—I read with interest in the July issue of the Archives the editorial concerning primary care physicians performing skin biopsy procedures. Last week, I was asked to see a young woman by a primary care physician for evaluation of a single lesion on her upper arm. A biopsy specimen of this lesion had been obtained by the physician, who referred the patient to a general pathologist who made a histopathologic diagnosis of "nonspecific dermatitis." Due to the chronic nature of this lesion, a potent topical steroid (betamethasone dipropionate) as well as prednisone (30 mg/d) were prescribed, and, finally, due to a lack of response to this therapy, the patient was referred to me, and a copy of her pathology report was provided.
Findings from a clinical examination revealed an obvious inflammatory tinea infection, for which a three-week course of griseofulvin (500 mg/d) was prescribed, leading to a total clearing of