Lives of the fellows

Alfred Wilson McKenzie

b.12 October 1929 d.13 July 2016 MB ChB Edin(1955) MRCP(1959) FRCP(1975)

Alfred Wilson McKenzie, known as ‘Freddie’, was a consultant dermatologist of international repute who was responsible for the creation of a revolutionary method for assessing and quantifying topical anti-inflammatory activity through the application of steroids to human skin – the McKenzie test.

He was born and spent his childhood in Edinburgh, apart from a year in Burghead as an evacuee. His father was John McKenzie, an electrical engineer. He attended the Royal High School in Edinburgh, where he learnt the bagpipes and the violin. The violin was to prove a lifelong love and he was proud that as a boy he not only performed on the stage of Edinburgh’s Usher Hall, but was singled out for praise by the music critic of the Edinburgh Evening News. His love of the bagpipes did not endure, perhaps because he had to practice in the Anderson shelter in the garden to avoid annoying neighbours.

He finished his National Service as a second lieutenant in 1949 and began his medical training at Edinburgh University. As an undergraduate he was awarded the gold medal for medicine, the gold medal of the Royal Victoria Hospital Tuberculosis Trust and the Murchison Memorial scholarship in clinical medicine from the Royal College of Physicians. He was junior president of the Royal Medical Society, Edinburgh – one of the oldest medical societies in the world and the only student society with a Royal Charter – writing his presidential dissertation on Addison’s disease. House appointments followed at the Edinburgh Royal Infirmary, first as a house physician to Sir Derrick Dunlop [Munk’s Roll, Vol.VII, p.170] and then as a house surgeon to Sir James Learmonth. He always felt fortunate to have been exposed to the highest academic and ethical standards through his work with Dunlop and Learmonth.

Deciding to specialise in dermatology, he worked successively at St John’s Hospital for Diseases of the Skin, Guy’s Hospital and then St Thomas’, where Hugh Wallace [Munk’s Roll, Vol.VIII, p.520] was instrumental to his subsequent career.

In 1961 he was sent as a visiting fellow to the dermatology department of Western Reserve University in Cleveland, Ohio, USA. There, under an inspiring chief, Richard Stoughton, he pursued research into drug absorption through the skin, developing a test for predicting the efficacy of corticosteroids when applied to the skin, which he wrote up and first published in the American Archives of Dermatology in 1962 (‘Method of comparing percutaneous absorption of steroids’ Archives of Dermatology 86[5]:608-10 November 1962).

His research was to have a significant impact on the fortunes of the drug company Glaxo, whose skin products were, in the early 1960s, facing major competition from a new dermatological product containing fluocinolone, produced by the Syntex Corporation. The product was proving far more effective than any existing treatments for eczema and psoriasis, and it began to dominate the topical steroid market, threatening Glaxo’s commercial position. With no reliable animal test for quantifying topical anti-inflammatory activity, it was difficult for Glaxo’s laboratories to identify product candidates. The problem was solved when Glaxo chemists were introduced to McKenzie’s method for assessing topical activity simply by applying steroids to human skin (dilutions were applied to the forearms of volunteers and covered with a plastic film protected by either a metal guard or Saran wrap).

The technique, which McKenzie helped Greenford scientists to perfect, enabled them to explore hundreds of compounds very quickly and led directly to the development of betamethasone valerate, launched as Betnovate in 1963, and then Dermovate in 1973. In his history of Glaxo, Edgar Jones noted that ‘Sadly Dr McKenzie’s reward for his crucial part in the research and development of betamethasone valerate was a gramophone…’.

In September 1963 he was appointed as a consultant dermatologist to the Norfolk and Norwich Hospital where, until his retirement in 1989, he was the single specialist over a huge geographical area. In spite of a heavy caseload (on retirement he was replaced by four dermatologists), he played an active role in the administration of the Norfolk and Norwich Hospital, chairing is medical staff committee, as well as being treasurer and then chairman of the Norwich and Norfolk Medical Benevolent Fund. He published more than 25 original articles on dermatology. He was also an inveterate writer of letters to The Times.

He met his wife Ann (née Holbrook) when they both worked at the Royal Masonic Hospital in London in 1958 and she joined him in America in 1961. They travelled around America in a 1950s Chevrolet Bel Air, something that should have warned Ann about his other great passion in life – cars. Though he owned and drove many classic cars, his pride and joy was the 1936 Rolls Royce he bought in 1969, a 2.5 tonne car with no power steering, which he continued to drive until he had a stroke just months before his 85th birthday. During a long and happy retirement, he and Ann toured Europe in various interesting cars, as well as making regular visits to the beautiful holiday home they created in the Majorcan mountains.

He was remembered by his colleagues for his diagnostic skill and for the interest he took in the teaching of junior staff. Always immaculately dressed (and never without a necktie), invariably smoking a cigarette (usually in a cigarette holder), McKenzie was one of life’s optimists who never let adversity get the better of him. Even after the stroke that prevented him from playing the violin or driving, he remained cheerful and positive, interested in everything and everyone around him. He was survived by Ann, and their sons Donald and Colin.

Colin McKenzie

[Jones, E. The business of medicine: the extraordinary history of Glaxo, a baby food producer, which became one of the world’s most successful pharmaceutical companies London, Profile, 2001]

(Volume XII, page web)

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