In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe – others unsung heroes. All of these colleagues have much to share from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them.
Biography: Dr. Wen-Hung Chung has served as a dermatologist at Chang Gung Memorial Hospital, Taiwan, since 1999. In 2008, he received his PhD from the Taiwan International Graduate Program, sponsored by Academia Sinica — a research institute with the highest scientific impact — and National Yang Ming University. Dr. Chung’s research started in 2002 in the field of cutaneous adverse drug reactions. His most important finding was the strong association between the HLA-B*1502 allele and Stevens Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN), which was first published in Nature in 2004. His ongoing research has found the crucial role of granulysin in the pathogenesis of SJS/TEN. Dr. Chung has won numerous awards, including the 2011 ILDS Young Dermatologist International Achievement Award. He was also named one of the Top 10 Rising Stars in Taiwan in 2006 and one of the Ten Outstanding Young Persons in Taiwan in 2009.
Q. What part of your work gives you the most pleasure?
A. Devoting myself to research and clinical management of patients with severe drug hypersensitivity has always been pleasing for me. The feeling when patients recover from severe cutaneous adverse reactions such as SJS or TEN brings me great satisfaction.
Q. Are an understanding and appreciation of the humanities important in dermatology and why?
A. An understanding and appreciation of the humanities are essential and very important in dermatology and also other specialties. To solve patients’ suffering, I need not only my dermatologic specialty, but empathy as well. Diseases such as SJS or TEN cause patients to endure both physical and mental pressures. As a dermatologist, I treat patients’ diseases, and the inevitable thing is to comfort patients’ feelings at the same time. In particular, these patients may have lifelong complications and after-treatment follow-up appointments; furthermore, there is actively tracking the possible similar predisposition of family members. One of the most valuable things is helping patients return to their life normally — such a passion encourages me to sustain both my clinic and research work.
Q. What is your greatest regret?
A. Patients who die from TEN or severe drug hypersensitivity bring me the greatest regret every time. It is not only because of the deep sincere sympathy to their deaths from my heart, but also because of my disappointment of not being able to provide effective treatment from current knowledge.
Q. Which patient had the most effect on your work and why?
A. I remember 10 years ago there was a patient with TEN caused by antiepileptics; before his death, he asked me to study his gene to avoid other people developing the same disease. TEN is a life-threatening disease that causes large areas of skin detachment, just like in burn patients. It was the motive for me to study the genetic link of SJS and TEN, and I finally found a strong HLA-B*1502 association related to carbamazepine-induced SJS/TEN. The legacy of this patient did prevent the tragedy of other patients developing SJS/TEN after taking carbamazepine, now the leading cause of SJS/TEN in Asian countries. This genetic finding has prompted the FDA and the Taiwan Department of Health and also other countries to re-label the drug warning information and suggest having a test before prescribing this drug.
Q. What is the best piece of advice you have received and from whom?
A. There is a Chinese proverb that expresses humanities to the life of being a good doctor; it advised me when I was in medical school. A doctor is more than an occupation; it is a responsibility I have to put myself in with the work, body and soul. Being a good doctor to serve patients, solve their problems and care for their needs is much more important than being a famous doctor.
Q. What is the greatest political danger in the field of dermatology?
A. Less and less dermatologists devote themselves to traditional dermatologic diseases. Instead, young dermatologists are attracted to cosmetic medicine. The value from solving patients’ suffering is priceless and cannot be evaluated by money alone.
Dr. Barankin is a dermatologist based in Toronto, Canada. He is author-editor of six books in dermatology and is widely published in the dermatology and humanities literature. He is also co-editor of Dermanities (dermanities. com), an online journal devoted to the humanities as they relate to dermatology.