Archive for the ‘dermatology’ Category

The sebocytes appear clear because the processing removed the lips from within the cells. The hair follicle is cut obliquely — rarely do you even see the pilosebaceous unit in full cross section as you see in most skin schematics

Feb 29, 2016




Red hair is due to the predominance of pheomelanin (red or yellow) over eumelanin (brown or black). The control of which melanin is produced (or at least the relative amounts of the two melanin types) is largely determined by the melanocortin 1 receptor (MC1R).

Robust experimental evidence supporting many attempts to facilitate early melanoma diagnosis is lacking. In an experimental study using a browser interface we have examined diagnostic accuracy, sensitivity and specificity of novices in distinguishing between melanomas and mimics of melanoma. We show that rule-based ABC methods and image training, based on random images of melanoma, improve […]

Commentary in Acta. Full (open access) paper here Frank Davidoff, the celebrated US physician, has a telling metaphor for medical competence: he likens it to Dark Matter, the material physicists think makes up most of the Universe, and about which we know so little (1). Clinical competence would, in this analogy, be the material that literally […]

Nick Carr writes about e-textbooks, quoting research that students don’t like them, or at least they prefer conventional textbooks. Seems reasonable to me. We know a lot more about the design of conventional textbooks, layout, indexing, and interaction and so on. But for dermatology it seems to me e-textbooks offer a way forward. If you […]

If you are not a medic and reading this blog, and would like to take part in some research over the net into how to diagnosis melanoma, click here. The link is You will be shown some pictures, and asked to judge whether they are melanomas or not. What you see is ‘randomised’ so you […]

My letter in the BMJ is here. Sadly they sanitised my rapid response (here) which ended saying: Finally, the simplest explanation for the persistence of SLN — in the absence of convincing RCT support— is surely that given by people such as John Wennberg in explaining variation in health care provision: money — or at […]

The current management of skin cancer in the UK and many countries is based on what might be termed a ‘corner shop’ model. Patients present to their general practitioner (GP) or to a single- handed dermatologist in office practice and either (i) are diagnosed as not needing further treatment because the suspect lesion is benign, […]

Musing on markets and health care, and what happens when literally it is your own skin at risk. The man had good insurance, and he and his family used it freely to provide him with as much comfort and care as possible. I can’t imagine they’d have acted differently were they paying out of pocket. […]

One of the most telling metaphors about competence I know  comes from Frank Davidoff: Competence, in contrast, is like “dark matter” in astronomy: although it makes up most of the universe of working knowledge, we understand relatively little about it. What does it really consist of? Which of its components are most important? How do […]

Our paper on what students actually see during their attachment rather than what we think they see is available (no paywall). Abstract below Background Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible for the initial assessment of skin lesions and are required to act as the gatekeepers to dermatological cancer […]

A paper of ours is now in press and available online as a provisional pdf here. Abstract is below Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence R Benjamin Aldridge, Susanne S Maxwell and Jonathan L Rees Abstract (provisional) Background Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible […]

I am talking (briefly) at the Times Cheltenham Science Festival in a session entitled Out of Africa. As usual the other speakers look as though they know much more about the topic than me.  For booking details follow the link. Saturday, June 16, 2012 – 17:00 Throughout history, as humans migrated further away from the […]

Ervin Epstein in the Preface to Controversies in Dermatology, 1984 The difference between a clinician and an academician, basically, is the experience of 200 to 400 patient visits a week. Most academicians practice dermatology but on a limited scale. Yet the tail is definitely wagging the dog that we call dermatology. This quote has bugged […]

There is a terrific series of articles on skin biology and dermatology published this month in the Journal of Investigative Dermatology. Of course there is one by your’s truly written jointly with Rosalind Harding on the Population Genetics of Human Pigmentation, but there are great reviews on a whole range of topics: langerhans cells, clinical […]

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