Book Review: October 2003
Oxford University Press
Previous editions of this textbook have been standard reading for medical students in New Zealand. The latest edition of 371 pages is a suitable size and complexity for medical students. Paperback binding means it is relatively affordable, but it might not survive regular thumbing-through in general practice. It introduces important advances in our understanding of the molecular biology of common skin diseases, and is up-to-date, describing new
designer biologic drugs and physical therapies.
Professor MacKie starts off describing case histories that could be used in problem-based student discussion groups. Each chapter includes additional project ideas, problem cases, questions and discussion. In the Preface, she indicates she hopes these will be used and adapted in medical schools worldwide; the cases are certainly relevant to practice in New Zealand.
The layout and four-colour text printing means this book is easy to read, with colourful text boxes for tables and key points. The content includes a comprehensive introduction to dermatology, skin biology, common inflammatory and infectious diseases, skin tumours, relevant systemic conditions and therapy.
It is best read from cover to cover (slowly and thoughtfully!), but it should be kept on the shelf to refer to later. As a reference text, the illustrative case histories will probably be ignored.
I hope the publishers are already planning for the sixth edition to correct a few errors and omissions. I found a spelling mistake on page 124 (
dishydrotic instead of
dyshidrotic). A photograph of a head louse on page 164 has the caption
Female scabies mite.
Terminology changes with time. Most authors have dropped the
et atrophicus from lichen sclerosus because atrophy is not required for diagnosis. Mycologists now prefer to refer to Malassezia species rather than Pityrosporum ovale, and Trichophyton interdigitale rather than T. mentagrophytes var. interdigitale.
Why use flucloxacillin for orf? Presumably because of secondary streptococcal infection but the rationale for treatment is not mentioned (page 148). Inevitably, dermatologists will differ in their management of infestations (page 167: I'd recommend more combing and less malathion for headlice) and warts (page 145-6: I don't use glutaraldehyde or podophyllin for common warts and I do use podophyllotoxin and imiquimod for genital warts). I would also have liked to see mention of imiquimod's use in cutaneous neoplasia. A paragraph or two on aesthetic dermatology would be useful (vascular lasers, anti-ageing and pigmentation treatments). Cryotherapy, curettage and excision surgery are mentioned but could usefully be described.
Although there are numerous suitable illustrations, the quality of the colour reproduction is variable; some images should have been replaced.
It is disappointing that Professor MacKie's list of reference websites does not include DermNet, which is used widely by medical practitioners and students worldwide. However, she has referred to patient support groups and understandably to the websites of the British Association of Dermatologists and the American Academy of Dermatologists.
The book should continue to be popular with undergraduates; I hope it will stimulate many to have a lifelong interest in diseases of the skin.