Book Review

Pathology of the Skin with Clinical Correlations

N Engl J Med 2005; 353:2522December 8, 2005

Article

Pathology of the Skin with Clinical Correlations
Third edition. Edited by Phillip H. McKee, Eduardo Calonje, and Scott R. Granter. 1865 pp., plus index, in two volumes, illustrated, with CD-ROMs. Philadelphia, Mosby, 2005. $399. ISBN: 0-3230-3672-4

Weighing in at close to 20 lb, this two-volume textbook is an excellent source of information concerning diagnostic and scientific aspects of dermatopathology. It should be no surprise that nearly 2000 pages would be required to cover the numerous pathologic conditions of skin that affect patients from the cradle to the grave. The skin is the largest organ of the body and reflects disease not only within the protective coat itself but often also primary maladies of noncutaneous origin inside the body.

McKee and his coeditors, with contributions by several other authors, have masterfully covered virtually all the diseases that are likely to be encountered by a contemporary dermatopathologist. They present a clear-cut and up-to-date set of microscopic images, complemented by relevant clinical features and pathophysiological perspectives. This third edition is organized into 31 chapters, with new chapters covering diseases of keratinization, oral mucosa, hair, and nails, as well as drug reactions.

Not every controversy or unresolved issue in the vast field of dermatopathology is covered in depth, but to do that would have required another volume. Thus, areas of controversy — such as whether a Spitz nevus is better classified as a Spitz tumor or whether toxic epidermal necrolysis is an immunologic disease — are not included in this textbook. Besides showing us what skin lesions look like clinically and histologically and helping us to understand the molecular basis of the lesions, the book offers extensive literature citations, which will lead the interested dermatologist or pathologist to further insights from experts around the world.

Imaging technology and the Internet now allow us to capture high-resolution images and transmit them within seconds for review by fellow dermatopathologists. What we cannot digitize, however, is the clinical and biologic context that is often essential in fully understanding the significance of photographs of skin. The beauty of this textbook, apart from the outstanding color images, is the spice of clinical perspective, pathophysiology, and literature citations that enhance the substance of the overall presentation in every chapter. Also valuable are the subsections about differential diagnosis that provide practical guidelines for cases in which a definitive pathological diagnosis cannot be rendered. For all these reasons, I highly recommend this textbook on dermatopathology.

Brian J. Nickoloff, M.D., Ph.D.
Oncology Institute at Loyola University of Chicago Medical Center, Maywood, IL 60153
bnickol@lumc.edu