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Doody's Review ServiceReviewer: Renata H. Mullen, MD (Palo Alto Medical Foundation)
Description: This is a pocket reference guide to the general field of clinical dermatology.
Purpose: According to the authors, the aim of the book is to serve as a "portable, visual, peripheral brain" for clinicians when confronted with patients with skin disease. These worthy objectives are, for the most part, met.
Audience: The book is written for any healthcare professional dealing with patients with skin disorders, including medical students, residents, and physicians, and it appears to be aimed primarily at nondermatologists. The authors are not themselves dermatologists, which on the one hand helps them understand and fulfill the needs of the nondermatology audience, but on the other hand, means they lack some of the expertise of specialists who see only skin problems on a daily basis.
Features: The book begins with a list of skin diseases by region of the body involved, then by morphology. This overlaps somewhat with the next section, which goes over differential diagnosis. The remainder, and majority, of the book is devoted to the description of 164 dermatologic conditions. Each entity is described in several sections: etiology, clinical features, diagnostic tests, differential diagnosis, treatment, and clinical pearls. The book closes with appendixes, a useful listing of cortisone strengths, cutaneous manifestation of internal disease, nail disease, and stings and bites. The idea of a concise pocket guide that can be used in a busy clinical setting is brilliant. The section describing dermatologic disorders is well organized, concise yet complete, and incorporates much practical information. The book has a plastic cover that makes it truly pocket-friendly. The major shortcoming of the book lies in the clinical photos, many of which are taken from too far away or without adequate lighting to be of pedagogic value. Several well done photos from other books are used and should serve as a guide for the remaining photos. Since the book is physically small, the photos need to be large enough to show enough detail. In several instances, two small very similar photos are shown, whereas one larger, more detailed photo would be more illustrative. The problem is further highlighted in the appendix with nail photos, where a close-up lens would have added much clinical detail. Moreover, several of the disease entities do not include important variations of the clinical presentation; for example, only one photo of a nodular melanoma is shown, with a second photo illustrating a resultant surgical scar. Instead, additional photos of superficial spreading, amelanotic, and acral melanoma would be more informative. Secondly, the terminology section has some inconsistencies as well, making the distinction between a papule and plaque/nodule at 5mm. The more widely accepted description is at 10mm, which would be important when documenting the physical exam or describing a lesion to a consultant. Furthermore, there are several typos, which might be confusing to the nondermatologist, such as vipoma, agnogenic flushing, and pemphigus bulgaris (maybe found in Bulgaria only). Lidex is incorrectly listed as fluticinomide rather than fluocinonide, causing it to be possibly mistaken for Cutivate (fluticasone). Yet another shortcoming is in the appendix on cutaneous manifestations of internal disease, which shows only nine photos, with room for seven more, which would have been valuable additions. Two of the existing photos fail to mention the associated internal disease. Lastly, two important diseases are omitted, namely pityriasis lichenoides chronica and pityriasis lichenoides et varioliformis acuta. Since these are encountered only in dermatology, a detailed description would be helpful.
Assessment: A book of this type is needed and extremely useful. This particular one is valuable despite its shortcomings and could be improved upon in subsequent editions. I would love to offer a dermatologist's perspective in the second edition.