Comment: A problem shared ...

When I came to work in Lincolnshire 16 years ago, initially as a single-handed consultant, I had two principal concerns. First, what would I do when I did not know the diagnosis? Second, how I would cope with those patients with chronic, intractable dermatoses – patients with nodular prurigo, palmoplanter pustulosis, difficult atopic eczema, or severe psoriasis? I felt much better about the first group after recalling the kind and wise words of the great Dr John Savin, who taught me as a Senior Registrar in Edinburgh. I had just finished my final dermatology clinic before leaving to become a consultant. I, somewhat ruefully, remarked, ‘I’ve just done my last clinic and I haven’t got a clue what was wrong with four of the patients’. Dr Savin responded along the lines of, ‘Don’t worry, I’ve been doing dermatology for over 30 years and it keeps happening to me – that’s the fascination of dermatology!’