Book Review

Cutaneous Medicine and Surgery: An integrated program in dermatology

N Engl J Med 1996; 335:826September 12, 1996

Article

Cutaneous Medicine and Surgery: An integrated program in dermatology
Edited by Kenneth A. Arndt, June K. Robinson, Philip E. Leboit, and Bruce U. Wintroub. 1899 pp. in two volumes, illustrated. Philadelphia, W.B. Saunders, 1996. $250. ISBN: 0-7216-4852-5

Weight and size impressed me as I pulled the two volumes of Cutaneous Medicine and Surgery out of the box. The two books together weigh about 15 lb and take up nearly 5 in. of shelf space. Bound in a handsome black cloth cover with gold and red print, Cutaneous Medicine and Surgery is subtitled An Integrated Program in Dermatology. I started hunting for a CD-ROM disk in the package, since I could not understand how a book could be considered an integrated program. I found the answer in the preface (after wading through 18 pages of contributors). The book is the flagship for an educational program of related books, including Atlas of Cutaneous Surgery (June K. Robinson et al., eds. Philadelphia: W.B. Saunders, 1996), Cutaneous Medicine and Surgery: Self Assessment and Review (Jeffrey S. Dover, ed., in consultation with Kenneth A. Arndt et al. Philadelphia: W.B. Saunders, 1996), and Pocket Guide to Cutaneous Medicine and Surgery (Jeffrey S. Dover, ed., in collaboration with Brooke A. Jackson et al., in consultation with Kenneth A. Arndt et al. Philadelphia: W.B. Saunders, 1996). These parts of the program do not come with the flagship book, but instead are additional items to be purchased, much like the peripheral electronics needed for a computer. To integrate Cutaneous Medicine and Surgery further, the editors asked authors to present clinical dermatology as a blending of dermatopathology, mechanisms of disease, and medical and surgical therapies.

The editors are talented, innovative dermatologists, and their flair for innovation announces itself in the titles of section headings: all questions. For example, chapter 1 is entitled “What is Normal Skin?” and chapter 2, “What Does Normal Skin Do?” Although these chapters could have been called “Normal Skin” and “Physiology,” and although a rose by any other name would smell as sweet, their headings somehow magically transform requisite introductory basic-science chapters into dynamic, interesting accounts.

The editors claim to “have organized dermatology into practical categories.” Well, at least they made an honorable attempt. Whenever one mixes sections on morphology (e.g., “What Diseases Cause Blistering of the Skin?”) with sections on pathobiology (e.g., “What Disorders Present with Inflamed Skin?”), etiology (e.g., “What Infections and Infestations Affect Skin?”), and structure (e.g., “What Diseases Alter Hair, Nails, and Sweat Glands?”), there is bound to be overlap, omission, and arbitrary assignment. Nonetheless, it is hard to imagine a better effort; all textbooks of dermatology struggle with the impossibility of organizing a set of cutaneous diseases with diverse causes and appearances.

I really like the work because it is current, comprehensive, inviting, easy to read, and generally authoritative. It stands on my shelf for the moment as my reference of choice. Buyers, please note: it is a reference book. A buyer most likely will not read it cover to cover as one might read W. Mitchell Sams, Jr., and Peter J. Lynch's Principles and Practice of Dermatology (New York: Churchill Livingstone, 1990) or an array of simpler textbooks for students and physicians with less need for depth. Although arguably not as comprehensive as the four-volume gold standard, Textbook of Dermatology (Arthur Rook et al. Oxford, England: Blackwell Scientific, 1968), Cutaneous Medicine and Surgery contains enough up-to-date information that one usually closes the book feeling that no additional reference need be consulted. Furthermore, Rook's textbook is little help as a surgical reference.

This work has only a few color pictures (clustered on a few pages early in the book), but dermatologists and others who need a book of this scope probably do not need color photographs.

At a list price of $250, this work offers real value for residents in dermatology and physicians, mostly specialists, seeking a reference book to consult in the office as they see patients. It costs only about $17 a pound!

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