Skins Are Simpler Than You Think

Dermatology is an incredibly simple subject. The fact that there are over 1000 different skin diseases, each of which may appear in several disguises, with a correspondingly confusing nomenclature, is irrelevant, since diagnosis is not necessary for successful therapy. Dermatological diagnosis is undoubtedly useful for impressing less gifted colleagues who are only to be trusted with mechanistic trivia such as the replacement of heart valves, but its value to the patient is limited. Most patients will accept that they are suffering from 'poikiloderma atrophicans vasculare of Jacobi' just as readily as they would accept the diagnosis of 'pityriasis lichenoides acuta et varioliformis of Mucha-Habermann'. Alastair Cooke recounts the story of how he once suffered from a very irritating rash around the ankles which completely defeated his own General Practitioner.