Dermatology Online Journal

Dermatology, 2nd Edition - 2-Volume Set
Noah Scheinfeld, MD
Dermatology Online Journal 15 (1): 17

Department of Dermatology, Columbia University, New York, NY. NSS32@columbia.edu

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Dermatology, 2nd Edition - 2-Volume Set
By Jean L. Bolognia, MD, Joseph L. Jorizzo, MD and Ronald P. Rapini, MD
2432 pages 2625 ills, Trim size 11 7/16 X 9 15/16 in, 2008
$449.00, Hardcover, Reference
$549.00, Book With Online E-dition, Reference

Few sequels in movies or in life match the initial effort. The Seven against Thebes told the story of heroes who almost over-turned the wall of the city that was home of Oedipus's son Eteocles. However the sons, termed the epigones, tried to copy the great deeds of the father, but were distinctly unremarkable. The instance that I can think of in which an original movie and the sequel won academy awards for best movie is "The Godfather" and "The Godfather Part Two." Dermatology (editors Bolognia, Jorizzo, and Rapini) is an excellent text book and a hard work to surpass. In Dermatology 2nd Edition, the editors do measure up to the achievement of Francis Ford Coppola and have produced a part two, second edition, that equals and in many ways trumps Dermatology part one, first edition.

The pictures in Dermatology are lavish. Especially notable pictures include those of acute generalized exanthematous pustulosis (AGEP) and neutrophilic eccrine hidradenitis (NEH). Other great pictures include disseminate and recurrent infundibolofolliculitis, lichen spinulosis, POEMS syndrome and ulerythema ophryogenes, just to mention a few.

Dermatology's charts and cartoons of pathways and cytokines that in the first edition set a new standard, continue to impress. These cartoons and charts are available with the e-edition and are so well done and easy to download that residents use them to the exclusion of their own creations in their lectures. Dermatology solves the problem of graphic arrangement of dermatology knowledge and leaves the reader doubting that there would be any way to improve upon the tables other than adding new information as it is discovered.

An example of the improvement of the 2nd edition is the discussion of keratolysis exfoliativa (KE). In the first edition, this common condition was not given a separate entry and treatment information noted "no treatment is necessary." In the second edition it is correctly noted that moisturizers containing lactic acid and urea are effective and that corticosteroids are not needed. However, I still think that KE should not be included in the section on sweat glands. It is more likely that the disease involves the impairment of epidermal integrity due to stress from physical factors, which the authors note.

The text would likely be even better if the editors showed more supporting data for the use of medications and gave more insight into the relative effectiveness of treatments. For hidradenitis suppurativa, the text relates that a retrospective study of 68 patients found isotretinoin to be of limited effectiveness and comments upon a case study of acitretin (which is seldom used). Misleadingly, the two treatments receive equal negative and positive mentions in the text. The next edition should mention that combinations of rifampin and clindamycin or minocycline can be helpful in the treatment of hidradenitis.

The 159 chapters of the new Dermatology present a breathtaking amount of material. It is hard to find any entity that is not included or well discussed. That being said, I did look hard for some lacunae and I do note that in the index I did not find the entity termed "confluent and reticulated papillomatosis," often neglected in dermatology texts in general. Also in the discussion of the topical treatment of psoriasis I did not find mention of the new and expensive preparation of betamethasone and calcipotriene. Instead this combination medication finds a place in the discussion of topical preparations in chapter 129. In chapter 126, it might be useful to note that oral alitretinoin had been abandoned before 2008 as a treatment of Kaposi sarcoma and psoriasis, but is nearing approval for chronic hand dermatitis in the European Union.

To conclude, I am lucky to have Dermatology Second Edition on my shelf. For the dermatology resident who needs to master the minutiae of dermatology it is hard to beat. I am sorry that I don't have the e updates that are available on the web and continuously update the text. The second edition is better than the first edition. Perhaps its subtitle should be (modestly) "Three heroes successfully summarize dermatology."

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