Book Review

Textbook of Pediatric Dermatology

N Engl J Med 2000; 343:744-745September 7, 2000

Article

Textbook of Pediatric Dermatology
Edited by John Harper, Arnold Oranje, and Neil Prose. 1931 pp. in two volumes, illustrated. Malden, Mass., Blackwell Science, 2000. $495. ISBN: 0-86542-939-1

It is quite fitting that as board certification in pediatric dermatology finally becomes a reality, the first major textbook in this subspecialty with the gravitas to stand up to its “adult” counterparts has been published. The Textbook of Pediatric Dermatology, an outstanding contribution edited by three highly experienced consultants from the United Kingdom, the Netherlands, and the United States, is the first edition of a two-volume work that covers the spectrum of childhood mucocutaneous disorders from the prenatal period through adolescence. It is perhaps not surprising that the format chosen for this textbook is by and large the same as that used so successfully for one of the two heavyweight textbooks of general dermatology — the Rook/Wilkinson/Ebling Textbook of Dermatology, sixth edition (Boston: Blackwell Science, 1998) — since they have the same publisher.

The chapters in this book are divided into sections according to subtopics, with a reference list at the end of each section, rather than at the end of the chapter, so that the list is relatively short and is placed where the reader will find it most useful. The book is richly illustrated with high-quality color photographs interspersed with the text. As one might expect, the encyclopedic information and images do not come cheap; the price of the book is $495.

Of particular interest are a number of chapters found in few (if any) other textbooks, including those on embryonic skin development, the genetics of skin disorders, iatrogenic skin disorders in children, and cutaneous poisoning, with entire sections devoted to atopic dermatitis and to dermatologic surgery in children. There are few disorders involving the skin, hair, or nails in children that escape at least some mention in this textbook. Even in the discussions of disorders that are covered in general dermatology textbooks, however, this book takes a uniquely pediatric perspective.

The contributors to the Textbook of Pediatric Dermatology span the globe. This international effort pays off in a broad clinical perspective (with chapters on tropical cutaneous diseases, for example, that have been written by people who actually see these disorders in children). Unfortunately, the multiauthored format, especially in a first edition, comes at the price of unevenness. Whereas some chapters illustrate conditions in children with various ethnic backgrounds and skin types, others include only white children or only Latino children. A greater effort could have been made to illustrate the various presentations of skin disorders in different ethnic groups, at least for common skin diseases.

Also uneven is the coverage of certain conditions. The discussion of Henoch–Schönlein purpura, for example, is accompanied by only two photographs of the same patient, whereas the discussion of the disorder's much less common counterpart in infants, acute hemorrhagic edema of the newborn, includes seven illustrations. Similarly, a five-page chapter with four photographs is devoted to pityriasis rosea, a self-limited exanthematic eruption, whereas pityriasis lichenoides, which is often chronic, is given short shrift, with just three pages of discussion and one clinical photograph. One expects an encyclopedic textbook such as this one to cover everything (try finding another color photograph of granulosis rubra nasi in a child). Nonetheless, lichen planus, which is quite rare in childhood, is discussed in 10 pages with 7 clinical photographs, yet acrodermatitis enteropathica is not illustrated at all, and the only photographs of acquired zinc deficiency show the disorder in an older, malnourished child rather than in an infant, even though the deficiency is more common in infants. The discussion of aplasia cutis congenita is accompanied by only one illustration.

There are other quirky omissions — for example, the failure to mention curettage as a treatment for molluscum contagiosum. In addition, the organization of the book is imperfect. For example, why is alopecia areata, a very common disorder, relegated to the section on miscellaneous disorders at the end of the textbook?

Given the wealth of information provided in the two volumes of this textbook, the index could also be improved. For example, pyogenic granuloma is listed not under “pyogenic granuloma” but rather under “granuloma, pyogenic” and the infrequently used term “granuloma pyogenicum.”

These are the sorts of problems that the editors of a multiauthored textbook undoubtedly seek to overcome in subsequent editions, and I am sure there will be many editions of this book. For the first go-around, and considering the massive undertaking that such a textbook entails, there is much to praise about the Textbook of Pediatric Dermatology.

With any textbook, one must ask who its readers will be. This book will be welcome and well used in the library of any dermatology or pediatric department or division. The price tag will probably limit individual purchasers, aside from pediatric dermatologists, to other dermatologists who have a special interest in children's disorders and pediatricians with a special interest in mucocutaneous disease.

Seth J. Orlow, M.D., Ph.D.
New York University School of Medicine, New York, NY 10016