Tekiner H, Karamanou M, et al.
Acta dermatovenerologica Croatica : ADC. Date of publication 2019 Dec 1;volume 27(4):273-274.
1. Acta Dermatovenerol Croat. 2019 Dec;27(4):273-274.
The Unna Boot: A Historical Dressing for Varicose Ulcers.
Tekiner H(1), Karamanou M.
Author information:
(1)Assoc. Prof. Halil Tekiner, MD, PhD, Department of the History of Pharmacy
and Ethics, Erciyes University School of Pharmacy , 38280 Kayseri, Turkey;
htekiner@erciyes.edu.tr.
The German dermatologist Paul Gerson Unna (1850-1929) is a prominent figure in
the history of medicine for pioneering modern dermatopathology and dermotherapy
(Figure 1) (1). Aside from writing extensively on anatomy, histopathology, and
treatment of skin diseases, he contributed to medicine in many other ways: he
originated the idea of using coated pills to enhance local absorption in the
intestine, introduced ammonium bituminosulfonate (ichthyol) and resorcinol into
medicine, and described several skin conditions including seborrheic dermatitis.
Moreover, in 1881 he established a private clinic in Hamburg, Germany, which
became a leading expert center in the diagnosis and treatment of skin disorders,
hosting postgraduate physicians from all over the world for training (2). Unna
also was one of the first to work with pharmacology of dermatotherapeutic agents
(1). With the help of pharmacists Paul Carl Beiersdorf (1836-1896) and Oscar
Troplowitz (1863-1918), Unna greatly enriched dermatologic formulas with new
ingredients (2). As an alternative option to the poorly tolerated compression
bandages of his time, in 1885 he invented a special gauze bandage impregnated
with a mixture of 15% zinc oxide in a glycogelatin-based paste for treatment of
varicose ulcers. This mixture had drying and cooling effects as well as
antipruritic effects due to its continuous slight pressure on the skin (1).
After numerous tests on different forms of bandages in the following years, Unna
presented a new form of skin-tone compression bandage at the Third International
Congress of Dermatology in London in August 1896 and published a paper on the
topic in the Wiener medizinische Wochenschrift (Vienna Medical Weekly) on 17
October 1896 (3). His bandage technique later became a widely recognized therapy
because of its effectiveness and simplicity. Several companies subsequently
introduced similar ready-to-use zinc bandages to the market after the turn of
the century. Furthermore, in 1910 Unna's pupil Heinrich Fischer (1857-1928), MD
also recommended a modified version of the Unna boot for deep vein thrombosis
(1,4). Having partially lost its earlier prominence in the first phase of
compression therapy, the historical paste dressing and its modified versions are
still used effectively to contribute to quicker healing in patients with chronic
venous ulcers, and are sometimes used for diseases such as nummular dermatitis,
lichen simplex chronicus, and atopic dermatitis on the extremities (4,5).
Although the current trend in the use of medical eponyms is likely to decrease
in literature, the Unna boot is one of those that have been fortunate to
survive, honoring its inventor's name.
PMID: 31969242 [Indexed for MEDLINE]
