Clinical dermatology: a color guide to diagnosis and therapy, fourth edition: Habif TP Mosby, 2004 1,024 pages, $149 ISBN 0-323-01319-8

Thomas P. Habif's Clinical Dermatology: A Color Guide to Diagnosis and Therapy will excite even those for whom “rash” is a tiresome chief complaint. From cover to cover, stunning pictures show every condition from several points of view and in multiple stages of development. An opening chapter lays out numerous examples of each dermatologic lesion, from macules to scars. A differential on the same page with each lesion type is one of many mechanisms designed to simplify clinical recognition; a differential diagnosis based on body parts just inside the back cover is another.

The book is written in a short, declarative style. At times this makes it difficult to read, but the preface suggests the better approach for most physicians is to concentrate on the photographs. The emergency physician might find greatest utility in the first two chapters, which review the principles of dermatologic anatomy and diagnosis and the details of topical therapy including, most essentially, topical steroid treatments. Chapters on eczema and dermatitis, urticaria and angioedema, bacterial infections, sexually transmitted infections, exanthems and drug eruptions, and infestations and bites find easy application in the emergency department (ED).

The entire volume succeeds in making itself accessible and usable if not always immediately applicable to emergency management. Helpful touches include discussions on the application of wet dressings and pediatric concerns vis-à-vis topical corticosteroids. Specific tidbits pertinent to typical ED care include antibiotic choices for hidradenitis suppurativa and the potential usefulness of C-reactive protein and creatine kinase to distinguish necrotizing fasciitis from cellulitis. Discussion of the management of urticaria and angioedema delves into the relative usefulness of sedating antihistamines, nonsedating antihistamines, and corticosteroids. On the other hand, a discussion of Henoch-Schönlein purpura delineates multiple complications of the disease and reviews several therapies, but does not detail what testing to undertake at the first evaluation and stops short of recommending any specific initial therapy.

An included CD-ROM contains JPEG and PDF files for every picture in the book plus additional supplemental photos, all designed for easy removal to presentations. Password-protected access to a Web site containing the full text and all pictures is also included. The access lasts until publication of the next edition. This means that one can keep the book at home and still have full access in the ED if the Internet is available.

The only major limitation to the reference value of this text may be the absence of colored skin types; the majority of the photographs picture white patients. It would be helpful to see representations in darker skin and even a differential diagnosis mannequin with selectable skin tones. Overall, Clinical Dermatology is a well-organized text. Multiple lists and tables, all with ample illustration, make it a clinically accessible and helpful resource. The text is too long for dedicated review from cover to cover, but specific chapters are easily readable and enjoyable.