Book reviews

edited by Mark Lebwohl, MD
      W.B. Shelley, E.D. Shelley, Advanced Dermatologic Therapy II, 2001, 1299 pages, Philadelphia: W.B. Saunders, $239
      S.E. Wolverton, Comprehensive Dermatologic Drug Therapy, 2001, 954 pages, Philadelphia: W.B. Saunders, $89
      To say that therapy is the mainstay of medicine and that utilizing an appropriate therapeutic approach is what medicine is all about would be an understatement. The whole purpose of taking a history, examining the patient, ordering appropriate laboratory studies, and considering differential diagnoses is the making of a diagnosis. But a diagnosis which does not lead to a treatment plan would be an academic exercise that might be conducted even in a virtual atmosphere, possibly making the patient superfluous.
      Enough said, the choice of treatment becomes the backbone of dermatologic practice. If one shot of penicillin could dissipate acne as easily as it does syphilis, the discussion of these two books would be mute. Should psoriasis disappear with the application of one medicament, then neither of these books would have to be as thick and as crammed full of information as it is.
      While both volumes are obviously about how to treat the patient with a cutaneous affliction, each is significantly different. The Shelley and Shelley treatise represents a compilation of facts that uses the computer to obtain an assortment of regimens, augmenting the traditional 3 × 5 index card approach used in the earlier work for collecting data (Shelley WB, Shelley ED. Advanced dermatologic diagnosis, Philadelphia: W.B. Saunders, 1992, 1315 pages $295). The Wolverton text is multi-authored and is also the outgrowth of an earlier work (Wolverton, SE, Wilkin JK. Systemic drugs for skin diseases, Philadelphia: W.B. Saunders, 1991, 446 pages $79). Of interest is the fact that Walter Shelley was part of the triumvirate that pioneered the first major multi-authored dermatology textbook (Pillsbury DM, Shelley WB, Kligman AM. Dermatology, Philadelphia: W.B. Saunders, 1956, 1331 pages)
      The Shelleys have utilized a fascinating approach, one which fully represents their personalities. Let us take the cheilitis chapter as representative. It begins with a blue box listing essential measures: “eliminate contactants, patch tests. . .stop toothpaste, stop spices, stop lipstick.” Next is the diary to illustrate the types of problems found in patients with lip dermatitis. (Many of these have been taken from their series “Portrait of a Practice: A Dermatologic Diary,” published in Cutis during the 1990s). This is followed by an annotated bibliography selected from a vast literature: i.e. chlorquine (250 mg bid × 3 months and decreased doses) relieved one patient and stopping the excessive use of dental floss cured six soldiers. Another blue box containing their famous aphorisms concludes the chapter.
      Wolverton has assembled an outstanding group of contributors who cover the broad spectrum of dermatologic therapy. He begins the information-packed book with “Basic Pharmacologic Principles” and “Principles for Maximizing the Safety of Dermatologic Drug Therapy.” Consider the contribution of Russell Hall on dapsone as a typical chapter. He initiates the review by recalling Costello’s 1947 use of sufapyridine in the treatment of dermatitis herpetiformis. Hall continues with tables comparing dapsone, sufapyridine, and sulfasalazine and discussions of the pertinent pharmacology. The uses are highlighted in another table. Adequate space is given for sections on untoward effects, monitoring, and guidelines for prescribing. The references are extensive and made easier to find with the use of subheads.
      Which book to buy? Both! They complement and supplement each other. They are wonderful additions to the dermatologic literature. Space should be found for each in the clinician’s office and in the institutional library. The authors are to be congratulated on jobs well done.