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Skin disorders (AAFP)
BOOK
REVIEWS
E. Schaefer, MD, Philadelphia, 1999, Lippincott Williams & Wilkins. 432 pages. $39.95 (softbound).
Skin disorders (AAFP) Eugene J. Barone, MD, Judson C. Jones, MD, Joann J AM ACAD DERMATOL
The authors of the text Skin Disorders state in their acknowledgments section that “writing a book is a massive, time-consuming undertaking which requires the support of many individuals.” Anyone who has attempted to write a book cannot agree more with this pithy statement. To the authors’ credit, and perhaps to the detriment of the text, it is remarkable that no assistance from dermatologists was needed to complete this work. This is a unique and admirable approach, and the book is a member of a larger collection, The Academy Collection: Quick Reference Guides for Family Physicians. These books are written by and for family physicians. It is a fact that most dermatologic care within the United States is provided by primary care physicians. Family physicians do provide a substantial proportion of such care, and trainees at our university demonstrate intense motivation to learn core knowledge about skin disorders. (Please note that the author of this review has a potential conflict of interest, inasmuch as recently he has published a text aimed at the generalist audience entitled “20 Common Problems in Dermatology.”) The text has several strengths. First, the overall organization of the text is logical and reasonable. Dividing all of dermatologic disease into separate chapters is not an easily accomplished task. Each chapter and section is brief and is presented in strict outline form. A unique feature of this work is a subsection present in the discussion of many disease states entitled “Family and Community Support.” The perspective of treating the entire patient within the context of the patient’s relationship to his or her community is a superb one that dermatologists should consider. However, these recommendations for support are frequently absurd. For instance, the potentially lifethreatening disease bullous pemphigoid requires family and community support because the disease is “cosmetically disfiguring.” Pemphigus vulgaris requires no such support. The authors’ concept of support is a superb one, but in this text it is not included or excluded in a uniform and consistent manner. As a dermatologist reviewing this text, I was uncomfortable with the “Diagnostic Chart” that serves as a combination of an instructive differential diagnosis table and detailed table of contents. This chart lists symptoms such as “rash, flat, (macule or patches)” and then suggests diagnoses that fit the description. I found the inclusions and exclusions to JANUARY 2001 151
152 Book reviews
the categories most extraordinary. For instance, there was no mention of tinea capitis as a cause of alopecia or pigmented purpuric eruptions as the cause of purpura. Within the category “facial hyperpigmentation,” the only differential diagnostic entity was porphyria cutanea tarda. To help the clinician, I would have expected a broad differential diagnosis for facial hyperpigmentation ranging from melasma and atopic dermatitis to chronic cutaneous lupus erythematosus. Incidentally, the index to Skin Disorders does not list lupus erythematosus, nor does the chapter on “Photosensitivity” or “Immune and Autoimmune Disorders” discuss chronic cutaneous lupus. By contrast, there was a nice and complete differential diagnosis listed in the diagnostic chart for the symptom “pruritis” (although “pruritus” was misspelled). Throughout the text, recommendations for biopsy technique mention exclusively punch biopsies, ignoring potential benefits of shave or excisional biopsy techniques. The only treatment recommend-
J AM ACAD DERMATOL JANUARY 2001
ed for herpes labialis is topical penciclovir, an agent of marginal usefulness. In the section discussing urticaria, the authors state: “Attacks of chronic urticaria can persist for 30 to 45 days before resolving on their own.” My patients with daily urticaria of many years’ duration will be pleased to know that they have only a few fortnights of urticaria remaining. I could continue along this line of discussion, but this would accomplish little more than to solidify the lack of depth of understanding of the authors. I have utmost respect for the magnitude of the project that these authors have undertaken, and, indeed, there are strengths that are notable. However, for the educational purposes of the readers, there are numerous general and specific texts of dermatology that provide thorough coverage of the subject matter. Alan B. Fleischer, Jr, MD Winston-Salem, North Carolina 16/8/110657
BOUND VOLUMES AVAILABLE TO SUBSCRIBERS Bound volumes of the Journal of the American Academy of Dermatology are available to subscribers (only) for the 2001 issues from the Publisher at a cost of $123.00 for domestic, $151.94 for Canadian, and $142.00 for international for volume 44 (January-June) and volume 45 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact Mosby, Subscription Customer Service, 6277 Sea Harbor Dr, Orlando, FL 32887; phone 800-654-2452 or 407-345-4000. Subscriptions must be in force to qualify. Bound volumes are not available in place of a regular journal subscription.
REVIEWS
E. Schaefer, MD, Philadelphia, 1999, Lippincott Williams & Wilkins. 432 pages. $39.95 (softbound).
Skin disorders (AAFP) Eugene J. Barone, MD, Judson C. Jones, MD, Joann J AM ACAD DERMATOL
The authors of the text Skin Disorders state in their acknowledgments section that “writing a book is a massive, time-consuming undertaking which requires the support of many individuals.” Anyone who has attempted to write a book cannot agree more with this pithy statement. To the authors’ credit, and perhaps to the detriment of the text, it is remarkable that no assistance from dermatologists was needed to complete this work. This is a unique and admirable approach, and the book is a member of a larger collection, The Academy Collection: Quick Reference Guides for Family Physicians. These books are written by and for family physicians. It is a fact that most dermatologic care within the United States is provided by primary care physicians. Family physicians do provide a substantial proportion of such care, and trainees at our university demonstrate intense motivation to learn core knowledge about skin disorders. (Please note that the author of this review has a potential conflict of interest, inasmuch as recently he has published a text aimed at the generalist audience entitled “20 Common Problems in Dermatology.”) The text has several strengths. First, the overall organization of the text is logical and reasonable. Dividing all of dermatologic disease into separate chapters is not an easily accomplished task. Each chapter and section is brief and is presented in strict outline form. A unique feature of this work is a subsection present in the discussion of many disease states entitled “Family and Community Support.” The perspective of treating the entire patient within the context of the patient’s relationship to his or her community is a superb one that dermatologists should consider. However, these recommendations for support are frequently absurd. For instance, the potentially lifethreatening disease bullous pemphigoid requires family and community support because the disease is “cosmetically disfiguring.” Pemphigus vulgaris requires no such support. The authors’ concept of support is a superb one, but in this text it is not included or excluded in a uniform and consistent manner. As a dermatologist reviewing this text, I was uncomfortable with the “Diagnostic Chart” that serves as a combination of an instructive differential diagnosis table and detailed table of contents. This chart lists symptoms such as “rash, flat, (macule or patches)” and then suggests diagnoses that fit the description. I found the inclusions and exclusions to JANUARY 2001 151
152 Book reviews
the categories most extraordinary. For instance, there was no mention of tinea capitis as a cause of alopecia or pigmented purpuric eruptions as the cause of purpura. Within the category “facial hyperpigmentation,” the only differential diagnostic entity was porphyria cutanea tarda. To help the clinician, I would have expected a broad differential diagnosis for facial hyperpigmentation ranging from melasma and atopic dermatitis to chronic cutaneous lupus erythematosus. Incidentally, the index to Skin Disorders does not list lupus erythematosus, nor does the chapter on “Photosensitivity” or “Immune and Autoimmune Disorders” discuss chronic cutaneous lupus. By contrast, there was a nice and complete differential diagnosis listed in the diagnostic chart for the symptom “pruritis” (although “pruritus” was misspelled). Throughout the text, recommendations for biopsy technique mention exclusively punch biopsies, ignoring potential benefits of shave or excisional biopsy techniques. The only treatment recommend-
J AM ACAD DERMATOL JANUARY 2001
ed for herpes labialis is topical penciclovir, an agent of marginal usefulness. In the section discussing urticaria, the authors state: “Attacks of chronic urticaria can persist for 30 to 45 days before resolving on their own.” My patients with daily urticaria of many years’ duration will be pleased to know that they have only a few fortnights of urticaria remaining. I could continue along this line of discussion, but this would accomplish little more than to solidify the lack of depth of understanding of the authors. I have utmost respect for the magnitude of the project that these authors have undertaken, and, indeed, there are strengths that are notable. However, for the educational purposes of the readers, there are numerous general and specific texts of dermatology that provide thorough coverage of the subject matter. Alan B. Fleischer, Jr, MD Winston-Salem, North Carolina 16/8/110657
BOUND VOLUMES AVAILABLE TO SUBSCRIBERS Bound volumes of the Journal of the American Academy of Dermatology are available to subscribers (only) for the 2001 issues from the Publisher at a cost of $123.00 for domestic, $151.94 for Canadian, and $142.00 for international for volume 44 (January-June) and volume 45 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact Mosby, Subscription Customer Service, 6277 Sea Harbor Dr, Orlando, FL 32887; phone 800-654-2452 or 407-345-4000. Subscriptions must be in force to qualify. Bound volumes are not available in place of a regular journal subscription.