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Correspondence |

Fill the Mind—and Exercise It, Too!

A. Bernard Ackerman, MD
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Copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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Arch Dermatol. 2003;139(7):940-940. doi:10.1001/archderm.139.7.940-a
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I read with pleasure Dr Rycroft's1 essay titled "Going to See Jack" in the "The Art and the Calling" section of the November 2002 issue of the ARCHIVES. His paean to Samuel Johnson and to the unique turn of mind of that polyglot is a poignant reminder of our own intellectual obligations to our art and to our calling. In seeking to capture the distinctive mentality of Johnson in his own words, Rycroft quotes him as writing that after a "hard journey in the Scottish highlands . . . I should have been sorry to have missed any of the inconveniences, to have had more light, or less rain, for their cooperation crowded the scene, and filled the mind." Rycroft then continued, in his own words, as follows: " ‘Filled the mind'—that surely is the key to our professional well-being."

After having perused the rest of the issue, I am prompted to suggest that as important as it is that the mind be filled, it is just as essential that the mind be exercised effectively by dint of logical, critical, incisive thought. And that brings me to 3 statements made in different articles in the same issue that not only are clichés but also, in my opinion, contain ideas that should be passé: (1) "Actinic keratoses (AKs) are precancerous epidermal lesions found most frequently on areas of the skin exposed to the sun."2 (2)"Basal cell carcinoma (BCC) is the most common skin cancer in whites, with a steadily increasing incidence."3 (3) "The annual incidence of malignant melanoma per 100 000 individuals almost tripled among American men, from 6.7 in 1973 to 19.3 in 1997, and more than doubled among American women, from 5.9 to 13.8 for the same period."4

I believe that all evidence leads to the conclusions that actinic keratoses are not precancerous lesions but superficial squamous cell carcinomas,5 that squamous cell carcinoma (of which actinic keratosis is 1 type), not basal cell carcinoma, is the most common cancer of the skin,6 and that there is no epidemic of melanoma.7

In sum, as wonderful as it is to fill the mind, it is equally as marvelous to use it in a critical manner.

The author has no relevant financial interest in this article.

REFERENCES

Rycroft  RJG. Going to see Jack. Arch Dermatol. 2002;1381435- 1436
PubMed
CrossRef
Stockfleth  E, Meyer  T, Benninghoff  B.  et al.  A randomized, double-blind, vehicle-controlled study to assess 5% imiquimod cream for the treatment of multiple actinic keratoses. Arch Dermatol. 2002;1381498- 1502
PubMed
CrossRef
Heckmann  M, Zogelmeier  F, Konz  B. Frequency of facial basal cell carcinoma does not correlate with site-specific UV exposure. Arch Dermatol. 2002;1381494- 1497
PubMed
CrossRef
Al Mahroos  M, Yaar  M, Phillips  TJ, Bhawan  J, Gilchrest  BA. Effect of sunscreen application on UV-induced thymine dimers. Arch Dermatol. 2002;1381480- 1485
PubMed
CrossRef
Heaphy  MR  Jr, Ackerman  AB. The nature of solar keratosis: a critical review in historical perspective. J Am Acad Dermatol. 2000;43138- 150
PubMed
CrossRef
Brand  D, Ackerman  AB. Squamous cell carcinoma, not basal cell carcinoma, is the most common cancer in humans. J Am Acad Dermatol. 2000;42523- 526
PubMed
CrossRef
Swica  Y, Koehler  A, Ackerman  AB. Lies, damn lies, and statistics: why there is no epidemic of melanoma. Dermatopathol Pract Concept. 2001;7347- 354

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Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Rycroft  RJG. Going to see Jack. Arch Dermatol. 2002;1381435- 1436
PubMed
CrossRef
Stockfleth  E, Meyer  T, Benninghoff  B.  et al.  A randomized, double-blind, vehicle-controlled study to assess 5% imiquimod cream for the treatment of multiple actinic keratoses. Arch Dermatol. 2002;1381498- 1502
PubMed
CrossRef
Heckmann  M, Zogelmeier  F, Konz  B. Frequency of facial basal cell carcinoma does not correlate with site-specific UV exposure. Arch Dermatol. 2002;1381494- 1497
PubMed
CrossRef
Al Mahroos  M, Yaar  M, Phillips  TJ, Bhawan  J, Gilchrest  BA. Effect of sunscreen application on UV-induced thymine dimers. Arch Dermatol. 2002;1381480- 1485
PubMed
CrossRef
Heaphy  MR  Jr, Ackerman  AB. The nature of solar keratosis: a critical review in historical perspective. J Am Acad Dermatol. 2000;43138- 150
PubMed
CrossRef
Brand  D, Ackerman  AB. Squamous cell carcinoma, not basal cell carcinoma, is the most common cancer in humans. J Am Acad Dermatol. 2000;42523- 526
PubMed
CrossRef
Swica  Y, Koehler  A, Ackerman  AB. Lies, damn lies, and statistics: why there is no epidemic of melanoma. Dermatopathol Pract Concept. 2001;7347- 354

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