Publication Analysis 2005-2011
by Kathleen Gransalke, Labtimes 05/2014

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Germany has a particularly long tradition in dermatology research. And our publication analysis is proof. The country leads both nations and most-cited authors ranking.

“To have a thick skin”, “by the skin of one’s teeth”, “to be scared out of one’s skin” – our protective barrier against the outside world has made itself comfortable in our everyday parlance. And that’s no big surprise. The largest organ of our body is also the most visible one. Made up of three primary layers – epidermis, dermis and subcutaneous tissue – skin is also an important factor in a person’s physical attractiveness. And here we enter the realm of poetry.

Aside from the heart (typically not because of its physiological function), the skin is perhaps the most sung/written about human organ. Recently, British dermatologists even blamed William Shakespeare as being responsible for our negative attitude towards impure skin. “Rat-infested with open sewers, overcrowding and sexual promiscuity, Elizabethan London was a melting pot for diseases such as plague, syphilis and smallpox. Tell-tale cutaneous signs heightened the fear of contagion (…) Shakespeare was no stranger to insults derived from skin troubles. (…) Rhinophyma [a large, red-coloured nose] seems to have triggered Shakespeare’s sense of humour, likening the resultant erythema to the glow of a lantern: ‘thou art a perpetual triumph, an everlasting bonfire night. Thou hast saved me a thousand marks in links and torches’ (Henry IV). While infective lesions such as boils, carbuncles and pox were often used as curses and insult,” write Catriona Wootton, Queen’s Medical Centre, Nottingham, and colleagues in the British Journal of Dermatology, adding that “Shakespeare uses these negative undertones to his advantage, employing physical idiosyncrasies in his characters to signify foibles in their behaviour.”

Germany – The country of dermatologists

Obviously, over the next 500 years, hygiene and sanitation improved and many infectious skin diseases disappeared. But enough remained or has newly emerged to keep European dermatologists busy, also in the 21st century. Our publication analysis “Dermatology” gives you an idea of the hot spots, the hottest topics and the most-cited authors of skin research in Europe between 2005 and 2011.

Let’s begin, as usual, with the “places to be” for any ambitious dermatologist. For our country ranking, we, once again, relied on the so-called “expert journals”, as defined by the Web of Science database. The resulting list for European countries revealed a very clear leader. With almost twice as many citations (and even more papers) than runner-up, England, Germany is apparently not only the “country of poets and thinkers” but also the country of dermatologists. France and Italy follow in 3rd and 4th place. Looking at the citations per article ratio, one country that didn’t even make the cut for our top 20 nations scored particularly well. Researchers working in Iceland – 25th according to total citations – submitted only 25 articles, reviews or proceedings papers to dermatology expert journals but those few papers gathered more than 600 citations, resulting in a citations per article ratio of 24.3. Also doing well in this category are Scotland (18.7), Wales (17.8) and Denmark (17.4). Internationally, European dermatologists wrote more articles and collected more citations than their US-American colleagues but, still, US dermatologists received more citations per article (13.2 vs 10.7) than their European peers.

Melanoma papers excluded

Next, let’s have a look at the discipline’s most-cited papers, presumably reflecting the hottest topics in dermatology research between 2005 and 2011. Well, in this case, it didn’t work out quite as imagined. Did you begin to wonder why there is no paper on melanoma research among the top five? There’s a simple reason. Although some of our most-cited authors, including Caroline Robert (2nd), Dirk Schadendorf (3rd) and Céleste Lebbé (7th), contributed to the would-be top two papers “Improved Survival with Ipilimumab in Patients with Metastatic Melanoma” (N Engl J Med, 363(8):711-23, over 1,700 citations) and “Improved Survival with Vemurafenib in Melanoma with BRAF V600E Mutation” (N Engl J Med, 364(26):2507-16, over 1,500 citations), the reprint addresses are in the USA and therefore excluded from our analysis. Thus, our top paper spotlight is on other, not less important-to-study, skin disorders like cutaneous lymphoma (a cancer of lymphocytes that leads to itchy and thickened patches of skin and tumour formation), dermatitis (an inflammation of the skin, often triggered by contact with certain metals like nickel, gold or chromium) and psoriasis (a sometimes painful condition of scaly, dry patches of skin, caused by hyperproliferation of epidermal keratinocytes).

Which brings us to our most-cited dermatologists in Europe, who published articles, reviews or proceedings papers between 2005 and 2011. Before we go into detail, a quick word about our inclusion/exclusion criteria, especially concerning melanoma researchers. To make it into our top 30 most-cited researchers list, scientists must have published a significant amount of papers in dermatology expert journals. To be more specific, we defined that when “Dermatology” appeared as one of the top three research areas of a given scientist in the Web of Science database, he or she can pass off as a “born-and-bred” dermatologist.

Now, looking at the researcher’s affiliations, we have had to shake our head in astonishment quite a few times. Half of our most-cited researchers (in numbers: 15 of 30!) are employed at institutes in Germany. But this was not the only surprise. All three top dermatologists from France are women. And they did amazingly well: Caroline Robert came in at second place, and with Céleste Lebbé (7th), there’s another French female scientist among the top 10. By comparison, no single French researcher managed to snatch a top 30 spot in our previous dermatology publication analysis from 2008. Also, the three Austrian top dermatologists have one thing in common: they all work or worked at the University of Graz. At the other end of the spectrum, UK dermatologists must make up their leeway, it seems. Only three (one in Scotland, two in England) were able to collect the necessary amount of citations.

So, what are the favourite topics of our distinguished circle of highly-cited “skin doctors”? They are mostly related to diseases of the skin, of course. In particular, to cancers of the skin (melanoma and cutaneous lymphoma) and (allergic) inflammation of the skin (dermatitis). Focussing on the black cancer are, for instance, Caroline Robert (2nd), Dirk Schadendorf (3rd), Claus Garbe (5th), Axel Hauschild (12th), Brigitte Dreno (19th) and Jürgen Becker (26th), who is also interested in Merkel cell carcinoma. Studying cutaneous lymphomas is high on the agenda of our number one dermatologist, Wolfram Sterry (1st), at the Charité in Berlin. Berlin is, incidentally, also the cradle of dermatopathology, with Gustav Simon (1810-1857), professor at the Charité, publishing the first textbook “Die Hautkrankheiten durch anatomische Untersuchungen erläutert” (“Skin diseases elucidated by anatomic investigation”) of the new discipline. Lymphomas aren’t Sterry’s only area of expertise. In other experiments, together with Jürgen Lademann (18th), he tested whether the porcine snout is a good in vitro model for human lips (Exp Dermatol, 14(2):96-102). Their answer: yes, it is. Cancers involving the skin is also of interest to Reinhard Dummer (4th) and Rein Willemze (14th).

Most researched: cancers of the skin and dermatitis

Dermatitis is the second big field of research for our top 30 dermatologists. W. H. Irwin McLean (8th), Johannes Ring (9th), Thomas Bieber (16th), Alan Irvine (17th) and Natalja Novak (28th) spend some of their precious research time understanding this disease. Similar to atopic dermatitis, another skin disorder, ichthyosis vulgaris, is also believed to be caused by a mutation in the filaggrin gene (Nat Genet, 39, 650-4). McLean and Irvine are also on this case.

A few researchers opted in their research for less ‘popular’ dermatological topics. Sabine Werner (22nd), for instance, studies the parallels between wound healing and cancer, Marcus Maurer (29th) urticaria (hives) and Ralf Paus (6th) hair disorders and skin stem cells. Paus might be familiar to some of you, following the Silvia Bulfone-Paus case three years ago.

In the 16th century still waved aside as the outer envelope that holds everything together, skin has since increasingly become acknowledged for what it really is: our protection, our contact, our business card to the outside world. Not surprisingly, skin care products for body, hand and sun care as well as anti-aging and anti-wrinkle creams are one of the cosmetics industry’s biggest blockbusters. A recent report by Research and Markets forecasts revenue of $102.3 billion (approx. €80 bn) in 2018. If only the same amount of money would be invested into dermatology research...

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Last Changed: 16.09.2014