We read with interest the article by Feldman and colleagues,1 who report on the most common dermatologic problems identified by internists. We found the data on the number, percentage, and ethnicity of patients with dermatologic disorders seen by internists compared with those seen by dermatologists informative. Unfortunately, using various methods, internists have repeatedly incorrectly diagnosed skin disorders at a rate of 50%.2- 5 Therefore, using a database that is based on self-coding by internists incorporates a possible 50% error into dermatologic diagnoses. While educational efforts for internists in dermatology are worthwhile, the foundation of any educational program for internists should not be based on data with this degree of potential error.
Kirsner RS, Federman DG. Dermatology Education for Internists. Arch Intern Med. 1998;158(17):1952-1953. doi: