Bernard Ackerman, skin specialist

'Force in his field' at diagnosing ills

NEW YORK - Dr. A. Bernard Ackerman, a founding figure in the field of dermatopathology who trained a generation of doctors to recognize skin diseases under the microscope, died Dec. 5 at his home in Manhattan. He was 72.

The cause was heart failure, said his nephew Andy Zwick, who was his collaborator.

Dr. Ackerman was also a forceful voice on a wide range of subjects, including the causes of melanoma and the ethical issues that arise when doctors testify in court.

In the 1960s he developed a diagnostic method that involved viewing skin tissue at low magnification until he saw a broad pattern, which he called a silhouette. Only later would he zoom in to the cellular level to refine the diagnosis.

Dr. Ackerman trained a generation of doctors to use his method on an 18-headed microscope, through which they could view slides from dozens of cases at a sitting.

He was a prolific researcher, the author of more than 700 papers and more than 60 books.

"He had his detractors and he had his sycophants, but everyone recognized that he was the force in his field," said Dr. Geoffrey Gottlieb, managing director of the Ackerman Academy of Dermatopathology, which Dr. Ackerman founded in 1999.

He often argued for unpopular positions.

Recently he expressed strong skepticism that exposure to sunlight causes melanoma, saying the case was not proved.

He also lamented what he saw as a trend toward overtreatment of benign skin conditions.

"There has been a mania for taking off these moles that are of no consequence," he told The New York Times in 2005. "We're talking about billions and billions of dollars being spent, based on hype."

As a resident at the University of Pennsylvania hospital, Dr. Ackerman was sent to work at Holmesburg prison, where inmates were paid to endure exposure to toxic chemicals. His experience there led to a lifelong preoccupation with medical ethics.

After serving as an expert witness in more than 200 trials, Dr. Ackerman had a personal brush with the law in 2000, when he reluctantly reached a $2.7 million settlement in a malpractice suit in a skin cancer death in which he said there had been fraudulent medical testimony. In 2003, he started a website to expose expert witnesses whom he saw as unreliable; it can be found at www.truthfultestimony.org.

In 1969, Dr. Ackerman was hired at the University of Miami, and in 1973, he joined the faculty of New York University Medical School, where he ran the Skin and Cancer Institute. His laboratory there was one of the first to screen for early signs of Kaposi's sarcoma, a fatal skin cancer now understood to have been closely linked to the AIDS epidemic.

In 1992, he moved to Philadelphia to teach at Jefferson Medical College.

He returned to New York City in 1999 to found his own institute, the Ackerman Academy of Dermatopathology, one of the largest training centers for the diagnosis of skin diseases in the world; it is now part of Dermpath Diagnostics, which is owned by Quest Diagnostics.

Dr. Ackerman recently endowed a professorship for the study of culture and medicine at Harvard University.

This year, he donated his collection of antique microscopes to Massachusetts General Hospital.

In addition to his nephew, he leaves his brother, James of Pittsboro, N.C., and his sister, Susan of Summit, N.J.

Asked to describe himself in an interview with a medical journal, Dr. Ackerman used the terminology of the microscope. He said he was "dogmatic and unyielding at scanning magnification" but "reasonable and accommodating at high power" and "humane and empathic up close."

Little escaped his keen diagnostic eye.

One of the last papers he published bore the title, "An Inquiry Into the Nature of the Pigmented Lesion Above Franklin Delano Roosevelt's Left Eyebrow."