From high-flying trapeze to highly infectiousdisease: The history of dermatology in the circus.

There is fascination with the bright lights and high-risk stunts of circus performances that originated in 18th-century Paris. The idea began as a way to display the impressive horsemanship skills of trick-riders. In London, England, former cavalry Sergeant-Major Philip Astley (1742-1814) created a grand performance of horseback riders by adding several unique acts to distinguish his show. Astley's original riding school would later become his own circus, the Amphitheatre Anglais. By 1782, the Amphitheatre Anglais could boast of performances by acrobats, jugglers, gymnasts, and tight-rope walkers. Since then, the circus, as the concept became formally known, has grown worldwide. With its development, however, several unanticipated occurrences have followed, including various dermatologic pathologies. High physical demands on circus performers and close physical contact led to cellulitis, pyoderma, callosities, and various other soft tissue manifestations. However, some members of the circus family were, in fact, chosen due to their genetic and acquired aesthetic abnormalities: the more grotesque, the more sought after.