Albert Montgomery Kligman (March 17, 1916 – February 9, 2010)was an American dermatologist who co-invented Retin-A, the acne medication, with James Fulton in 1969. Kligman is known for the medical experiments he performed on inmates at Holmesburg Prison in Philadelphia, and the resulting scandal that followed years later. The experiments intentionally exposed humans to pathogens and the chemical warfare agent dioxin, and later became a textbook example of unethical experimenting on humans. He and others involved were sued for alleged injuries, but the lawsuit was dismissed due to the statute of limitations expiring.
Albert Montgomery Kligman was born in Philadelphia on March 17, 1916, the son of Jewish immigrants. His father, born in Ukraine, was a newspaper distributor; his mother, born in England, was a sales clerk. As a child, he was a Boy Scout, developing a love of plants on scouting trips to the countryside.
With financial support from Simon Greenberg, a major rabbi of the time, he attended Pennsylvania State University, earning a bachelor's degree in 1939. He was captain of the gymnastics team.
He went on to receive a Ph.D. in botany from the University of Pennsylvania in 1942, specializing in the study of fungi. He continued at the University of Pennsylvania, enrolling in its medical school, earning his M.D. in 1947. He chose dermatology as his specialty in order to apply his expertise in fungi.
Upon graduation, he joined the dermatology faculty as an associate, also signing on at the Hospital of the University of Pennsylvania.
Kligman was a prolific scholar and was known for bringing scientific rigor to a field that, at the time, was lacking it. Kligman wrote numerous papers on run-of-the-mill dermatological conditions such as athlete's foot and dandruff. He also worked at the intersection of cosmetics and medicine. [ citation needed ]
The identification of the use of tretinoin along Dr. James E. Fulton and Dr. Gerd Plewig as a treatment for acne and wrinkles was perhaps their best-known contribution to dermatology. Sold as Retin-A, this innovation earned Kligman significant royalties. He was a generous supporter of the department of dermatology at the University of Pennsylvania and donated over $4 million by 1998.
Kligman is best known for having conducted human experiments on prisoners at Holmesburg Prison in Philadelphia. Stemming from early testing of treatments for ringworm, his work there started with an effort to control athlete's foot at the invitation of prison officials. He found the environment fraught with possibilities, and undertook dozens of experiments on prisoners there for pharmaceutical companies and government agencies. Between 1951 and 1974, Kligman exposed approximately seventy-five prisoners at Holmesburg to high doses of dioxin, the contaminant responsible for Agent Orange's toxicity. Dow Chemical paid Kligman $10,000 to conduct the experiments on the toxicity effects of this chemical warfare agent. While the prisoners were paid for their participation, little effort was taken to assure the safety of the test subjects, some of whom were intentionally exposed to pathogens causing infections, including herpes, staphylococcus, and athlete's foot. Moreover, Kligman's payment of subjects had other unintended consequences: the economic power gained by subjects was used by some of them to "coerce sexual favors from other inmates".
Kligman's prisoner testing for the government was not limited to dermatology, extending even to the testing of psychoactive drugs for the Department of Defense.
While Kligman maintained that the testing was consistent with scientific and ethical norms of the era, nearly 300 subjects tested while in prison sued him, the University of Pennsylvania, and Johnson & Johnson. The lawsuit was brought because of violations of the Nuremberg Code. Though the suit was dismissed under the statute of limitations, the public reaction to the testing program contributed to the enactment of federal regulations restricting medical studies in prisons.Later commentators, including Senator Ted Kennedy, remarked how, in spite of the sets of ethical principles laid out in the 1947 Nuremberg Code and (much later) the Declaration of Helsinki, the poorer members of society typically bore the brunt of unethical biomedical research; Kligman's research at Holmesburg prison has become a textbook example of such unethical experimenting, and has been denounced as equivalent to "the barbarity and sadism of Auschwitz and Dachau."
Beyond the controversies relating to the testing on prisoners, Kligman was found to have discrepancies in the data underlying his experiments. This led to his research being barred by the Food and Drug Administration for a period.
Kligman was married three times. He divorced from his first wife and became a widower from his second. He died of a heart attack in February, 2010, at age 93. He was survived by his third wife.
Polychlorinated dibenzodioxins (PCDDs), or simply dioxins, are a group of polyhalogenated organic compounds that are significant environmental pollutants.
Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.
Isotretinoin, also known as 13-cis-retinoic acid and sold under the brand name Accutane among others, is a medication primarily used to treat severe acne. It is also used to prevent certain skin cancers, and in the treatment of other cancers. It is used to treat harlequin-type ichthyosis, a usually lethal skin disease, and lamellar ichthyosis. It is a retinoid, meaning it is related to vitamin A, and is found in small quantities naturally in the body. Its isomer, tretinoin, is also an acne drug.
Human subject research is systematic, scientific investigation that can be either interventional or observational and involves human beings as research subjects, commonly known as test subjects. Human subject research can be either medical (clinical) research or non-medical research. Systematic investigation incorporates both the collection and analysis of data in order to answer a specific question. Medical human subject research often involves analysis of biological specimens, epidemiological and behavioral studies and medical chart review studies. On the other hand, human subject research in the social sciences often involves surveys which consist of questions to a particular group of people. Survey methodology includes questionnaires, interviews, and focus groups.
Hidradenitis suppurativa (HS), sometimes known as acne inversa or Verneuil's disease, is a long-term dermatological condition characterized by the occurrence of inflamed and swollen lumps. These are typically painful and break open, releasing fluid or pus. The areas most commonly affected are the underarms, under the breasts, and the groin. Scar tissue remains after healing. HS may significantly limit many everyday activities, for instance, walking, hugging, moving, and sitting down. Sitting disability may occur in patients with lesions in sacral, gluteal, perineal, femoral, groin or genital regions; and prolonged periods of sitting down itself can also worsen the condition of the skin of these patients.
Tretinoin, also known as all-trans retinoic acid (ATRA), is medication used for the treatment of acne and acute promyelocytic leukemia. For acne, it is applied to the skin as a cream, gel or ointment. For leukemia, it is taken by mouth for up to three months.
Albert Ludwig Sigesmund Neisser was a German physician who discovered the causative agent (pathogen) of gonorrhea, a strain of bacteria that was named in his honour.
Holmesburg began as a Village within Lower Dublin Township, Pennsylvania. It is now a neighborhood in the Northeast section of Philadelphia, Pennsylvania. Holmesburg was named in Honor of Surveyor General of Pennsylvania Thomas Holme, who was a cartographer.
A comedo is a clogged hair follicle (pore) in the skin. Keratin combines with oil to block the follicle. A comedo can be open (blackhead) or closed by skin (whitehead) and occur with or without acne. The word "comedo" comes from the Latin comedere, meaning "to eat up", and was historically used to describe parasitic worms; in modern medical terminology, it is used to suggest the worm-like appearance of the expressed material.
A pimple is a kind of comedo that results from excess sebum and dead skin cells getting trapped in the pores of the skin. In its aggravated state, it may evolve into a pustule or papules. Pimples can be treated by acne medications, antibiotics, and anti-inflammatories prescribed by a physician, or various over the counter remedies purchased at a pharmacy.
Throughout history, prisoners have been frequent participants in scientific, medical and social human subject research. Some of the research involving prisoners has been exploitative and cruel. Many of the modern protections for human subjects evolved in response to the abuses in prisoner research. Research involving prisoners is still conducted today, but prisoners are now one of the most highly protected groups of human subjects
Acres of Skin: Human Experiments at Holmesburg Prison is a 1998 book by Allen Hornblum. The book documents clinical non-therapeutic medical experiments on prison inmates at Holmesburg Prison in Philadelphia from 1951 to 1974, conducted under the direction of dermatologist Albert Kligman. The title of the book is a reference to Kligman's reaction on seeing hundreds of prisoners when he entered the prison: "All I saw before me were acres of skin" ... "It was like a farmer seeing a fertile field for the first time".
Holmesburg Prison was a prison operated by the city of Philadelphia, Pennsylvania and the Pennsylvania Department of Prisons (PDP) from 1896 to 1995. The facility was located at 8215 Torresdale Ave in the Holmesburg section of Philadelphia. It was closed and decommissioned in 1995. The structure still stands.
Numerous experiments which were performed on human test subjects in the United States are considered unethical, because they were illegally performed or they were performed without the knowledge, consent, or informed consent of the test subjects. Such tests were performed throughout American history, but most of them were performed during the 20th century. The experiments included the exposure of humans to many chemical and biological weapons, human radiation experiments, injections of toxic and radioactive chemicals, surgical experiments, interrogation and torture experiments, tests which involved mind-altering substances, and a wide variety of other experiments. Many of these tests were performed on children, the sick, and mentally disabled individuals, often under the guise of "medical treatment". In many of the studies, a large portion of the subjects were poor, racial minorities, or prisoners.
The Guatemala syphilis experiments were United States-led human experiments conducted in Guatemala from 1946 to 1948. The experiments were led by physician John Charles Cutler who also participated in the late stages of the Tuskegee syphilis experiment. Doctors infected soldiers, prostitutes, prisoners and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects. The experiment resulted in at least 83 deaths. Serology studies continued through 1953 involving the same vulnerable populations in addition to children from state-run schools, an orphanage, and rural towns, though the intentional infection of patients ended with the original study. On October 1, 2010, the U.S. President, Secretary of State and Secretary of Health and Human Services formally apologized to Guatemala for the ethical violations that took place. Guatemala condemned the experiment as a crime against humanity, and a lawsuit has since been filed.
Dr. James E. Fulton Jr., M.D., was an American dermatologist and medical researcher who co-invented Retin-A, a popular acne medication, in 1969.
Allen M. Hornblum is an author, journalist and a former criminal justice official and political organizer based in Philadelphia, USA. He has written seven non-fiction books running the gamut from organized crime and Soviet espionage to medical ethics and sports. His first book, Acres of Skin, published in 1998, detailed unethical human medical experiments at Holmesburg Prison. The publication of Acres of Skin attracted considerable international media interest. Subsequently, Hornblum wrote Sentenced to Science, a book about the experience of an African American inmate in Holmesburg prison.
Cicely Pearl Blair FRCP was a British dermatologist. She discovered that people who had albinism did not get blackheads, as they did not produce melanin, the pigment that makes the comedones black. She also wrote about rashes caused by brown-tailed moth caterpillars. After her retirement, she turned her hand to art and especially silver smithing, fashioning a "chain of office" for the president of the British Association of Dermatologists.
Lajos Kemény is a Hungarian dermatologist, venereologist, allergologist, medical researcher, full professor and the Head of the Department of Dermatology and Allergology, the director of the Albert Szent-Györgyi Health Center, Faculty of Medicine, University of Szeged (SZTE) and the Vice-Rector for Science, Research Development and Innovation, SZTE. He is a notable and respected scientist both in Hungary and around the world.
Lucius Duncan Bulkley was an American dermatologist and alternative cancer treatment advocate.