, the attention of skin diseases in children and adolescents—currently known as pediatric dermatology—was defined as a medical subspecialty until the 1970s. However, there were previous pioneers in this field. Among them is Henry Harris Perlman, a physician in Philadelphia, USA, certified in dermatology and pediatrics, who was probably the first to limit his clinical practice to the management of dermatosis in children3.
In Mexico, Dr. Roberto Núñez Andrade (Figure 1), the first dermatologist at the HIM2,4,5, was also interested in the care of children with skin diseases. Despite his notable contributions, he is a little-known character in the history of medicine in Mexico. Therefore, the objective of the present work was to write a biographical sketch of his professional trajectory.
2Personal and professional background
Dr. Roberto Núñez Andrade was born on June 7, 1905, in Huejutla, Hidalgo. His parents were Francisco A. Núñez and Eva Andrade de Núñez. He started his studies at his native town. Subsequently, he continued his academic formation in Mexico City. He was a student at the National Preparatory School and the National School of Medicine, where he studied medicine from 1924 to 19295,6. Due to his economic conditions, he received a scholarship from the state of Hidalgo to study high-school and Medicine. Given his academic performance, he was awarded a gold medal, granted by the Rotary Club of Mexico City. Dr. Núñez Andrade presented his professional examination on June 16 and 17, 19305 with a thesis entitled Considerations on cervical cancer and its treatment7. Later, he was inclined to Dermatology. Thus, he was trained in this area of medicine at hall No. 10 of the General Hospital of Mexico, under the tutorship of Dr. Salvador González Herrejón6,8.
In 1933, Dr. Núñez Andrade attended the Course of most common skin diseases in children, given by Dr. González Herrejón, as part of the academic activities to commemorate the centenary of the National School of Medicine5,9. Afterwards, he attended a postgraduate course in Leprology at the U.S. Marine Hospital in Carville, Louisiana, USA, with the help of a scholarship jointly granted by the U.S. Public Health Service, the Leonard Wood Memorial and the Department of Inter-American Affairs5. Roberto Núñez Andrade died in Mexico City on January 5, 19796,8.
3His work at the Hospital Infantil de Mexico and his interest in skin diseases in childrenThe professional activity of Dr. Núñez Andrade can be divided in two stages according to the position he held at the HIM. In the first stage, he was head of the Dermatology and Syphilology service from 1943 (year of inauguration of the hospital) until 1950, when the area was transformed into a mixed ward due to the disappearance of cases of congenital syphilis5,6. During this time, he published several cases in the Boletín Médico del Hospital Infantil de México, the institution's official journal10–13. His most well-known contribution was the description of a new cutaneous parasitosis, trombidiasis by Neoschoengastia nuñezi6,8,14, molluscoid dermatitis by Neoschoengastia Nuñezi Hoffmann or Núñez-Andrade disease15. In September, 1944, he presented a report of six patients, members of the same family, afflicted with a generalized, pruriginous dermatitis, characterized by molluscoid elements at the hospital's clinical session. A microscopic exam of the product of these lesions revealed the presence of numerous parasites, which were identified at the Institute for Salubrity and Tropical Diseases by Anita Hoffmann16. The causal agent was named Neoschoengastia nuñezi n. sp., in honor of Dr. Roberto Núñez Andrade17. It should be noted that this disease is not exclusive to childhood16. However, this finding described in the HIM, along with the discovery of the treatment of hemorrhagic colitis in children with sulfonamides, were considered by Dr. Ignacio Chávez as the two most important Mexican contributions to pediatrics made until that date18.
In a second stage, between 1950 and 1969, Dr. Núñez Andrade worked in the Outpatient Clinic of the Hospital Infantil de Mexico as a consulting dermatologist5,6. Since 1956, the Dermatology consult was integrated within the Allergology service19, which in 1967 changed its category to Department of Allergology and Dermatology and was headed by Dr. Luis Gómez Orozco. According to its organization, the consultant dermatologist functions were the following: providing medical attention, offering counseling, conducting clinical research, collaborating in the planning of programs and education and to participate in the clinical and bibliographical sessions20. In 1968, Dr. Núñez Andrade published an article in the Boletín Médico del Hospital Infantil de México regarding genodermatoses, in which he carried out an ample revision on the subject and presented a brief description of five new entities21. In 1969, Dr. Núñez Andrade retired from the hospital. Dr. Rigoberto Aguilar Pico, the hospital's director, gave him a gold medal and a diploma for 25 years of service and appointed him as Emeritus Honorary Counselor of the Dermatology Service. Moreover, from the Department of Allergology and Dermatology, he received a diploma acknowledging him for his work and as a professor of Mexican dermatology5.
Dr. Núñez Andrade's interest in the dermatosis affecting children was not only limited to his work at the HIM. He was a member of the Mexican Pediatric Association and Dermatologist at the National Children's Boarding School5, in which, in 1945, he described the first 21 cases of Haematosiphoniasis, a dermatosis caused by the stings of Haematosiphon inodora Duges (commonly known as Mexican chicken bug), which affected children and personnel of the institution22. Furthermore, he conducted several works about infantile dermatological diseases that contributed to the medical education. In 1970, he collaborated with the edition of the Pediatrics Manual by Rogelio Hernández Valenzuela5 and published some review articles concerning cutaneous manifestations of some infectious diseases that were part of his life in institutions like the congenital syphilis23 and tuberculosis24 or leprosy, which were important to diagnose and treat adequately due to their endemic character in the country25. These contributions became invaluable knowledge for the practice of medicine.
4Other professional activitiesDr. Núñez Andrade held different positions in the Department of Public Health. He was a medical inspector and deputy assistant of the Federal Service of Leprosy Prophylaxis, health delegate in Quintana Roo, Morelos and Tamaulipas5,6, assistant medical officer of the Venereal Disease Service and the Antituberculosis Service. In 1938, through an opposition contest, he was appointed head of the Leprosy Service of the General Hospital of Mexico, and from 1939 to 1941 he served as a director of the Hospital Pedro López for leprosy patients in Zoquiapan, State of Mexico5. He was a dermatologist at the Anticancer Dispensary Dr. Ulises Valdés, and he served as head of the Department of Dermatology of the Hospital Juárez from 1947 to 19675,6,8.
This personage was distinguished by having an outstanding trajectory in teaching. He was a clinical professor of Dermatology at the School of Medicine of the National Autonomous University of Mexico (UNAM) for 25 years5,6,8 and of the Courses for Post-Graduates offered by the Mexican Society of Dermatology and the School of Pediatric Nurses. In 1940, he founded the chair of Dermatology at the School of Medicine of the National Polytechnic Institute5, where he taught until his death6,8. He participated as a writer in the Dermatology section of the Revista Medicina5. Dr. Núñez authored some chapters in books like José Luis Cortés’ Clinical Dermatology5,6,8,15 and over 150 articles, mainly about leprosy and dermatology. His work was characterized for studying dermatozoonoses and genodermatoses5,6.
In 1936, Dr. Núñez Andrade in collaboration with Dr. Fernando Latapí contributed to the foundation of the Mexican Society of Dermatology6,8, an association in which he was appointed president from 1946 to 1948. He was member of several international medical societies of Dermatology and national societies of different specialties5. In 1952, he was one of the founders of the Mexican Academy of Dermatology5,6. In 1947, on the occasion of his admission to the National Academy of Medicine as a member of the Dermatology section, he presented a work regarding the molluscoid dermatitis that he had previously described at the HIM26. As this was an original contribution, his lecture received favorable comments27. Subsequently, the dermatozoonoses were the subject of other works which he presented in the clinical sessions of this society13 and some articles that he published in the Gaceta Médica de México22,28.
Dr. Roberto Núñez Andrade (1905-1979) was a dermatologist with an ample professional trajectory that comprised numerous activities involving hospital care, university teaching and clinical research. Children's dermatoses were the object of his attention. His performance in this field of medicine made him a forerunner of pediatric dermatology in Mexico. As a result of his professional activities during a great part of his life in institutions like the HIM and the National Children's Boarding School, he studied the skin conditions present in the children's consult, described some clinical pictures, and with his publications, contributed to the dissemination of medical knowledge about a future specialty.
Conflict of interestThe author declares no conflict of interest of any nature
To Gamaliel Andrés Pineda Cervantes, library manager of the Mexican's National Academy of Medicine, C.S., for his support in the search of the material and for providing the picture of Dr. Roberto Núñez Andrade.
Please cite this article as: Vega-Morquecho OA. Semblanza del doctor Roberto Núñez Andrade (1905-1979): el primer dermatólogo del Hospital Infantil de México. Bol Med Hosp Infant Mex. 2016;73:357–360.