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Article

Harvard derm delves into origin of pruritus, adding to long list of accomplishments

Born into an accomplished dermatology family, Ethan Lerner, M.D., has had to ask himself if he had any choice but to join the specialty. His father, the late Aaron B. Lerner, M.D., former professor and chairman of the Yale University dermatology department, discovered melatonin and developed transplantation therapy for vitiligo.

Key Points

Ethan Lerner, M.D.

Born: 1955, Portland, Ore.

Medical degree: Yale University New Haven, Conn.

Residency: Massachusetts General Hospital Boston

Hobbies: Swimming, running (marathons), coin collecting, cooking.

Family: Wife and three children.

His father, the late Aaron B. Lerner, M.D., former professor and chairman of the Yale University dermatology department, discovered melatonin and developed transplantation therapy for vitiligo. He also isolated melanocyte stimulating hormone, or MSH. Ethan's mother, Marguerite Lerner, M.D., was a dermatologist and Yale professor and an author of numerous children's books.

The Lerner household was a snapshot of dermatology history, with frequent guest appearances by such notable dermatologists as Thomas B. Fitzpatrick, M.D., Ph.D. Drs. Fitzpatrick and Aaron Lerner collaborated to scientifically explain skin pigmentation. "Fitz and my dad were very close friends," Dr. Ethan Lerner says. "I knew him very well, too, having trained under him."

Destined for dermatology

Before he was a teenager, Dr. Lerner remembers wanting to be a brain surgeon. But two things, he says, made him navigate toward dermatology. "I've always liked looking at things close up, because I'm nearsighted," he says. "The other is that I wanted to do research. Dermatology is one of the few specialties in which you can do a lot of research and spend time in the clinic. I love treating patients."

Dr. Lerner, associate professor of dermatology at Harvard Medical School, leads a research group funded by the National Institutes of Health at his laboratory at Massachusetts General Hospital. His focus: the how and why of itch. He also holds more than 12 patents and has authored 90-plus peer-reviewed articles.

Taking it to market

Among Dr. Lerner's many patents is Levia (Lerner Medical Devices), the first personal targeted phototherapy device cleared by the Food and Drug Administration for the self-treatment of small-area and scalp psoriasis, vitiligo and atopic dermatitis. He says he came up with the idea in the 1980s.

"At Mass General, we used a lot of light therapy for treating psoriasis. One of the problems was that you could not treat the scalp because hair blocks light. That was frustrating, because having a flaky scalp is particularly bothersome to patients," he says. "I looked at the problem very simply because there's an old comment that luck favors the prepared mind. And I said, why don't we have a brush, the bristles of which would be fiber optic, to deliver light directly to the scalp? It was so obvious to me that it didn't take any thinking."

The Levia device has been available by prescription for about a year.

Dr. Lerner says he thinks the answers to itch - i.e., why skin itches and how to block the sensation - are within reach.

"It turns out that some of the people working on pain were actually working on itch, but they didn't know it," he says. "As a result of this mix of the neurosciences and a relatively small number of dermatologists, the itch field gets to take advantage of work that has gone on in the pain field for many decades. I'm optimistic that we are going to have good drug targets and much better drugs in the not-too-distant future."

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