Editorial, JCMS Vol. 2(1)
I am delighted to welcome our readers to the second volume of the Journal of Cutaneous Medicine and Surgery. In this issue, our basic science section features a number of significant issues that reflect the quality and diversity of inquiry and explanation in the field of cutaneous biology and dermatology. Paul Oh and colleagues have applied their expertise in pharmacoeconomics to compare the cost-effectiveness of two dermatologic treatments, calcipotriol versus topical corticosteroids, in the management of plaque-type psoriasis. With third-party payers and government scrutinization becoming a major influence on our prescribing habits, this is clearly a relevant concern. This matter is also underscored by our Point-Counterpoint this month from Drs. Lyn Guenther and Neil Shear, who examine the pros and cons of comprehensive and limited government-sponsored drug benefit plans. Krueger and Jorgensen are also featured in the basic science section of this issue, with an article that supports a role for mesenchymal cells, namely fibroblasts, in regulating epidermal cell proliferation and differentiation in psoriasis.
Continuing with the CME articles on assessing scientific data, Heacock and Rivers review the case-control study as it applies to dermatology. We have received very positive feedback on our critical appraisal series thus far, and I hope that it continues to act as an effective mechanism for interpreting the solutions to problems facing the practicing dermatologist. Methotrexate has been a mainstay as a treatment for severe psoriasis for over three decades. Yet, our understanding and management of methotrexate-treated patients is under constant flux. One of the most efficacious advances we have seen is the routine use of folic acid supplementation on a daily basis in patients receiving methotrexate. Drs. Rosenthal, Guenther, and Kelly further review and provide us with an educational update on this important subject.
One of the most rapidly changing areas in dermatology relates to the changes in dermatologic surgery, with new modalities and advances in lasers being developed on almost a monthly basis. Although lasers have indeed transformed our treatment of dermatologic diseases, in some situations standard effective therapies are being supplanted by more modern therapies that have not received the test of time. Electrocautery is a modality that has been used for more than a century, yet still has a significant place in the treatment of a number of cutaneous lesions. This technique is examined in an interesting article by Langtry and Carruthers regarding the treatment of benign cutaneous lesions.
It is with regret that I convey the message of Dr. James Nethercotts tragic death on February 2, 1997. Dr. Nethercott contributed greatly to our understanding of contact dermatitis and occupational dermatology, locally at the University of Toronto, nationally, and internationally. As head of dermatology at St. Michaels hospital, his keen interest and indefatigable efforts established an expertise in occupational skin disease. This expertise eventually was instrumental in establishing the Department of Occupational and Environmental Health at the University of Toronto, where he became the first director. I had the privilege of working with him on a number of panels, where his insights and expertise were invaluable. Dr. Nethercotts commitment and dedication as an Editorial Board member contributed to bringing JCMS to its fruition, and his irreplaceable efforts have played a significant role in the success of our Journal. Dr. Linn Holness, a colleague and friend of Dr. Nethercotts, has provided us with a tribute in his memory (see page 29).
Daniel N. Sauder
Division of Dermatology
University of Toronto
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