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The skin doctor's skin doctoring book
Volume 10 Number 1 January, 1984 ingly complete compendium of therapeutic tips or " p e a r l s " or (as Rees B. Rees, M.D., suggests in the foreword) "arrows for the therapeutic q u i v e r . " The publishers have produced a sturdy, attractive little manual with an appealing format and v e r y few typographic errors. The organization of the book is simple. A disease is briefly introduced and then a number of acceptable therapies are discussed critically in varying degrees of detail. Brief appropriate references a r e included after each disease section. While s o m e diagnostic information is given, I am sure Dr. Landow would be quick to agree that his m a n u a l cannot replace an introductory textbook. It does n o t even have the degree of diagnostic detail i n c l u d e d in Kenneth Arndt's now widely accepted Manual of Dermatologic Therapeutics. While Dr. L a n d o w states in his introduction that his book is " d i r e c t e d at medical students, house officers, p r i m a r y care physicians, and dermatologists in t r a i n i n g , " I fee! that only physicians already exp e r i e n c e d in diagnosing skin diseases can benefit fully f r o m the vast array of therapeutic suggestions offered. I e x a m i n e d the book particularly carefully as it c o v e r e d the areas that I find most difficult to treat. In the realm of hand dermatitis I was frankly disappointed. But in every other section, I was most pleased. Ten approaches to Raynaud's phenomenon o r disease are offered, including the use of nifedipine. Colchicine in Beh~et syndrome is detailed carefully, as are dinitrochlorobenzene ( D N C B ) and bleomycin in recalcitrant warts. W h e n discussing potentially troublesome or unp r o v e d therapies, Dr. Landow is quick to point out their disadvantages and I doubt if he will lead a n y o n e astray. Dr. R e e s also states in his foreword that "there are t h o s e who might be critical of the book, especially certain academicians." At the risk of being labeled a "certain academician," I will make only a few constructive suggestions which I would hope c o u l d be incorporated into the next edition. First, although we all agree that organizing a derm a t o l o g y textbook is a hopeless task, I see little r e a s o n to include acne as a "bacteria-like infect i o n " o r to designate Darier's disease as a "papu-
Book reviews
153
losquamous disorder" but put Halley-Halley disease in with the "bullous disorders." Fortunately, the index is very workable, and each section can be read as it stands, so any question of organization is strictly aesthetic, Second, Dr. Landow has been unable to resist the temptation to include certain lists which we have all memorized at one time or another. I think the space occupied by the types of ichthyosis or the use of special histologic stains could have been devoted to matters therapeutic. But despite these minor criticisms, I am most enthusiastic about this little gem. I think every clinician likes to have as many books as possible that provide him with additional therapeutic suggestions for cases that fail to respond to his ordinary treatment. Dr. Landow has certainly succeeded in sharing a vast clinical experience with his colleagues both in general medicine and in dermatology. "Old Blue Eyes" can be proud of him.
Walter H. C. Burgdorf, M.D. Oklahoma City. OK The skin doctor's skin doctoring book Thomas Goodman, M.D., New York, 1984, Sterling Publishing Co. Inc. Soft cover, $7.95; hard cover, $14.95. One way to reduce the cost of medical care is to avoid all unnecessary visits to the doctor. For instance, a family could reduce spending if they were able to do much or all of the routine medical care for themselves and utilize the true medical expert only for the difficult jobs. The medical sophistication needed for this task is what the consumerist movement hopes to develop. Consumerists will like this book concerning the dermatologic side of the effort. The simple routine therapies for skin are well presented. All precautions are made clear to any careful reader of Dr. Goodman's book. The author displays his skill and long experience in instructing patients, accurately and cheerfully. Ailments such as mild and routine acne. eczema, warts, seborrheic dermatitis, poison ivy dermatitis, psoriasis, lice infestation, herpes simplex infection, canker sores, shingles, pityriasis versicolor and pityriasis rosea, when they remain
154
Book reviews
uncomplicated, seem to be manageable just as well by the well-informed patient himself as by the family physician or by the nurse practitioner. When the conditions are unusual, the case atypical, or the affliction severe, the practical route for the patient is straight to the dermatologist. Patients are likely to understand a better concern with technical quality in medical care as they gain experience and sophistication. Goodman recommends the dermatologist, but with such elaborate tact (so as not to offend anyone) that sometimes he is difficult to understand. At least he does say plainly that dermatologists are the best choice for treating mycotogic infections. I would urge that if consumers do comparison shopping, they soon will recognize the benefits of having a dermatologist treat all complex integumental diseases. These consumerist medical books sincerely aim to educate the patients and this is a major challenge. Most popular press and television journalists are so inept that they have failed to communicate reliably even the faintest fundamental truths about science or medicine. The public and private schools have never been willing to teach human biology suitable for the 1980s. Therefore, Dr. Goodman begins with an enormous pedagogic disadvantage and a vast backlog of misinformation to correct. His main goal in the book is education of the public. For the most part he does the job well, but he cannot bring himself to explain the direct placebo effect, or the uselessness of most "alternative or folksy therapy. ' ' With these lapses, he is drawn into recommending some dubious food and vitamin therapies for herpes and aphthous stomatitis and some other folk medicine for warts. Not too bad, overall. You can recommend this book to any lay audience, and it would be most suitable for consumerist groups or those forced to limit their spending. Should welfare agencies consider major cutbacks in unnecessary medical care? It would be interesting to decide what savings would be possible if even a modest amount of consumerist self-care were taught and encouraged, and if back-up specialized care were strongly in support. The new sense of self-sufficiency alone would be worth it. Dr. Goodman has given a strong push to the growing consumerist effort in medi-
Journal of the American Academy of Dermatology
cine, and his well-planned book deserves your attention.
Philip C. Anderson, M.D. Columbia, MO Chemotaxis and inflammation Peter C. Wilkinson, M.D., ed. 2, New York, 1982, Churchill Livingstone Inc. 205 pages. $37.50. Over the last 20 years, medical science has witnessed an explosion of information relevant to the inflammatory process and the function of leukocytes in inflammatory events. The directional movement of leukocytes to chemical stimuli has been shown to be a critical phenomenon in inflammation. Previously obscure terms, such as chemotaxis and chemokinesis, have assumed major importance to scientists and physicians involved in the study of normal inflammation and derangements of the process. Physicians, including dermatologists, who deal with inflammatory diseases have followed the developments in this area with interest and have appreciated a better understanding of a number of disease processes. The medical literature pertinent to the understanding of leukocyte function in inflammation has become so voluminous that there is a pressing need for a scholarly update of the subject. The first edition of the monograph, Chemotaxis and Inflammation, served this purpose in 1974. In the second edition, published in 1982, Dr. Peter C. Wilkinson has summarized and put into perspective the current knowledge of leukocyte movement. This area has been such an active area of investigation that this book represents not just a revision of the first edition but a completely rewritten monograph. Chemotaxis and Ir~ammation will serve as a valuable reference for seasoned researchers, novice researchers, and clinicians. Dr. Wilkinson appropriately spends two chapters describing leukocyte movement, defining terms, and summarizing the developments in the field prior to the advent of the Boyden chamber in 1962. Technics used to assay leukocyte movement are described and evaluated in a single chapter, and the appen-
Book reviews
153
losquamous disorder" but put Halley-Halley disease in with the "bullous disorders." Fortunately, the index is very workable, and each section can be read as it stands, so any question of organization is strictly aesthetic, Second, Dr. Landow has been unable to resist the temptation to include certain lists which we have all memorized at one time or another. I think the space occupied by the types of ichthyosis or the use of special histologic stains could have been devoted to matters therapeutic. But despite these minor criticisms, I am most enthusiastic about this little gem. I think every clinician likes to have as many books as possible that provide him with additional therapeutic suggestions for cases that fail to respond to his ordinary treatment. Dr. Landow has certainly succeeded in sharing a vast clinical experience with his colleagues both in general medicine and in dermatology. "Old Blue Eyes" can be proud of him.
Walter H. C. Burgdorf, M.D. Oklahoma City. OK The skin doctor's skin doctoring book Thomas Goodman, M.D., New York, 1984, Sterling Publishing Co. Inc. Soft cover, $7.95; hard cover, $14.95. One way to reduce the cost of medical care is to avoid all unnecessary visits to the doctor. For instance, a family could reduce spending if they were able to do much or all of the routine medical care for themselves and utilize the true medical expert only for the difficult jobs. The medical sophistication needed for this task is what the consumerist movement hopes to develop. Consumerists will like this book concerning the dermatologic side of the effort. The simple routine therapies for skin are well presented. All precautions are made clear to any careful reader of Dr. Goodman's book. The author displays his skill and long experience in instructing patients, accurately and cheerfully. Ailments such as mild and routine acne. eczema, warts, seborrheic dermatitis, poison ivy dermatitis, psoriasis, lice infestation, herpes simplex infection, canker sores, shingles, pityriasis versicolor and pityriasis rosea, when they remain
154
Book reviews
uncomplicated, seem to be manageable just as well by the well-informed patient himself as by the family physician or by the nurse practitioner. When the conditions are unusual, the case atypical, or the affliction severe, the practical route for the patient is straight to the dermatologist. Patients are likely to understand a better concern with technical quality in medical care as they gain experience and sophistication. Goodman recommends the dermatologist, but with such elaborate tact (so as not to offend anyone) that sometimes he is difficult to understand. At least he does say plainly that dermatologists are the best choice for treating mycotogic infections. I would urge that if consumers do comparison shopping, they soon will recognize the benefits of having a dermatologist treat all complex integumental diseases. These consumerist medical books sincerely aim to educate the patients and this is a major challenge. Most popular press and television journalists are so inept that they have failed to communicate reliably even the faintest fundamental truths about science or medicine. The public and private schools have never been willing to teach human biology suitable for the 1980s. Therefore, Dr. Goodman begins with an enormous pedagogic disadvantage and a vast backlog of misinformation to correct. His main goal in the book is education of the public. For the most part he does the job well, but he cannot bring himself to explain the direct placebo effect, or the uselessness of most "alternative or folksy therapy. ' ' With these lapses, he is drawn into recommending some dubious food and vitamin therapies for herpes and aphthous stomatitis and some other folk medicine for warts. Not too bad, overall. You can recommend this book to any lay audience, and it would be most suitable for consumerist groups or those forced to limit their spending. Should welfare agencies consider major cutbacks in unnecessary medical care? It would be interesting to decide what savings would be possible if even a modest amount of consumerist self-care were taught and encouraged, and if back-up specialized care were strongly in support. The new sense of self-sufficiency alone would be worth it. Dr. Goodman has given a strong push to the growing consumerist effort in medi-
Journal of the American Academy of Dermatology
cine, and his well-planned book deserves your attention.
Philip C. Anderson, M.D. Columbia, MO Chemotaxis and inflammation Peter C. Wilkinson, M.D., ed. 2, New York, 1982, Churchill Livingstone Inc. 205 pages. $37.50. Over the last 20 years, medical science has witnessed an explosion of information relevant to the inflammatory process and the function of leukocytes in inflammatory events. The directional movement of leukocytes to chemical stimuli has been shown to be a critical phenomenon in inflammation. Previously obscure terms, such as chemotaxis and chemokinesis, have assumed major importance to scientists and physicians involved in the study of normal inflammation and derangements of the process. Physicians, including dermatologists, who deal with inflammatory diseases have followed the developments in this area with interest and have appreciated a better understanding of a number of disease processes. The medical literature pertinent to the understanding of leukocyte function in inflammation has become so voluminous that there is a pressing need for a scholarly update of the subject. The first edition of the monograph, Chemotaxis and Inflammation, served this purpose in 1974. In the second edition, published in 1982, Dr. Peter C. Wilkinson has summarized and put into perspective the current knowledge of leukocyte movement. This area has been such an active area of investigation that this book represents not just a revision of the first edition but a completely rewritten monograph. Chemotaxis and Ir~ammation will serve as a valuable reference for seasoned researchers, novice researchers, and clinicians. Dr. Wilkinson appropriately spends two chapters describing leukocyte movement, defining terms, and summarizing the developments in the field prior to the advent of the Boyden chamber in 1962. Technics used to assay leukocyte movement are described and evaluated in a single chapter, and the appen-