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However, this has led to the publication of lower quality research which requires diligent discernment by the healthcare provider. In the publication of scientific manuscripts, a balance must be struck between access and cost by publishers, researchers, and the readership. Balance may be obtained via a hybrid model in which manuscripts are submitted freely, subject to stringent peer review, and become open access after a set period (i.e., 6 months).

Eruptive seborrheic keratosis: A perilous clueA 51-year-old man presented with a 1-month history of multiple eruptive seborrheic keratoses on his back and a single painless nodule on his chest. He reported occasional dry cough and loss of appetite over the past 3 months, but he did not seek medical care for them. He had no history of fever, weight loss, night sweats, or gastrointestinal complaints.The physical examination revealed an erythematous nodule measuring 3 cm by 3 cm in the right midaxillary line (Figure 1). The nodule was fi rm, mobile, and nontender on palpation, and it had a normal temperature. Also noted were multiple seborrheic keratoses of various sizes arranged in a "Christmas tree" pattern on his back (Figure 2). The rest of the examination was unremarkable.A punch biopsy was taken from the nodule. The histopathology report described an THE CLINICAL PICTURE

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