BOOK AND MEDIA REVIEWS

PRIMER ON THE RHEUMATIC DISEASES

Edited by John H. Klippel, John H. Stone, Leslie J. Crofford,
and Patience H. White
13th ed, 724 pp, $79.95
New York, NY, Springer and Arthritis Foundation, 2008
ISBN-13 978-0-3873-5664-8

I N 1934, A 52- PAGE PAMPHLET UNDER THIS SAME NAME

introduced rheumatology to US physicians. It was a modest effort, but for a new discipline in internal medicine, it
was a beginning. Rehabilitation was in its infancy, beds
were occupied for lengthy periods by patients who had
rheumatoid arthritis, and Forrestiers discovery of the
efficacy of gold salts was still to come and would be
opposed by Russell Cecil because Forrestier thought he
was treating tuberculosis. Even 20 years later, not much
had changed. Hans Wayne could still write an article in
Archives of Internal Medicine advocating 10.8 g of aspirin
as treatment of rheumatoid arthritis, osteoarthritis was
still considered to be predominantly a degenerative disease, and fibromyalgia was still termed fibrositis. Arthritis
surgery consisted chiefly of osteotomies. This latest edition of the Primer testifies to how far the field has come
since then.
Despite its title, the Primer really is a textbook that discusses evaluation and treatment, much of it new since the
12th edition. Except for surgery, patients are no longer hospitalized or, if so, only for brief stays. The inpatient arthritis centers are a relic of the past. The editors are new, as are
many of the authors. Rheumatic fever has become a rarity,
at least in the Western world. Many chapters discuss disorders that were unknown 75 years ago. In fact, the Primer
has become a textbook.
I suspect that much of it is too detailed for the general
clinician who wants clues as to what to diagnose and
what to do. But with some effort the answers are there,
and referral to a specialist is rarely needed or necessary.
Although the writing is at times pedestrian, and too many
sentences are in the passive mode, they still provide the
basic outline for assessment and treatment. Regrettably,
fibromyalgia still gets a chapter and a mention in other
chapters, though it is part of the chronic pain spectrum
and neither fibrous tissue nor muscles seem to be
involved. Clauw and Dadabhoy give a measured description of this syndrome, whose naming remains controversial.
An international array of experts constitutes the primary
list of contributing authors. The soft-cover book leads off
with Patience White and Rowland Chang discussing public health and arthritis. They emphasize that the gamut of
disorders are foremost in the complaints of patients, whether
they present with these disorders as sole symptoms or part
of a cacophony of distress. A section on evaluation follows,
and a reasonable discussion of musculoskeletal signs and
symptoms is attempted.

The molecular and cellular basis of immunity is broached

and remains all-important in understanding most of the diseases. Individual diseases (syndromes?) are covered in the
next 29 chapters. These chapters are as up-to-date as the
latest journals. Rehabilitation, psychosocial factors, and selfmanagement strategies are insightfully detailed. Whereas pain
may be the chief reason patients become patients, adequate management protocols and regimens are importantly elaborated and stressed.
All the current treatments fill the remaining chapters, including complementary and alternative therapies, and the
appendices feature criteria and guidelines. Any physician
who reads the book may feel no need for specialist referral,
but rheumatologists will, in fact, feel more confident and
assured as they offer their diagnoses and recommend treatment options. As Shakespeare noted, the rheumatic diseases do abound; these rheumatic diseases and the pain and
disability they cause still remain the chief reasons for medical consultation.
George E. Ehrlich, MD, FRCP(Edin)
Department of Clinical Medicine
University of Pennsylvania
Philadelphia
ge2@mindspring.com
Financial Disclosures: None reported.

FITZPATRICKS DERMATOLOGY IN GENERAL MEDICINE

Edited by Klaus Wolff, Lowell A. Goldsmith, Stephen I. Katz,
Barbara A. Gilchrest, Amy Paller, and David J. Leffell
7th ed, 2 vols, 2402 pp, $495
New York, NY, McGraw-Hill Professional, 2007
ISBN-13 978-0-0714-6690-5

FITZPATRICKS DERMATOLOGY IN GENERAL MEDICINE IS THE CLASsic dermatology textbook1,2so the question of whether a
skin care professional needs to own it is moot. The real question is whether to buy the new seventh edition or scrape by
with the 6th edition for a few more years.
Opening the new edition, we noted its dedication to Dr
Thomas B. Fitzpatrick, who served as the editor-in-chief
of the first 4 editions, and Dr Irwin M. Freedberg, who
served as the editor-in-chief of the fifth and sixth editions; both have died since the release of the sixth edition
in 2003.3,4 In their introduction, the editors highlight the
dramatic extent of change in this edition (p xxxiii):
More than 50% of the text and figures of our 257 chapters are new to this edition, as are 50% of the authors.
This recalled for us the days when our medical school
professors promised that half of what they taught us
would be true (if only they knew which half); luckily, the
field of dermatology hasnt changed 50% since 2003, and
we dare say that despite the hype, the true content of the
sixth and seventh editions hasnt either.

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BOOK AND MEDIA REVIEWS

We next reviewed the claims made on the texts back cover,

where the hyperbole continues. Here chapters are listed as
new that contain the same images, and that are written largely
by the same authors, as the corresponding chapters in the
sixth edition. For example, see Sweet syndrome (chapter
94 in the sixth edition, chapter 31 in the seventh) and Parapsoriasis (chapter 47 in the sixth edition, chapter 25 in the
seventh).
The versatility of the e-edition of the new book (an Adobe
Digital Editions PDF) is also overstated on the back cover.
While purchasers can download a single copy of the text,
they cannot access or copy the additional images, or open
or annotate the text, on a handheld instrument. These operations are possible only with the purchase an additional
online yearly subscription (http://www.accessmedicine.com
/public/rates_indv.aspx).5
Other changes in the new edition include the shedding
of 192 pages and more than a pound of weight, as well as
adding content such as new chapters on complimentary and
alternative dermatology and surgical complications. The book
has been reformatted, compressing the text and clinical photographs onto the page in a new 3-column format. As a result, the pages appear busier, and many of the clinical photographs are smaller. The vast majority of chapter references
have been moved online (http://books.mcgraw-hill.com
/medical/digm7/toc.html).
Of the texts new features, the most useful are the At a
Glance lists of boxed and bulleted bottom-line summary
statements, which have been added to most chapters. Fullcolor clinical photographs at the beginning of each of the
41 sections are newa feature that adds flair but that may
be more appropriate for a coffee table book of photography. Miniature photographs indexing the chapter tabs also
have been added.
Field-testing the sixth and seventh editions in our dermatology clinics, we found that integrating the basic science with relevant skin diseases as part of the books reorganization has improved the text. For example, DarierWhite disease and Hailey-Hailey disease have been combined
to appear in the same chapterAcantholytic Disorders of
the Skin. While the basal cell carcinoma and melanoma
chapters are more extensive and clearly improved, some relatively common skin ailments (eg, knuckle pads) still lack
an accompanying clinical photograph.
At a time when all the leading clinical dermatology journals (Archives of Dermatology, Journal of the American
Academy of Dermatology, and British Journal of
Dermatology)6-8 do not allow masked photographs (photographs with black bars over patients eyes), we noted an
increased number of masked clinical photographs (25 in
the sixth edition, 34 in the seventh) and at least 1 new
masking of a previously unmasked photograph (compare
Figure 71-33 [p 652] in the sixth edition with Figure
86-29 [p 776] in the seventh). This finding suggests that
standards for clinical photography in this textbook may
1196

need updating to meet the current standards of the leading

journals in the field.
Overall, our recommendation on the seventh edition is a
buy for clinicians who treat patients with skin disease and
do not own the text and a hold for those who own the
sixth edition.
Cory A. Dunnick, MD
Robert P. Dellavalle, MD, PhD
Department of Dermatology
University of Colorado School of Medicine
Denver
robert.dellavalle@uchsc.edu
Financial Disclosures: None reported.
Editors Note: Dr Dellavalle is the dermatology section editor for UpToDate.
1. Brodin MB. Review of: Fitzpatricks Dermatology in General Medicine. JAMA.
2004;291(3):377-378 reviewer.
2. Alam M. Review of: Fitzpatricks Dermatology in General Medicine. Arch
Dermatol. 2004;140(3):372 reviewer.
3. Parrish JA. Obituary: Thomas B. Fitzpatrick, MD, PhD (1919-2003). Arch
Dermatol. 2003;139(12):1613.
4. Goldsmith L. Irwin Freedberg, Odysseus for our generation. J Invest Dermatol.
2006;126(3):513-514.
5. Customer review of: Fitzpatricks Dermatology in General Medicine, 7th ed.
Amazon.com Web site. http://www.amazon.com/review/R3918VE8WPZH0D
/ref=cm_cr_pr_viewpnt#R3918VE8WPZH0D. Accessed December 18, 2007.
6. Instructions to authors. Archives of Dermatology Web site. http://archderm
.ama-assn.org/misc/ifora.dtl. Accessed December 18, 2007.
7. Information for authors. Journal of the American Academy of Dermatology
Web site. http://www.eblue.org/authorinfo. Accessed December 18, 2007.
8. Author guidelines. British Journal of Dermatology Web site. http://www
.blackwellpublishing.com/submit.asp?ref=0007-0963&site=1#top. Accessed December 18, 2007.

LIVER AND BILIARY TRACT SURGERY: EMBRYOLOGICAL ANATOMY

TO 3D-IMAGING AND TRANSPLANT INNOVATIONS
Edited by Constantine C. Karaliotas, Christoph E. Broelsch,
and Nagy A. Habib
638 pp, $259
Athens, Greece, Springer-Verlag/Wien 2007
ISBN-13 978-3-2114-9275-8

THE PREFACE TO LIVER AND BILIARY TRACT SURGERY INDIcates that the volume was commissioned by the Executive Committee of the Hellenic Surgical Society at the
time of the 25th Panhellenic Congress of Surgery to
honor the 79th anniversary of the society. The stated reason for printing the text in English was so that it might
be read outside Greece.
The book is divided into 4 sections. With the exception of the first chapter on embryology and anatomy of
the biliary tract, which was written cooperatively by 2
authors from North America, all of the other authors of
the succeeding 47 chapters are from Greek academic
medical centers, a German academic medical center (University Hospital Essen), or the Hammersmith Hospital at
Imperial College, London.
Section 1 presents the intricacies of biliary ultrasound and
endoscopic retrograde pancreatography (ERCP) as well as
the diseases of the biliary and pancreatic systems that a hepa-

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