Narrative fallacy is a problematic heuristic that leads us to make inaccurate causeeffect relationships. They are a particular issue in case reports because of the limited scope of these papers, the perpetuated biases they proffer and the misperception of 'black swan' events. This article highlights the negative effects of these fallacies in dermatological practice through three case studies: the use of epinephrine with lignocaine at distal sites, the difference between once-daily and twice-daily application of topical steroids, and the effect of sterile gloves for skin surgery on infection rates. Awareness of the biases in case reports and the employment of metacognition may help us to avoid falling victim to narrative fallacies. Given the potential problems with this heuristic, Clinical and Experimental Dermatology (CED) utilizes case reports to further medical education and offer different clinical perspectives, rather than as a driver of medical knowledge. What is narrative fallacy?'Medicine is a science of uncertainty and an art of probability' -William Osler

Cognitive biases are a significant cause of medical error. They arise from “system 1” thinking, which depends on heuristics to make quick decisions in complex situations. Heuristics make us “predictably irrational,” distorting our ability to accurately assess probabilities in clinical scenarios. It is well reported in the literature that metacognition, the art of reflecting on one's thought processes, is the optimal way to deal with cognitive biases. However, it is unclear how this can be consistently implemented in dermatological practice. Our debiasing attempts thus far have been sporadic at best. This article categorizes important cognitive biases according to each stage of the doctor–patient interaction (history taking, clinical examination, investigations, diagnosis, and management). We hope that providing this clinically relevant framework can foster metacognition and a platform for algorithmic debiasing. This will enable us to engage “system 2” (analytical thinking) in a targeted way, thereby avoiding excessive cognitive load. Organization‐level interventions should also be implemented to free up the cognitive capacity of an individual and to enable them to employ system 2 thinking more regularly.

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