How does dermatology benefit from systematic reviews

Dermatology can benefit from systematic reviews in three main ways.

• They provide a much more comprehensive literature search than a standard review. For example, when issues of Clinical and Experimental Dermatology from 1976 to 1997 were hand searched, 96 clinical trials were identified whereas Medline listed only 47.8

• People with skin problems are helped by clinical recommendations. For example, the CSG's review on "local treatments for cutaneous warts" found that simple topical treatments containing salicylic acid appear to be both effective and safe. There was no clear evidence that any other treatments have a particular advantage in terms of higher cure rates and/or fewer adverse effects.9

• Cochrane reviews have been criticised for not always providing evidence on which to base clinical decisions but a recent review examined all 26 systematic reviews relevant to dermatology in the CDSR and found sufficient evidence to make therapeutic recommendations in at least half of these reviews.10 Even when no evidence is available, Cochrane reviews identify gaps in knowledge and frame the future research agenda. For example, the CSG's review on "Drugs for discoid lupus erythematosus" highlighted the need for RCTs looking at the use of potent topical steroid versus chloroquine/hydroxychloroquine.11

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