Handbook of Atopic Eczema
http://www.100md.com
《新英格兰医药杂志》
Handbooks are generally small books that serve as guides for study. The Handbook of Atopic Eczema is not a small book. Its 613 generally well written pages are grouped into 66 chapters and represent a treatise in themselves; this is a good thing. I spent a good part of a long plane ride learning the nuances of atopic eczema from this book.
The chapters on clinical aspects of atopic dermatitis cover not only its signs and symptoms but also the suffering that patients with the disorder endure from maddening itch and obvious rash. The diagnosis can be tricky, and the subtleties of making a determination are discussed. I liked the chapters on the pathophysiological features of the disorder, and the arguments for various primary causes, including genetic, allergic, immunologic, environmental, neural, and structural (aberrant barrier) abnormalities, are well aired here. The subclassification of atopic dermatitis into so-called "intrinsic" and "extrinsic" forms is helpful.
The chapters on management, however, are weaker. Wet compresses, which are safe and incredibly effective, are hardly mentioned, and no chapter deals specifically with the choice of management with systemic therapies — such as interferon-, cyclosporine, methotrexate, and azathioprine — or with hospitalization. The chapter on complementary therapies is surprisingly more detailed, data-driven, and intriguing.
In the preface, the editors say they are proud to have experts from "all over the world" as contributors. But by my count, 56 of the 107 authors are from Germany, including the three editors; 98 are from Europe. None of them are from Africa, Australia, or South America, although Saudi Arabia is represented. This is unfortunate, since atopic dermatitis is highly influenced by environmental factors. Experts from a variety of climates and traditions could share interesting and enlightening experiences in the treatment of patients who have different genes and different skin colors and may receive different drugs in different care systems.
Despite these shortcomings, I liked the book. As an eczema-phile, I would buy it. The book shows that we know a lot, and it is an encyclopedic reference. A researcher will quickly spot many fertile fields for investigation. Biology watchers will ponder the workings of ceramides, cytokines, and phosphodiesterase 4 inhibitors. The chapters on genetics are interesting, although it is frustrating that we do not know more about how genes work in this disease, in which a genetic link seems obvious.
This book has a place on my bookshelf next to the first edition, published more than 15 years ago. In fact, it frequently has a place in my hands. Perhaps the editors foresaw this outcome when they chose to call their compendium a "handbook."
Mark V. Dahl, M.D.
Mayo College of Medicine
Scottsdale, AZ 85259(Second edition. Edited by)
The chapters on clinical aspects of atopic dermatitis cover not only its signs and symptoms but also the suffering that patients with the disorder endure from maddening itch and obvious rash. The diagnosis can be tricky, and the subtleties of making a determination are discussed. I liked the chapters on the pathophysiological features of the disorder, and the arguments for various primary causes, including genetic, allergic, immunologic, environmental, neural, and structural (aberrant barrier) abnormalities, are well aired here. The subclassification of atopic dermatitis into so-called "intrinsic" and "extrinsic" forms is helpful.
The chapters on management, however, are weaker. Wet compresses, which are safe and incredibly effective, are hardly mentioned, and no chapter deals specifically with the choice of management with systemic therapies — such as interferon-, cyclosporine, methotrexate, and azathioprine — or with hospitalization. The chapter on complementary therapies is surprisingly more detailed, data-driven, and intriguing.
In the preface, the editors say they are proud to have experts from "all over the world" as contributors. But by my count, 56 of the 107 authors are from Germany, including the three editors; 98 are from Europe. None of them are from Africa, Australia, or South America, although Saudi Arabia is represented. This is unfortunate, since atopic dermatitis is highly influenced by environmental factors. Experts from a variety of climates and traditions could share interesting and enlightening experiences in the treatment of patients who have different genes and different skin colors and may receive different drugs in different care systems.
Despite these shortcomings, I liked the book. As an eczema-phile, I would buy it. The book shows that we know a lot, and it is an encyclopedic reference. A researcher will quickly spot many fertile fields for investigation. Biology watchers will ponder the workings of ceramides, cytokines, and phosphodiesterase 4 inhibitors. The chapters on genetics are interesting, although it is frustrating that we do not know more about how genes work in this disease, in which a genetic link seems obvious.
This book has a place on my bookshelf next to the first edition, published more than 15 years ago. In fact, it frequently has a place in my hands. Perhaps the editors foresaw this outcome when they chose to call their compendium a "handbook."
Mark V. Dahl, M.D.
Mayo College of Medicine
Scottsdale, AZ 85259(Second edition. Edited by)