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PapersLocal treatments for cutaneous warts: systematic reviewCommentary: Systematic reviewers face challenges from varied study designs

BMJ 2002; 325 doi: (Published 31 August 2002) Cite this as: BMJ 2002;325:461

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Re: Re: Is the practice of dermatology based on science or anecdotal opinion?

Many moons ago, I like so many before me, suffered with a rather
large and painful plantar wart. Its discomforts forced upon me were burned
with every second step. I suffer fools badly, and I suffered this very
wart with an even shorter temper.

Not for me the patience demanded of salicylic acid. The anecdotes of
the quick fix drew me into a world of falsehood. In this world the gases
boiled across the earth and transient thick white fogs dissipated with the
speed of ghosts at sunrise. But this devil's world of untruths held me
fast for nigh on twelve months. I could not release myself from the
temptation of the instant cure. And so the liquid nitrogens burned deep
into my sole, and time winced at every step.

Of course, in time I was taken from this mysterious world and forced
to walk upon the hot and scorched earths of the Northern Territory (in the
southern lands). Day in, day out, I walked (and limped) upon the burning
and ash laden earth.

The mechanical stresses upon my dear sole prooved offensive to the
grim and ugly wart. And so the afflicted sole took flight, leaving my soul
to rejoice. No longer would I have to suffer the empty promises of those
boiling cold mists. No longer would I suffer the jests of all those other
merry anecdotes (with bells on). Hoorah, no longer would I pass a week
with a browning, rotting banana skin taped about my wretched foot!

And so to consider the lessons of my trials. The anecdote suggests
all too strongly the ephemeral nature of success with the boiling gases.
The banana skin was quite frankly, little more than slapstick humour at my
expense. But maybe I could seek pleasure in the last laugh.....I could
send people half-way round the world to walk through burning lands, where
not fogs and mists tumble through the air, but thick and blackened smoke
seeks out and chokes the depths of the lungs.

But then that would be to forget the most important lesson. The
tempest may torment the soul, but the temporal heals the sole. And that of
course is why we must suffer the trials and tribulations of evidence based

Competing interests: No competing interests

07 September 2002
Christopher A Weiner
SpR Public Health Medicine
Wolverhampton PCT WV3 0XE