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Forty years ago, dermatology relied heavily on anecdotal observations and empiric formulations. The most eminent clinicians had personal recipes, some jealously guarded, for the topical treatment of eczema, psoriasis, acne, warts, and a wide variety of other common dermatoses. Our progress since that time toward a uniform, rigorous scientific basis for diagnosis and therapy of skin disease is impressive. Although there may be dissenters, most dermatologists agree that optimal patient care can be achieved only by the superposition of caring individualization on a foundation of statistically validated controlled observations, built with the most sophisticated available research tools.
This idealized dermatologic data base is not easily acquired. Each worthwhile diagnostic categorization, prognostic association, or therapeutic regimen is established by hard work. Many hours are required at the bedside (or equivalent) and many more hours in the library (or equivalent), usually away from family and friends and in lieu of activities offering
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