Wallace H. Clark Jr.
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Wallace H. Clark Jr. (May 16, 1924 – November 28, 1997) was an American
dermatologist Dermatology is the branch of medicine dealing with the skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medi ...
and
pathologist Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
. He is best known for devising the "
Clark's level Clark's level is a staging system, which describes the level of anatomical invasion of the melanoma in the skin. It was developed by Wallace H. Clark Jr. at Harvard University and Massachusetts General Hospital in the 1960s. Levels Five anatomi ...
", or Clark Level, system for classifying the seriousness of a
malignant melanoma Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye (uveal melanoma). In very rare case ...
skin cancer based on its microscopic appearance.


Early life and education

Clark was born and raised in
LaGrange, Georgia LaGrange is a city in and the county seat of Troup County, Georgia, United States. The population of the city was estimated to be 30,858 in 2020 by the U.S. Census Bureau. It is the principal city of the LaGrange, Georgia Micropolitan Statist ...
the son of a country doctor. After graduating from
The Citadel The Citadel Military College of South Carolina (simply known as The Citadel) is a public senior military college in Charleston, South Carolina, United States. Established in 1842, it is the third oldest of the six senior military colleges ...
he attended
Tulane University The Tulane University of Louisiana (commonly referred to as Tulane University) is a private research university in New Orleans, Louisiana, United States. Founded as the Medical College of Louisiana in 1834 by a cohort of medical doctors, it b ...
, where he received a bachelor's degree in 1944 and an M.D. degree in 1947.


Career

He stayed at Tulane as a faculty member until 1962. He was an assistant professor of pathology and chair of the department of dermatopathology at
Harvard University Harvard University is a Private university, private Ivy League research university in Cambridge, Massachusetts, United States. Founded in 1636 and named for its first benefactor, the History of the Puritans in North America, Puritan clergyma ...
and
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is a teaching hospital located in the West End neighborhood of Boston, Massachusetts. It is the original and largest clinical education and research facility of Harvard Medical School/Harvar ...
from 1962 until 1969. He then moved to
Temple University Temple University (Temple or TU) is a public university, public Commonwealth System of Higher Education, state-related research university in Philadelphia, Philadelphia, Pennsylvania, United States. It was founded in 1884 by the Baptist ministe ...
, where he was a professor of pathology until 1978, including four years as chair of the department. From 1978 until his retirement in 1991 he was on the faculty of the
University of Pennsylvania School of Medicine The Perelman School of Medicine (commonly known as Penn Med) is the medical school of the University of Pennsylvania, a Private university, private, Ivy League research university located in Philadelphia. Founded in 1765, the Perelman School of M ...
as a professor of dermatology and pathology; he also founded and chaired the university's Pigmented Lesion Clinic. Post-retirement he became a visiting professor of pathology at Harvard. He conducted research, primarily at Beth Israel Hospital, until just a few days before his death in November 1997.


Scientific contributions

While working at Harvard and Mass General during the 1960s he studied many melanomas. In 1966 he and dermatologist Thomas B. Fitzpatrick created the first Pigmented Lesion Clinic in the United States. He went on to create Pigmented Lesion Clinics at Temple University and the University of Pennsylvania. He made several seminal contributions to the understanding of melanoma. ''"Clark's Classification" of melanoma'' Together with Martin Mihm, Clark described histogenic types of melanoma which differ in their epidemiology, as well as their clinical and histological appearance. The four major categories of Lentigo Maligna Melanoma, Superficial Spreading Melanoma, Nodular Melanoma, and Acral Lentiginous Melanoma loosely correspond to more recent molecular classification of the disease. ''"Clark's level" and melanoma prognosis'' Clark correlated the microscopic appearance of the tumor with careful followup of the progression of the tumor and the patient's outcome. From these studies he developed a five-part scale, based on the depth of penetration of the lesion from the epidermis into the dermis and down to the subcutaneous tissue, which can be used to predict the likely progression of the tumor and the prognosis for the patient. While largely superseded by other prognostic attributes, pathologists evaluating a melanoma still classify it according to its
Clark's level Clark's level is a staging system, which describes the level of anatomical invasion of the melanoma in the skin. It was developed by Wallace H. Clark Jr. at Harvard University and Massachusetts General Hospital in the 1960s. Levels Five anatomi ...
, and treating physicians consider that information to choose the appropriate treatment. Clark and his colleagues also made seminal observations on the importance of mitotic rate and tumor infiltrating lymphocytes in primary melanomas as important prognostic variables. ''Dysplastic nevi'' Together with Mark Greene, Margaret Tucker, and David Elder, Clark described atypical appearing moles associated with increased risk for developing
melanoma Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye (uveal melanoma). In very rare case ...
and termed them dysplastic nevi. Clark also helped to develop criteria for recognizing the early signs of a melanoma, important in promoting early diagnosis and treatment. He was a strong a proponent of patient education and gave many public lectures teaching people how to recognize the warning signs of a possible melanoma.


Recognition

The May 1999 issue of the journal Human Pathology was dedicated to the memory of Dr. Clark. The University of Pennsylvania School of Medicine hosts an annual Wallace H. Clark Jr., MD, Lectureship in Cutaneous Oncology as a living memorial to Clark, describing him as a "caring and expert physician, an imaginative and rigorous investigator, and a charismatic and provocative teacher," whose "recognition of what makes people susceptible to melanoma and the appearance of early, highly curable forms of melanoma has saved countless lives."


Personal

He was married to Patricia Clark. He had two sons and four daughters. He died of a ruptured aneurysm on November 28, 1997, at his home in
Kennebunkport, Maine Kennebunkport is a resort town in York County, Maine, United States. The population was 3,629 people at the 2020 census. It is part of the Portland-South Portland-Biddeford metropolitan area. The town center, the area in and around Dock Squa ...
, at the age of 74.


Selected publications

*Fitzpatrick TB & Clark WH Jr. "Problems in the diagnosis of malignant melanoma". ''Tumors of the skin'' (The University of Texas M.D. Anderson Hospital and Tumor Institute. Seventh Annual Clinical Conference on Cancer, 1962). Year Book Medical Publishers, Inc. Chicago (1963) pp. 169–83. *Clark WH Jr., From L, Bernardino EA & Mihm MC Jr. "The histogenesis and biologic behavior of primary human malignant melanoma of the skin". ''Cancer Res'' (1969) 29: 705–27. *Clark, Wallace H. (ed.), ''Human Malignant Melanoma'', Grune & Stratton, Inc., 1979, . *Clark WH Jr. "From the Melanocyte to Melanoma to Tumor Biology". ''Adv Cancer Res'' (1994) 65:113–40.


References

{{DEFAULTSORT:Clark, Wallace H. Jr. American pathologists American dermatologists Dermatopathologists American cancer researchers 1920s births 1997 deaths People from LaGrange, Georgia People from Kennebunkport, Maine The Citadel alumni Tulane University alumni Physicians of Massachusetts General Hospital University of Pennsylvania faculty Temple University faculty 20th-century American physicians Deaths from aneurysm