Dr Ian Bruce Sneddon CBE MD FRCP. 1915-1987

Dr WAD GRIFFITHS & R MOHAMMEDI


Ian Sneddon is widely known for the two diseases bearing his name - Sneddon's syndrome, and Sneddon & Wilkinson's disease. His activities however encompassed a much wider range than this.

He was one of our great British Dermatologists. He was clinical Dean of the University of Sheffield for 18 years - a great honour for a dermatologist. He was President of the British Association of Dermatologists in 1970. He was awarded an honorary degree of MD by his university and later was given the distinction of a Commander of the British Empire (CBE). He was also an honorary fellow of the Danish and South African dermatology Societies and he gave guest lectures all over the world.

He was educated at Uppingham School and Sheffield University. He qualified in 1937 and in his early career worked with Rupert Hallam a well known dermatologist in Sheffield. He returned to the skin department just before the outbreak of the Second World War. Although knowing only a little dermatology the officer to whom he reported at the Royal Navy Hospital at Haslar near Portsmouth decided that Sneddon should become the Naval Dermatologist. Protesting his inexperience he was told “there are some very excellent books in the library”. In the War he spent time in the Pacific and did a lot of sailing with Cyril Clarke later knighted and President of the Royal College of Physicians. With him he produced a film on the neuropathy of starvation among prisoners of war -a film now in the Imperial War Museum. After the war he joined Dr Renwick Vickers first as a registrar and later as a consultant dermatologist in Sheffield. Vickers later moved to Oxford. When he was a registrar one of the duties he had was to do clinics at an outlying hospital. With his naval training for punctuality he turned up promptly at 9 o'clock thinking the clinic started then. When he arrived the place was locked up. He knocked and got no reply so he went round the building to see if he could find anyone. He did! When he looked through one of the windows he saw the nurse and a doctor in flagrante delictu on the couch. The clinic was supposed to start at 10.

Dr Sneddon produced over 100 papers on a wide range of Dermatological topics. After his marriage to Joan who was a psychiatrist he studied the psychiatric aspects of dermatology and published on Dermatitis artefacta. A patient who jumped under a train after a consultation led him to strongly propound the present doctrine of the inadvisability of confronting dermatitis artefacta patients with one's suspicions. His wife Joan was an engaging character. At one dinner party she arrived and was offered a drink. She had a bad back and so she started the evening having her drink lying flat on the floor in front of the fire much to the amusement of the other guests. Darrel Wilkinson with whom his name is associated in the description of Subcorneal Pustulosis did not work closely with Sneddon but by chance discussion at the Royal Society of Medicine found that some unclassifiable cases he had were similar to some seen by Dr Sneddon. The cases were described in 1956 ( Br J Dermatol 1956.68.385). Wilkinson reports that the French dermatologists soon took hold of the disorder but that it was misunderstood for a long while in the U.S.A. The condition has moved on a lot since then and Dr Sneddon would have been intrigued to see the most recent findings on the disorder (Hashimoto et al. J Invest Dermatol 1997;109:127). Sneddon's syndrome of Reticular Livedo with systemic involvement came later (Br J Dermatol 1965;77:180). He wrote much on the causes of perioral dermatitis. When it was suggested that it might be caused by tooth paste he remarked to Darrell Wilkinson that he did not think that was very likely since in Sheffield at that time it was very difficult to find any young women who had any remaining teeth of their own.

Everyone with whom he came into contact is unanimous in finding Dr Sneddon a most charming and helpful man a view which my own experience confirms. Patrick Hall-Smith relates that his kindness was shown to a second MB medical student in London who had failed his exams. Sneddon said he would see if he could give him a chance in Sheffield. The young man did very well rising to become head of one of our largest pharmaceutical companies. So popular was he, and such a good diagnostician that his opinion was widely sought. Professor Chris Vickers was a medical senior registrar at Sheffield. He relates “ I shall never forget what finally caught me for dermatology. I was a Senior Registrar in General Medicine when we had a patient in the ward who puzzled us all. She had a big liver, funny heart murmurs that changed regularly causing great arguments on the ward rounds. (This was before the days of cardiac catheterisation or any of that clever stuff). The patient kept complaining about a wart on her finger so we asked for a Dermatology opinion. I was in Medical outpatients having a cup of tea with my boss when I got a call from the houseman to say did we want to know what was wrong with Mrs X. So we both rushed off ( I should add he was a cardiologist ). Ian the pointed out that the so called wart was ridging of the nail, that it was in fact a periungual fibroma characteristic of adenoma sebaceum and that he would suggest that there was an intra-atrial fibromyxoma prolapsing through the mitral valve which accounted for the variable murmurs. He thought that the lumps in the liver were of similar aetiology. Unfortunately he was proved right. The cardiac surgeons were about to have a try when the patient died in the anaesthetic room and the pathologists proved Ian right.” Dr Sneddon told me once that a high reputation had its problems since at one stage of his career almost a third of his private patients could be medical people (in those days invariably treated free). He was a keen sailor and a gardener.

 

Two boating stories from Dr Stephen Gold

In Scotland for one holiday Dr Sneddon and Joan had towed their cruiser on a trailer behind their Rover. On the way home, as he was winding the winch to haul the boat out of the water on to the trailer he was seized with gripping chest pain - they both realised its significance. However Joan had never driven the car towing the boat. So they decided to press on, drive to Sheffield and have his coronary seen to back home! All was well and there were no bad repercussions.

The final sea cruise was in a keel boat he had chartered from Poole. You know he had gained his Master's Certificate and felt happy about taking a mixed bunch of children, daughters' boyfriends and others as crew. Only one other was experienced at sailing. After a happy spell in France they set off home and met adverse weather, wind and tides. Fatigue was taking over and as they approached the Old Harry Rocks at Swanage, it was pitch black, Ian misread a light\buoy and they went aground. Shat humiliation! They could not move, dark and rough- so they sent up a flare. Poole Lifeboat arrived and they were instructed to abandon ship which Ian did with the utmost reluctance. Back on dry land they were all found beds and the two parents went to the boatswain's house where they spent the night. They were treated most graciously but were a bit cold in bed. Next day was calm and clear - they were able to go out to the beached boat which was still there and intact. GREAT RELIEF. Once they all got home they bought a present - a great double eiderdown for the bed at Mrs Bosun's - they thought an appropriate thank you. This prompted a reply from Poole, very pleased with eiderdown but wished to point out that the lifeboat gets called out frequently by silly yachtsmen and very rarely do they get properly thanked. This letter so impressed Ian that he sent it to the Yachting Magazine which printed it in full with the tale.

He continued his private practice until literally the end when he died suddenly after consulting. The Sneddon-Bowers trophy of the British Association of Dermatologists for the winner of the annual sailing competition was endowed in his honour.