Book Review

Advanced Dermatologic Diagnosis

N Engl J Med 1993; 328:1049-1050April 8, 1993

Article

Advanced Dermatologic Diagnosis
By Walter B. Shelley and E. Dorinda Shelley. 1300 pp., illustrated. Philadelphia, W.B. Saunders, 1992. $195. ISBN: 0-7216-3433-8

Many books are good. Some books are unique. Few medical books are fun to read. Advanced Dermatologic Diagnosis is all three.

The book is good (in fact, it is excellent). It presents a wealth of information in a stimulating style. Helpful diagnostic clues introduce specific articles the authors have abstracted to emphasize diagnostic points. The book is both a guide to diagnosis and a compendium of case reports, reviews of diseases, and hints. The hints are found simply by scanning and skimming the boldface type. Even the busiest clinician can grab the book to jog the memory or for help in the evaluation of a patient. The index is superb, covering 30 pages of tiny type.

The book is unique. Pick up this big red 1300-page book, open to any page, and be surprised. The book is based on the premise that all changes in the skin suggest some diagnoses. Each of these provisional diagnoses, listed alphabetically, takes you to a cluster of look-alike skin disorders. By means of annotated references, examples, and photographs, the book highlights the singular clinical features of each and the laboratory tests needed for diagnosis. The approach is novel.

The book is fun. The Shelleys write with a novelist's style, often in the second person. They talk to you. They give you lessons on how to think, a skill they call a “quiet art.” They list “diagnostic ploys.” One chapter is entitled, “Don't Just Stand There and Look: Do Something.” There is even text on the back of the hard front cover -- “Diagnostic ideas (What to think of when you don't know what it is).” The book lives. To read it is to hear your own brain thinking and at the same time hear it wish it could be so clever and clear.

Correct treatment depends on correct diagnosis. There is no dermatologist, no matter how good a diagnostician, who will not find a diagnostic pearl on every page. The authors have a bloodhound's nose for sniffing them out of each reference. For nondermatologists, the book may be less useful. After all, the book is called “advanced.” But because of its novel organization, it could give any physician puzzled by a diagnosis some bright ideas. If you are a dermatologist or an interested observer of skin, this book should definitely displace some other on your bookshelf.

Mark V. Dahl, M.D.
University of Minnesota Medical School, Minneapolis, MN 55455