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March 2017

Screening for Genital Herpes: What Is Not to Be Done

Author Affiliations
  • 1Kaiser Permanente, San Francisco, California
JAMA Dermatol. 2017;153(3):265-266. doi:10.1001/jamadermatol.2016.5546

Primum non nocere, the old maxim meant to guide physician conduct, translates as “first, do no harm.” Physicians too often stop following the maxim, as translated, halfway through.

Physicians are trained to act. They are taught—and, in many cases, paid—to elicit histories, conduct physical examinations, order tests, render diagnoses, prescribe treatments, perform procedures, and screen for disease. (Screening means checking for the presence of a disease in a person who has no signs or symptoms suggestive of that disease; testing, by contrast, means performing diagnostic tests on persons who have signs or symptoms suggestive of a disease.) The screening examination likely most familiar to dermatologists is the “skin check”—that is, the clinical visual skin examination for skin cancer. The utility of skin checks remains controversial; earlier this year, the US Preventive Services Task Force (USPSTF)—an independent national panel that makes influential recommendations regarding preventive health services—concluded, again, that evidence is insufficient to recommend skin checks in the general population.1