Pioneers in dermatology and venereology: an interview with Prof. Marcia Ramos‐e‐Silva

Marcia Ramos-e-Silva graduated from the Medical School of the Federal University of Rio de Janeiro in December 1978. After that, she was a resident in Dermatology for 2 years at the State Institute of Medical Assistance of Rio de Janeiro. At the end of her residency, she became, by being approved in examinations for obtaining these positions, Dermatologist of the State Institute of Medical Assistance of Rio de Janeiro and also of the National Institute of Medical Assistance. She also worked after her residency as a dermatologist at the Evandro Chagas Tropical Diseases Hospital for two years, gaining a great experience in this group of diseases. The degrees of MS and PhD in Dermatology from the Federal University of Rio de Janeiro were obtained in 1987 (Thesis: ‘Focal Acantolytic Dyskeratosis – Dyskeratosis follicularis – clinical or histopathological entity?’) and in 1992 (Thesis: ‘Capillaroscopy of Psoriasis’), respectively. She also has a second PhD degree from the University of Rio de Janeiro, which is another federal university in Rio de Janeiro. Her postdoctoral degree was with Prof. Larry Milikan, 2003–2004, at Tulane University, New Orleans, studying keloids. Dr. Ramos-e-Silva became Associate Professor in 1992 and the first woman Full Professor of the Federal University of Rio de Janeiro in 2015, both through dermatology examinations and CV analysis by a board of 5 full professors. She lived in the United Sates twice, from age 6 to 7 when she studied in elementary school, and also from age 16 to 18, when she studied in senior high school and college. She also lived in the city of Belem, located in the Amazon region, for one year; all these because of her father’s work in the Brazilian Navy. This made her to like very much to travel since a young age and gave her a good sense and culture from other different population groups and experiences. Professor Ramos-e-Silva was given several awards and honours, as the Maria Duran Lectureship and Honors of the International Society of Dermatology, received during the 2019 World Congress of Dermatology, Milan, Italy; the International Clinical Care Award of the European Academy of Dermatology and Venereology, received during the 2018 EADV Congress, Paris; 51st Jabuti Award 2009 – 1st place for the book Ramos-e-Silva M, Castro MCR. eds. Fundamentos de Dermatologia in the category of Health and Natural Sciences (most important literary award in different categories in Brazil); the Women’s Dermatologic Society International Pioneer Award for Distinguished Women in Dermatology, received at the World Congress of Dermatology, October 2007, Buenos Aires, Argentina; and the Maria Duran Medal of the International Society of Dermatology for Leadership in Dermatology, received during the 2005 CILAD Congress, Cartagena, Colombia. She is an honorary member of the following societies: American Academy of Dermatology since 2019; Philippine Dermatological Society since 2018; Canadian Dermatological Association since 2008; American Dermatological Association since 2005; Maltese Association of Dermatology and Venereology since 2003; and Cuban Society of Dermatology since 1996. She has given more than 900 lectures and presentations in almost 50 different countries. Currently, she holds positions in many important societies and editorial boards and has more than 400 articles and book chapters published, besides 6 books. Her major interests in research are acne, lichen planus, keloids, oral dermatology, photoageing, psoriasis and tropical dermatology. I wanted to be a physician since the age of 12 but I entered medical school thinking of becoming a paediatrician. My grandfather was a very important and well-known dermatologist in Brazil, and since he was born in the 19th century, in his mind, women were not supposed to be doctors. He tried to, very smoothly, convince me to do something else, such as becoming a teacher, which was the ‘right’ career for women. When I was approved after the very hard examination to enter medical school, he wrote me such a wonderful letter saying he was the proudest grandfather in the world and from then on, he began helping me and orientating my career decisions. During my fourth year in medical school, when I went through the specialty of Dermatology, I loved it, and during my fifth year my grandfather invited me to attend, as an observer, the dermatology department where he worked at the time – the Evandro Chagas Tropical Diseases Hospital, at the Oswaldo Cruz Foundation. And that experience was a turnaround. By watching his example, his work, his investigations and his patients, I decided to become a dermatologist. Prof. João Ramos-e-Silva, my grandfather; Prof. Glyne Leite Rocha, Chair of my Residency Program, at the State Institute of Medical Assistance of Rio de Janeiro; and Prof. Absalom Filgueiras, Chair of my MS and PhD Program, the Federal University of Rio de Janeiro. And I also had two excellent mentors in the United States at the beginning of my international career: Dr. Larry Millikan, Chair of Dermatology of Tulane University, and Dr. Lawrence Parish, Professor of Dermatology at the Thomas Jefferson University. I learned the most from my grandfather, with whom I began working at the Evandro Chagas Tropical Diseases Hospital, since my 5th year of medical school, and later also in his private office. And from Prof. Glyne Leite Rocha, as well, who was also my first boss after my Residency Program, and certainly from many other dermatologists, my students and my patients. My greatest achievement in my professional life was obtaining the position of Full Professor of Dermatology at the School of Medicine of the Federal University of Rio de Janeiro. Full Professorship is a position that very few people reach in Brazil. It is the last, most important step and the coronation of an academic career at a university in my country. My greatest disappointment is not being able to consult/diagnose/treat all the poor patients that need the help of our field of dermatology. It is very upsetting and discouraging to have to refuse some of the patients because we do not have enough beds. There are not sufficient professionals to perform consultations or that these consultations are in such a distant time that the patient will certainly get a lot worse. When I was a resident, the dermatologist that taught me and all the others about venereal diseases was a wonderful professor but he was always very afraid of catching those diseases, so it was hilarious to watch him during the consultations, telling the patient not to get nearer and having a big lamp between him and the patient, among other things, to avoid proximity with them. We had great laughs after these consultations supervised by him. And many others… And many, many more… The greatest problems will be the extreme high cost of medications and also the difficulties in separating the serious, good and knowledgeable dermatologists from the “fake” ones. Nowadays, we already have many that only know cosmetics and do not want to learn about physiopathology of the skin and cutaneous diseases but in my opinion, one cannot be a good cosmetic dermatologist if he/she does not know clinical dermatology in depth. New or old medicines with fewer side-effects for previously untreatable diseases, including the genetic therapies; less surgical procedures and more medications accomplishing the cure of cancer, like melanoma and other malignancies. Better and more efficient medications for autoimmune, infectious diseases and other severe diseases, with much less side-effects. And last but not least: a much better quality of life with ageing, with an overall improvement of the whole body functions, which certainly includes the skin aspect and a lot better self-esteem. Note: The Pioneers in Dermatology and Venereology interview was conceived and conducted by Johannes Ring.

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