John Berth-Jones, Eunice Tan and Howard I Maibach* *1st edition 2004, reprinted 2006, 94 pages, paperback with illustrations, ISBN 978-1-90374-32-2. Health Press Limited. Oxford, UK. RRP $44.00
Eczema is a common condition affecting both adults and children. Atopic eczema affects more than one in ten children in developed countries, with an incidence that is increasing.1 Adults are not spared, with eczematous diseases accounting for 94% of notifiable skin disease and ranked third among all notified occupational disease in one large Danish study.2 Both childhood atopic dermatitis and contact dermatitis have a major impact on both patients and their families’ quality of life.3,4 Confirmed diagnosis is associated with an improved quality of life for contact dermatitis.4 The Australian Bureau of Statistics also lists the most common reasons for using skin ointments or creams as eczema and/or dermatitis (22%).5 Of note for military personnel is that a history of atopic dermatitis is described as a contraindication to smallpox vaccination.
Most health personnel will encounter eczema in daily practice and correct and early diagnosis along with appropriate management is obviously important. Help with this is at hand thanks to this text.
Fast facts – Eczema and Contact Dermatitis is presented as a 94 page A5 publication that would fit easily into the briefcase or carry bag. The small footprint would make it equally valuable as an easy to access desktop reference and would also fit easily in the pockets of the rapidly disappearing but once ubiquitous white coats of hospital based medical staff. It contains a table of contents, introduction, eight sections, sources of further information and an index. There is no forward although this is not surprising given the concise nature of the text.
The text itself is intended to help familiarise “the non dermatologist reader with the aetiology, diagnosis and treatment of the various forms of this disease”. The target audience is described as “physicians in many different medical disciplines”, as well as primary care physicians and other healthcare professionals. This could include medical and nursing students, pharmacists, allied health staff and even the informed family member or patient.
The introduction is worth reading as a guide to definitions and classification of the disease. The subsequent sections include “1 – Allergy and contact dermatitis”, “2 – Irritant contact dermatitis”, “3 – Atopic eczema”, “4 – Photosensitive eczema”, “5 – Seborrheic eczema”, “6 – Hand and foot eczema”, “7 – Other forms of eczema” and “8 – Future trends”. Most sections follow a standard format consisting of epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, patient education, complications, prognosis, key points and key references. The sections are also colour coded enabling ease of access, which is important in a desk top ‘fast facts’ text.
The book is easy to read and clearly set out. Particular strengths are the ‘Key Points’ sections at the end of each section and the quality of the illustrations. The adage that ‘a picture tells a thousand words’ is never more so than in dermatology. The quality of image reproduction is very good for a pocket guide and each has been carefully selected to clearly demonstrate specific aspects of the disease. Additionally the diagrams illustrating body distribution of different types of eczema are a valuable reference and particularly suited to a fast facts style presentation. The reproduced diagram guiding application of the correct amount of topical steroid is especially useful and would be a valuable tool for patients or carers. This diagram is representative of the books approach to management advice which is practical and clearly stated. The inclusion of patient education is also a valuable and important resource. As both an Emergency Physician and the parent of a child with severe eczema, personal experience is that this is an important and often neglected area in many texts.
Brief details of the three authors are provided at the start of the book. John Berth-Jones is a Consultant Dermatologist at United Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. Eunice Tan is a Specialist Registrar in Dermatology at Norfolk and Norwich University Hospitals, Norwich, UK.
Howard I Maibach is a Professor of Dermatology at the University of California, San Francisco, USA.
The background of the authors is reflected in the book and creates some limitations particularly for Australasian readers. Sources of further information are limited to Europe, UK and USA associations for eczema and dermatology. Similarly the text uses the British National Formulary so there are likely to be some variations in practice and availability. A minor point is that although the stated intention of the authors is to use an evidence based approach whenable this is not clearly referenced. Key references are supplied at the end of each section but not directly linked to statements nor are levels of evidence supplied.
These issues aside this is an excellent text and one that is highly recommended. A minor but important point of note in today’s society is that the text is printed in vegetable ink and on biodegradable paper. The copy reviewed was provided by CSL Biotherapies as a service to medicine. The same can be said of the author’s contribution – well done.
Reviewed by: Peter Aitken, MBBS, FACEM: Associate Professor, Anton Breinl Centre, James Cook University, Townsville, Queensland 4811, Australia; Senior Staff Specialist, Emergency Department, The Townsville Hospital; Noel Stevenson Research Fellow, Queensland Emergency Medicine Research Foundation. Email: peter_aitken@health.qld.gov.au
