Book Reviews Differential Diagnosis in Dermatopathology II, by A. Bernard Ackerman, James L. Troy, Leslie B. Rosen, Suthep Jerasutus, Clifton R. White, Jr., and D. Friday King, 202 pp, with illus, $98.50, Philadelphia, Lea & Febiger, 1988 This book discusses 45 paired sets of skin diseases that have similar characteristics but in which differentiation is important because the disorders require different management. This challenge is frequently encountered by physicians who care for patients with skin conditions. The book is a pleasure to peruse because the clinical and histopathologic illustrations are sharp, superb, and flawless. The extreme care taken by the authors in choosing representative clinical lesions and showing their histopathologic features in low, medium, and high magnifications is readily apparent. The paired distinctions are demonstrated in capsule and table form and are well illustrated by the labeled photographs. The brief discussions that follow the illustrative and tabular material enhance the descriptions and provide the reader with a clear picture of the compared diseases. A glossary at the end of the book provides definitions and quick reference to the terms used in the text. A partial list of the differential diagnoses includes the following pairs of disorders: psoriasis vulgaris versus pityriasis rubra pilaris, erythema multiforme versus fixed drug eruption, lichen planus versus lichenoid discoid lupus erythematosus, chronic urticaria versus the urticarial stage of pemphigoid, Mucha-Habermann disease versus lymphomatoid papulosis, scleroderma versus scleredema, pseudocarcinomatous hyperplasia versus squamous cell carcinoma, pseudo-Kaposi's sarcoma (acroangiodermatitis) versus Kaposi's sarcoma, melanocytic nevus versus malignant melanoma in situ on the palms and soles, persistent melanocytic nevus versus persistent malignant melanoma, primary malignant melanoma versus epidermotropically metastatic malignant melanoma, B-cell malignant lymphoma versus Merkel cell neoplasm, bowenoid papulosis versus Bowen's disease, and mycosis fungoides (plaque stage) versus histiocytosis X (plaque stage). In "real life," each skin disease has various stages of development, and it is impossible for Mayo Clin Proc 64:733-744, 1989
any book to present all the varieties and stages of each condition. Because the authors intelligently used the classic presentations of fully developed lesions as their models, the book is a clear and simple teaching tool. The readers should realize, however, that the actual cases they see will conform to most, but not all, of the points mentioned in the book. In fact, I disagree with the authors on a few minor points regarding the differential diagnoses. Overall, this book is an outstanding contribution to the dermatologic and dermatopathologic literature by experts in these fields. Although the textbook is a "must" for dermatologists, general pathologists, and dermatopathologists, any physician interested in collecting medical books with a beautiful, well-designed atlas and superb scientific quality will find this text a valuable addition to his or her personal library. W. P. Daniel Su, M.D. Department of Dermatology
Handbook of Chronic Pain Management, edited by C. David Tollison, 714 pp, with illus, $87.95, Baltimore, Williams & Wilkins, 1989 The editor of this text, C. David Tollison, enlisted the expertise of a variety of health professionals involved in the management of chronic pain problems and produced one of the best manuals on the effective clinical care of patients with chronic pain that I have had the opportunity to read. The manual is divided into five sections: Foundations, Treatment Modalities, Selected Disorders, Selected Topics, and Pain Clinics. Each section is further divided into chapters, each of which generally deals with a specific area, treatment modality, or pain problem. Although some overlap or duplication of material is evident among the chapters, the presentation of the material varies because of the multiple authorship. The most serious omission that I found was the lack of discussion of nerve blocks for the control of pain due to malignant processes, an area that is a rather high priority in most pain treatment facilities. 733
In most of the chapters, the authors made appropriate use of tables and figures, although some chapters would have benefited from more liberal interspersion of such material to help make the contents easier to understand. The format allows readers to delve at their individual level of interest, whether it be the basics or a specific pain problem or treatment modality. All medical specialties and their specific roles in the overall therapeutic approach to pain problems are presented, both in general and in depth. I recommend this manual to anyone who cares for patients with chronic pain, from the practitioner who is only slightly interested in the subject to the specialist who needs a reference manual. Now that Dr. Tollison has produced the first comprehensive pain manual, I hope that he will update it as new information becomes available in this challenging and exciting field.
Mayo Clin Proc, J u n e 1989, Vol 64
and colleagues, 1986), from which the authors of this new text have borrowed 15 illustrations, most of which depict motility of the stomach and small bowel in health and disease states. The editorial direction in the text is disappointing for several reasons. Some topics receive inappropriate coverage for a book published in 1988. For example, the use of radiologic techniques for the evaluation of transit or motility is clearly outdated in clinical practice and research in the United States. The book also contains considerable repetition of concepts, diseases, and illustrations in the sections on normal gastrointestinal motility (the small intestine) and gastrointestinal motility disorders (chapters on the stomach and duodenum and the irritable bowel syndrome). The section on pharmacologic agents covers interesting aspects of drug delivery and provides a basic pharmacologist's compendium of agonists and antagonists that affect overall gut motility but provides little direction on patient management. Lee A. Nauss, M.D. Pain Clinic The chapters in the methodology section lack uniformity. For example, a section on limitations is included in the contributions on manometry and scintigraphy, widely used techniques that have been the subjects of a considerable body of An Illustrated Guide to Gastrointestinal current literature. In contrast, no such section is Motility, edited by Devinder Kumar and Sven provided in the material on new techniques such Gustavsson, 470 pp, with illus, $130, Chichester, as impedance or ultrasonography. The text does England, John Wiley & Sons (distributed in the not discuss the advantages of the various modaliUnited States by Alan R. Liss, New York), 1988 ties or the indications for the use of one or more In this multiauthored text, the editors undertook of these procedures in the assessment of patients the task of producing a practical guide for the with symptoms suggestive of motility disorders. In addition, the coverage of some topics, such "understanding, diagnosis and management of gastrointestinal motility disorders." Overall, I as the scintigraphic evaluation of gastric emptybelieve that only the first of these objectives has ing, is sketchy, inaccurate, and clearly inadequate in consideration of the widespread availability been achieved. The authoritative reviews on such topics as the and use of this technique in both clinical and reenteric nervous system, the structure of smooth search settings. In contrast, the chapters on ultramuscle, the motility of the esophagus and small sonography, electromyography, hydrogen breath bowel, esophageal motor disorders, chronic idio- testing, and the use of computers provide sufficient pathic pseudo-obstruction, and abnormalities of current information on principles, potentials, and anorectal function are excellent. In these areas, utilization. In summary, as with many multiauthored texts, this book is similar to A Guide to Gastrointestinal Motility, by Christensen and Wingate (1983). this book is essentially a collection of chapters Other reviews omit important data acquired dur- with various degrees of detail, applicability, and ing the past decade, particularly in the clinical sophistication. Two of the goals stated by the ediassessment and diagnosis of patients with sus- tors in the preface—to provide a practical guide for pected gastrointestinal motility disorders. These the diagnosis and management of gastrointestinal diagnostic considerations are addressed in other motility disorders—have clearly not been achieved. available texts such as Manometric Diagnosis of Although the book will undoubtedly find a place Gastrointestinal Motility Disorders (Malagelada in medical school or gastroenterology research