Early clues to dermatologic diagnosis

Can the classic detective Sherlock Holmes teach dermatologists a thing or two? The answer is yes, according to John E. Wolf Jr., MD, MA, professor and chairman of the department of dermatology at Baylor College of Medicine. Dr. Wolf led the Friday session “The Game’s Afoot: Sherlock Holmes & The Art of Dermatologic Diagnosis.”

The literary chronicles of Holmes’ adventures hold many references to dermatologic disorders and even more insights into the crucial art of observation and detection. The session looked at both Holmes’ literature and science, including specific diseases. Dr. Wolf offered clues in this audience participation session. Two of Holmes’ classic short stories, “The Adventure of the Blanched Soldier” and “The Adventure of the Lion’s Mane,” were a focus of Dr. Wolf’s lessons in the Sherlockian principles of detection and applying these principles to the diagnosis of a wide variety of skin disorders.

“The world is full of observations. Yet, sometimes we look at something and don’t really know what’s there,” Dr. Wolf said. “We look at it, not for it. That’s an important lesson.”

“The Adventure of the Blanched Soldier:” This scaly, white skin condition observed by Sherlock Holmes could be:
Tinea versicolor
Pityriasis Alba

“The Adventure of
the Lion’s Mane:”
This condition observed in Sherlock Holmes’ story could be:

A deadly encounter with a jellyfish (Cyanea capilata, the largest jellyfish in the world found in the deep, cold waters of the North Sea and the English Channel. Death is rare in healthy victims).

An encounter with a Portuguese man o’ war.