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Itch: Mechanisms and management of pruritus
304
Journal of the American Academy of Dermatology February 1995
Book reviews
the series of monographs in Clinical Dermatology. Following the tradition of its predecessors in the series, this volume is a timely, comprehensive, multiauthored contribution, which covers most of the relevant and intriguing territory related to cytokines and the skin, in particular, the epidermis. Although the vast majority of the information contained in this text has yet to be applied to the sphere of clinical dermatology, the objectives of assembling this monograph were not only to update the cognoscenti in related fields of cytokine investigation but also to educate both the neophyte and the seasoned clinical dermatologist who will, no doubt, eventually witness the application of these biologic response modifiers to treatment of patients. The focus and breadth of Epidermal Growth Factors and Cytokines is evident throughout, including the introductory overview (“Immunobiology of the Skin”) and the 22 chapters that follow. Topics range from the interleukins and growth factors to the epidermal cytokine network, and the monograph closes expectantly with a chapter on cytokine therapy by the editors and Dr. Trautinger. For the most part, the wealth of information contained in this single volume is current and accurate, although certain speculation about the role of several of these factors in cutaneous biology and pathology takes on almost a factual context and must be cautiously interpreted. The editors and authors were able, by and large, to meet the challenge of constructing a fairly complete scientific rendering depicting the many families of cytokines and growth factors that are produced within the skin. However, this field continues to advance rapidly and newer growth factors such as the neu differentiation factors (NDFs)/heregulins of the epidermal growth factor (EGF) family and vascular endothelial cell growth factor (VEGF) of the platelet-derived growth factor (PDGF) family were excluded. Several members of the interleukin family were only briefly mentioned or did not apparently merit discussion, although more recent evidence implicates their potential significance in the pathophysiology of several skin diseases. These shortcomings notwithstanding, the text is one of the most complete and up-to-date compendiums on cytokines and growth factors relevant to the skin. The volume serves as a handy reference to those dermatologists actively investigating the biology and disease of the skin and to other researchers desiring to learn what the skin has to offer in the search for the function of cytokines and growth factors. In addition, the text hopefully will make its way onto the bookshelves and reading lists of dermatologists in training and in practice who yearn to learn what’s new and important about growth factors and cytokines of the skin. Mark R. Pittelkow, MD Rochester, Minnesota
Itch: Mechanisms and management of pruritus
Jeffrey D. Bernhard, MD, editor, New York, 1994, McGraw-Hill, Inc. 454 pages. $50.00. Dr. Bernhard, known to readers as the author of interesting tidbits about pruritus that have arrived in the mail through various vehicles, has assembled contributors with knowledge and interest in mechanisms, diagnosis, and treatment of itch. The result is a portable resource that will serve a wide audience, from practitioners to drug designers, and even itching patients and the literally curious. The clinically oriented chapters start with our big problems (dealing with pruritus in atopic dermatitis and psoriasis) and then explore differential diagnosis of pruritic eruptions in morphologic categories at different body sites. The chapters on scratching, strange sensations, and pruritic curiosities are as entertaining as they are insightful. Dr. Fitzpatrick’s chapter recalling seven memorable scenarios involving itchy patients offers clinical lessons that effectively bridge the sections on cutaneous versus systemic aspects of pruritus. If you are looking for a single, recommended, cost-effective, managed-care-approved, “surefire” approach to assessmentof the patient with generalized pruritus in the absence of skin lesions, you will not find one. Instead, the reader is guided through several perspectives and possible approaches. Along the way, there are up-to-date discussions of pruritus in AIDS, pregnancy, malignancy, and a useful chapter on drugs that may be associated with pruritus without a skin eruption. As with most multiauthored texts, there are varying points of view and, thus, some inconsistencies in style and some tables. The photographs of prurigo nodularis do not add to the text. Therapeutic options are offered throughout the text, and the final sections of the book are focused on treatment of itch. Refreshingly, the offerings go into detail “beyond” steroids and antihistamines, to include psychobiologic, phototherapeutic, and additional topical options for itch management. The overall result is a user-friendly, yet definitive reference for us all, and the price is right. Perhaps Dr. Bernhard will be encouraged to tackle a topic such as “sensitive skin” next. Elizabeth F. Sherertz, MD Winston-Salem, North Carolina
Facial danger zones: Avoiding nerve injury in facial plastic surgery
Brooke Seckel, MD, St. Louis, 1994, Quality Medical Publishing. 52 pages. $85.00. This bookwas written to bring to the attention of a wide audience the anatomic locations of the most susceptible
Journal of the American Academy of Dermatology February 1995
Book reviews
the series of monographs in Clinical Dermatology. Following the tradition of its predecessors in the series, this volume is a timely, comprehensive, multiauthored contribution, which covers most of the relevant and intriguing territory related to cytokines and the skin, in particular, the epidermis. Although the vast majority of the information contained in this text has yet to be applied to the sphere of clinical dermatology, the objectives of assembling this monograph were not only to update the cognoscenti in related fields of cytokine investigation but also to educate both the neophyte and the seasoned clinical dermatologist who will, no doubt, eventually witness the application of these biologic response modifiers to treatment of patients. The focus and breadth of Epidermal Growth Factors and Cytokines is evident throughout, including the introductory overview (“Immunobiology of the Skin”) and the 22 chapters that follow. Topics range from the interleukins and growth factors to the epidermal cytokine network, and the monograph closes expectantly with a chapter on cytokine therapy by the editors and Dr. Trautinger. For the most part, the wealth of information contained in this single volume is current and accurate, although certain speculation about the role of several of these factors in cutaneous biology and pathology takes on almost a factual context and must be cautiously interpreted. The editors and authors were able, by and large, to meet the challenge of constructing a fairly complete scientific rendering depicting the many families of cytokines and growth factors that are produced within the skin. However, this field continues to advance rapidly and newer growth factors such as the neu differentiation factors (NDFs)/heregulins of the epidermal growth factor (EGF) family and vascular endothelial cell growth factor (VEGF) of the platelet-derived growth factor (PDGF) family were excluded. Several members of the interleukin family were only briefly mentioned or did not apparently merit discussion, although more recent evidence implicates their potential significance in the pathophysiology of several skin diseases. These shortcomings notwithstanding, the text is one of the most complete and up-to-date compendiums on cytokines and growth factors relevant to the skin. The volume serves as a handy reference to those dermatologists actively investigating the biology and disease of the skin and to other researchers desiring to learn what the skin has to offer in the search for the function of cytokines and growth factors. In addition, the text hopefully will make its way onto the bookshelves and reading lists of dermatologists in training and in practice who yearn to learn what’s new and important about growth factors and cytokines of the skin. Mark R. Pittelkow, MD Rochester, Minnesota
Itch: Mechanisms and management of pruritus
Jeffrey D. Bernhard, MD, editor, New York, 1994, McGraw-Hill, Inc. 454 pages. $50.00. Dr. Bernhard, known to readers as the author of interesting tidbits about pruritus that have arrived in the mail through various vehicles, has assembled contributors with knowledge and interest in mechanisms, diagnosis, and treatment of itch. The result is a portable resource that will serve a wide audience, from practitioners to drug designers, and even itching patients and the literally curious. The clinically oriented chapters start with our big problems (dealing with pruritus in atopic dermatitis and psoriasis) and then explore differential diagnosis of pruritic eruptions in morphologic categories at different body sites. The chapters on scratching, strange sensations, and pruritic curiosities are as entertaining as they are insightful. Dr. Fitzpatrick’s chapter recalling seven memorable scenarios involving itchy patients offers clinical lessons that effectively bridge the sections on cutaneous versus systemic aspects of pruritus. If you are looking for a single, recommended, cost-effective, managed-care-approved, “surefire” approach to assessmentof the patient with generalized pruritus in the absence of skin lesions, you will not find one. Instead, the reader is guided through several perspectives and possible approaches. Along the way, there are up-to-date discussions of pruritus in AIDS, pregnancy, malignancy, and a useful chapter on drugs that may be associated with pruritus without a skin eruption. As with most multiauthored texts, there are varying points of view and, thus, some inconsistencies in style and some tables. The photographs of prurigo nodularis do not add to the text. Therapeutic options are offered throughout the text, and the final sections of the book are focused on treatment of itch. Refreshingly, the offerings go into detail “beyond” steroids and antihistamines, to include psychobiologic, phototherapeutic, and additional topical options for itch management. The overall result is a user-friendly, yet definitive reference for us all, and the price is right. Perhaps Dr. Bernhard will be encouraged to tackle a topic such as “sensitive skin” next. Elizabeth F. Sherertz, MD Winston-Salem, North Carolina
Facial danger zones: Avoiding nerve injury in facial plastic surgery
Brooke Seckel, MD, St. Louis, 1994, Quality Medical Publishing. 52 pages. $85.00. This bookwas written to bring to the attention of a wide audience the anatomic locations of the most susceptible