John Terrence Headington, MD (1930-2021)
By Lori Lowe MD and Alvin R Solomon, MD | 11 November
John T. Headington, M.D. passed away on March 30, 2021. Terry was a brilliant, creative, and insightful dermatopathologist who made many seminal observations and contributions during his more than 30-year career. Terry was a Michigan man, having completed his undergraduate degree, medical degree, and residency training in anatomic and clinical pathology and dermatology at the University of Michigan. During the 1960s and 1970s, he had many colorful experiences that enriched his life and helped to make him the quintessential scholar that we remember so fondly. For two years, he served as Captain in the U.S. Army Medical Corps and was Chief of Clinical Pathology at Letterman General Hospital. He also spent two years as Visiting Professor of Pathology in northern Thailand with the United States Agency for International Development (USAID)/University of Illinois Chiang Mai Project. Before, during, and after his travels, Terry always returned to the University of Michigan, where he quickly rose through the ranks of academic medicine being promoted to Professor in 1971. He also pursued residency training in dermatology at the University of Michigan, which included a year of training at the prestigious St. John’s Institute of Dermatology, King’s College London, England.
Terry’s years of practicing both anatomic and clinical pathology were the foundation for his later dermatopathology expertise. Before concentrating on skin disease, Terry attained expertise in muscle biopsies. He was the hospital microbiology lab director for years. According to his close friend and colleague, the late John Batsakis of head and neck pathology fame, he even predicted that computers were the future of medicine – in the late 1960s!
This unique background provided the scaffolding for a brilliant and productive academic career in dermatopathology. Terry published greater than 100 manuscripts in peer-reviewed journals, delivered numerous invited lectures nationally and internationally, and helped to train hundreds of pathology and dermatology residents. Terry’s contribution to the field of follicular neoplasms, their identification, and classification remain seminal work.1-3 In 1984, he introduced us to the “Headington technique” of transverse (horizontal) sections for scalp biopsies for alopecia that is currently used worldwide. 4 He was the first to identify the dermal dendrocyte as a resident cell in the dermis and recognize it as an important member of the skin immune system.5-7 Terry co-founded the University of Michigan multidisciplinary melanoma clinic in 1982, enhanced our understanding of the pathology of melanoma8 and was instrumental in the development of the “square” technique for staged excision of lentigo maligna and lentigo maligna melanoma.9 He and colleagues were the first to describe cutaneous lymphadenoma10 and sclerosing sweat duct (syringomatous) carcinoma.11 He used his influence and voice to support his clinical colleagues publicly when the landscape of Mohs micrographic surgery had yet to be defined. 12
Terry was a skilled teacher who lectured audiences ranging from medical students to international experts. Terry crafted his lectures to perfection. In the pre-digital era, he insisted that professional medical illustrators prepare his 35 mm Kodachromes to the detriment of the departmental budget. Frequently voted the best laboratory instructor of the sophomore general pathology course, he is remembered by generations of Michigan medical students in fields far removed from dermatology and pathology. One of his favorite didactic techniques was to tear up articles from The New England Journal of Medicine to reinforce the need for constant critical thinking. “The worst thing you can do is make a diagnosis” was his mantra to emphasize the need to continually reassess a patient’s care.
Terry was active in the American Society of Dermatopathology. He served as Secretary-Treasurer from 1978-1981 and President in 1983. He was the recipient of the prestigious Founder’s Award in 1992 for his dedication and service to the American Society of Dermatopathology and his many outstanding and significant contributions to the field. His other awards include an honorary doctorate from the University of Bordeaux, France, honorary member of the British Association of Dermatology and Dermatology Society of South Africa, and a Fellow of the Royal College of Medicine.
Terry had tremendous charm, wit, and forever a twinkle in his eye as he let those around him know of his exceptionally high standards. While Terry was a dermatopathologist extraordinaire, he was also a world traveler, athlete, hiker, avid skier, oenophile (a Gougerot society founding member!), and bibliophile. He challenged residents to beat him in his daily noontime runs through Nichols Arboretum, and to our knowledge, he never lost. He lived life to the fullest with Jill, his lovely wife of 63 years who died two weeks before Terry.
Our field of dermatopathology and our careers have been shaped and influenced by Terry Headington, either directly or indirectly. Terry was truly one of a kind. All of us who were fortunate enough to know him are the lucky ones. He will be missed.
- Headington JT, French AJ. Primary neoplasms of the hair follicle. Histogenesis and classification. Arch Dermatol. 1962;86:430-441.
- Headington JT. Differentiating neoplasms of hair germ. J Clin Pathol. 1970;23(6):464-471.
- Headington JT. Tumors of the hair follicle. A review. Am J Pathol. 1976;85(2):479-514.
- Headington JT. Transverse microscopic anatomy of the human scalp. A basis for a morphometric approach to disorders of the hair follicle. Arch Dermatol. 1984;120(4): 449-456.
- Headington JT. The dermal dendrocyte. Adv Dermatol. 1986;1:159-171.
- Cerio R, Griffiths CE, Cooper KD, Nickoloff BJ, Headington JT. Characterization of the factor XIIIa positive dermal dendritic cells in normal and inflamed skin. Br J Dermatol. 1989;121(4):421-431.
- Headington JT, Cerio R. Dendritic cells and the dermis: 1990. Am J Dermatopathol. 1990; 12(3):217-220.
- Solomon AR, Ellis CN, Headington JT. An evaluation of vertical growth in thin superficial spreading melanomas by sequential serial microscopic sections. Cancer. 1983;52(12): 2338-2341.
- Johnson TM, Headington JT, Baker SR, Lowe L. Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the “square” procedure. J Am Acad Dermatol. 1997; 37(5 Pt 1): 758-764.
- Santa Cruz D, Barr RJ, Headington JT. Cutaneous lymphadenoma. Am J Surg Pathol 1991; 15(2): 101-110.
- Cooper PH, Mills SE, Leonard DD, Santa Cruz DJ, Headington JT, Barr RJ, Katz DA. Sclerosing sweat duct (syringomatous) carcinoma. Am J Surg Pathol. 1985; 9(6): 422-433.
- Headington JT. A dermatopathologist looks at Mohs micrographic surgery. Arch Dermatol. 1990; 126(7): 950-951.
The article above is "in press" in the Journal of Cutaneous Pathology. DOI: 10.1111/cup.14159. We wish to thank the editors of JCP for allowing us to publish this memorial to Dr. Headington prior to it appearing in print in their journal.