Skip to main content
Open Access Publications from the University of California

Dermatology Online Journal

Dermatology Online Journal bannerUC Davis

A review of Wolverton's

Main Content

A review of Wolverton's Comprehensive Dermatologic Drug Therapy (Second Edition)
Noah Scheinfeld
Dermatology Online Journal 14 (6): 18

Assistant Clinical Professor, Department of Dermatology,Columbia University, New York, NY.

Wolverton's Comprehensive Dermatologic Drug Therapy (Second Edition)

Paperback: 1104 pages
Publisher: Saunders; 2nd edition (March 8, 2007)
Language: English
ISBN-10: 1416024719
ISBN-13: 978-1416024712
Price: $99.00


In an early Dashiell Hammett story, "The Golden Horseshoe," the Continental Op (Hammett's Sam Spade forerunner) observes a sign over a bar in Tijuana and notes

"I was reading a sign high on the wall behind the bar:


I was trying to count how many lies could be found in those nine words, and had reached four, with promise of more."

Often I read a dermatology text and find 5 misstatements to quibble about on 1 page. How impressed I was with Wolverton's Comprehensive Dermatologic Drug Therapy (Second Edition) (CDDT2); I learned dozens of new factoids about pharmacology. Rather than finding 5 misstatements on every page, I found just 1 quibble for every 5 pages. This high quality text is an intellectual tour de force.

Wolvertons's CDDT2 is the book to consult when prescribing systemic medications. It provides detailed tables that outline the pertinent screening tests required before prescribing systemic medications and the tests recommended for monitoring (Do you remember to check the magnesium while a patient takes cyclosporine?). A future edition would benefit from separate chapters on each biologic agent (or at least each class of biologic). In this regard it might benefit in its next edition from work that Gottlieb, Menter et al. have done that identifies suggested pre-screening and follow-up laboratory tests for the biologic agents [1, 2].

Wolvertons's CDDT2 provides a thorough review of serious medication reactions. Combinations to avoid include: azathioprine and allipurinol, methotrexate and trimethoprim/sulfamethoxazole, and azoles and statins (both of which cause rhabdomyalisis). There is a comprehensive analysis of the P450 system and a discussion of its application in picking the right medications and understanding medication reactions. CDDT2 provides information for predicting an individual response to drugs on the basis of ethnicity and gender, a field that will explode in the next decade (and might then merit its own chapter). Wolvertons's CDDT2 provides medication dosages and weight-based dosing tables.

The book is longer than previous editions. Although longer is usually not better when it comes to dermatology books, future editions would benefit from additional chapters on the treatment of post-herpetic neuralgia and the treatment of complex skin and skin structure infections.

Data on the pregnancy categories assigned to individual medications need to be refined in the book. Cellcept (mycophenolate mofetil) is now pregnancy category D. Spironolactone is pregnancy category C and not X as is stated in CDDT2. Hydroxychloroquine does not have a pregnancy rating; its warning reads:

"Usage in Pregnancy. Usage of this drug during pregnancy should be avoided except in the suppression or treatment of malaria when in the judgment of the physician the benefit outweighs the possible hazard. It should be noted that radioactively-tagged chloroquine administered intravenously to pregnant, pigmented CBA mice passed rapidly across the placenta. It accumulated selectively in the melanin structures of the fetal eyes and was retained in the ocular tissues for five months after the drug had been eliminated from the rest of the body."

I have made some specific comments about this book on a page by page basis, in which I highlight the paucity of errors and misstatements in the book (Table 1).

To conclude, Wolverton's text is one of the few indispensable texts for the dermatologist in 2008. It should be part of every dermatologist library. There is enough new information in this edition to merit purchasing it even if you have the first edition.

This text, along with Scheman and Severson's Medications used in Dermatology [9], are the only books I keep in each of my examination rooms. There is no online or PDA resource that compares with Wolverton's written text.


1. Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, Van Voorhees AS, Elmets CA, Leonardi CL, Beutner KR, Bhushan R, Menter A. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol. 2008 May;58(5):851-64. PubMed

2. Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL, Gordon KB, Lebwohl M, Koo JY, Elmets CA, Korman NJ, Beutner KR, Bhushan R. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008 May;58(5):826-50. PubMed

3. Mease PJ, Gladman DD, Keystone EC; Alefacept in Psoriatic Arthritis Study Group. Alefacept in combination with methotrexate for the treatment of psoriatic arthritis: results of a randomized, double-blind, placebo-controlled study. Arthritis Rheum. 2006 May;54(5):1638-45. PubMed

4. Scheinfeld N. Red blood cell anemia in a patient with pemphigus vulgaris induced by the use of mycophenolate mofetil and prednisone. J Dermatolog Treat. 2007;18(4):243-5. PubMed

5. Boer J, van Gemert MJ. Long-term results of isotretinoin in the treatment of 68 patients with hidradenitis suppurativa. J Am Acad Dermatol. 1999 Jan;40(1):73-6. PubMed

6. Cohen J, Adams S, Patten S. No association found between patients receiving isotretinoin for acne and the development of depression in a Canadian prospective cohort. Can J Clin Pharmacol. 2007 Summer;14(2):e227-33. PubMed

7. Hydroxychloroquine Package insert available at (accessed May 14, 2008).

8. Scheinfeld N. Picaridin: a new insect repellent. J Drugs Dermatol. 2004 Jan-Feb;3(1):59-60. Review. Erratum in: J Drugs Dermatol. 2004 Mar-Apr;3(2):130. PubMed

9. AJ Scheman, DL Severson. Medications used in Dermatology 8th Edition. Lippincott Williams Wilkins Philadelphia 2003.

© 2008 Dermatology Online Journal