The Institute for Scientific Information (ISI) defines substantive articles as source items, which include only research and review (R&R) articles. This policy encourages some Journals to publish a significant number of original reports in the category of letters to the editor and reviews in the category of Editorials. Consequently, the Impact Factor (IF) fails to provide a fair comparison between medical journals. We introduce a new value, the Comprehensive Citation Factor (CCF), which would include in the denominator all original reports and review articles. We reassessed the 2007 ISI IF rankings of 39 dermatology journals using the CCF formula. Along with research and review articles, research letters, editorials and case reports were also included in the denominator value. The CCF was calculated for each journal and then compared with the IF provided by the ISI for 2007. The rank orders of 27/39 journals (69%) were altered by two or more places bi-directionally. Journals with a significant number of editorial and/or letters had a lower CCF. Only 4 of the 39 journals (10%) kept the same rank when evaluated with the new CCF formula. The CCF is a more accurate quantitative representation to use for individual journal comparison. This formula would encourage editors to publish more manuscripts as original or review articles, rather letters or editorials, and eliminate the need for the controversial subjective classification.