Dermatologist

Dr Alan Lyell

Born: 4 November, 1917, in India.

Died: 2 November, 2007, in Erskine, aged 89.

ALAN Lyell became a world figure in dermatology when, in 1956, he described four patients whom he had seen, over a period of seven years, in Cambridge, Edinburgh and Aberdeen. All appeared to have been scalded though none had experienced any extreme of temperature. He named the condition toxic epidermal necrolysis. His description, in the British Journal of Dermatology, reminded dermatologists throughout the world of similar individual cases they had seen and, in the absence of any known cause, many preferred the eponymous name of Lyell's disease or the scalded skin syndrome.

Lyell, with family roots in Angus and Fife, was born in India, the son of an officer in the Indian army. Shortly after his birth, his mother died of puerperal fever. After boarding school at Repton he went up to Pembroke College, Cambridge, and then studied clinical medicine at St Thomas' Hospital. He qualified in 1942 in the middle of the war and was soon commissioned in the RAMC. He saw active service in Europe and was wounded in the Normandy invasion. When peace came, he began seven years of formal dermatological training, initially under Whittle at Cambridge and then under Percival and Peterkin at Edinburgh.

His first consultancy was at Aberdeen, followed by charge of the skin department at Glasgow Royal Infirmary from 1962 until his retirement in 1980. During this time he healed many wounds, caused by the bitter rivalries between the different skin departments in Glasgow, and established a modern, yet traditional department at the Glasgow Royal. He recorded: "What a happy department I had the good fortune to belong to. We may not have engendered reams of paper, but we did generate a corporate climate of concern for skin patients, and of interest in skin diseases." This most fulfilling appointment in Glasgow was flawed only by his failure, due to limited university backing, to organise an academic department.

Lyell himself wrote many papers. They reveal a scholarly and scrutinising approach by an inquisitive physician and sharp observer. Soon after the publication of his paper on toxic epidermal necrolysis, it became evident that distinct staphylococcal and drug-induced forms existed. He believed that a new staphylococcal toxin was implicated. A search for this in the early seventies with Dr (later Sir) John Arbuthnott succeeded, but their discovery was pre-empted by Melish and Glasgow's entirely independent study in the US, of which they were unaware at the time. Lyell also published important papers on self-damage and on disorders of perception such as delusions of parasitosis. After retirement he continued to write and has left many absorbing historical studies of various dermatologists.

Lyell's absolute integrity and genuine concern for his patients did not, at times, engender warm relations with his medical administrators. In a way these qualities underpinned a medico-political naivety that made it difficult for him to solve problems that he had identified. He joked about the time when, as a young registrar at Leith Hospital, he suggested that liquid nitrogen would be safer than liquid oxygen for freezing warts. The response of the consultant in charge was not to order liquid nitrogen but to remove the liquid oxygen canister from his room, and to put it in Lyell's clinic. Three decades later, he was furious, and resigned dramatically his consultancy at the Glasgow Royal, when he was unable to persuade the administrative powers that a retiring consultant colleague in his department should be replaced. This sudden resignation meant that he had to forgo the presidency of the British Association of Dermatologists in 1981. Perhaps it was due to his firm Christian beliefs that he was able to overcome, at least in the public eye, a number of professional and personal setbacks. Happily, his vision of a unified dermatological service in Glasgow became more than a dream last year when the Alan Lyell Centre for Dermatology was inaugurated and named in his honour.

Lyell will be missed by all of his past members of staff in whom he inspired great loyalty, his colleagues throughout the United Kingdom and countless dermatologists abroad who read his writings and met him on lecture tours. His son predeceased him and his wife, Rachael, to whom he was devoted, died some years ago. He is survived by his daughter and three grandsons.