Dermatology Expert Group. *Version 3. xxiii+335pp, paperback, ISBN 978-0-9804764-3-9. Melbourne, Therapeutic Guidelines Limited, AUD39.00, 2009.
Apart from textbooks, including one recently received in this journal,1 there have been few handbooks published specifically on guidelines related to Dermatology. This third Version of Therapeutic Guidelines: Dermatology, part of a collection of 14 in the series of the popular and respected Therapeutic Guidelines series in Australia, is a major step forward in filling this gap. Therapeutic Guidelines: Dermatology has a table of Contents, list of Tables, boxes and figures, a list of the members of the Dermatology Expert Group and of the Skin Infections Expert Group, Acknowledgments, a list of Endorsements and Support, About Therapeutic Guidelines Limited and their Board of Directors, a Preface, 27 Chapters, two Appendices, a Glossary, a comprehensive Index and a Request for comment on guidelines proforma. It also includes 24 Tables, 13 Boxes and one Figure. As is usual in this series, the handbook is compact and, if consistent with others in the series, the reader will expect that updated guidelines would be released every few years. Although skin infections are covered in this instalment of the Therapeutic Guidelines series, it may be useful to consider whether the title should read Dermatology and Skin Infections, as a promotional consideration. The front cover has a basic but functional design, although the significance of the chosen image is not entirely clear. The back cover is virtually blank, except for the ISBN and barcode, and an opportunity has been missed to include a fast find contents list or an overview of the publication; however all of the Therapeutic Guidelines’ handbooks seem to take this minimalist approach. Similarly, it may be interesting to make better use of the inside front and back covers, as has been done in other series, such as the Oxford Handbooks, by listing for example major emergencies and the page references to find information to manage them. Each chapter has a useful highlighting strip on the edges of the pages, which importantly helps to identify the various chapters. It is also important to note that the handbook is also available electronically and this would make it very easy to print out patient information sheets, for example.
As an Australian based publication, it is inevitable that the writing group would be predominantly Australian. It is interesting however that all 14 members of the Dermatology Expert Group and all eight of the Skin Infections Expert Group are Australian based. Nonethe- less, many of these experts would be well known in the field of dermatology. Apart from the field of pharmacy, there are experts outside of dermatology from fields such as infectious diseases and general practice.
Therapeutic Guidelines: Dermatology is well researched, concise and consistent in its presentation. Chapters include “Skin biopsies and other diagnostic tests”; “Getting to know your drugs”, “Acne”, “Benign skin tumours and cysts”, “Blistering disorders”, “Connective tissue disorders”, “Contact dermatitis”, “Cosmetic dermatology”, “Cutaneous drug reactions”, “Cutaneous vasculitis”, “Dermatitis”, “Dermatological emergencies”, “Genital skin diseases”, “Hair disorders”, “Infectious skin diseases”, “Infestations and bites”, “Itch without rash”, “Nail disorders”, “Paediatric dermatology”, “Pigmentary disorders”, “Pregnancy rashes”, “Psoriasis”, “Rosacea, flushing and perioral dermatitis”, “Skin manifestations of internal disease”, “Solar damage and skin cancer”, “Sweating disorders” and “Urticaria and angioedema”.. There are also two Appendices, namely “Pregnancy and breastfeeding” and “Sources of information”. By far the largest chapter is the one on “Getting to know your drugs” (pages 7-44). The drugs are discussed by sub-headings, namely “Dermatological Vehicles”, “Moisturisers”, “Antiandrogens”, “Antibacterials”, “Antifungals”, “Antiparasitic Drugs”, “Antiseptics”, “Antivirals”, “Antipruritics”, “Biological Antipsoriatic Drugs”, “Botilinum Toxin Type A”, “Corticosteroids”, “Cytotoxics and Immunosuppressants”, “Dapsone”, “Dithranol”, “Eflornithine”, “Hydroquinone”, “Keratolytics”, “Tars”, “Vitamin D Analogues”, “Zinc Oxide” and “Complementary Medicines”. There is no set pattern to the structure of the sections in the guidelines, although most sections cover treatment or management.
Version 3 is a major update of Therapeutic Guidelines: Dermatology. There are new tables and boxes on “dosing of oral antihistamines” (Table 1, page 22), “important considerations when using topical corticosteroids in adults and children” (Box 5, page 115), and “indications for lasers and their efficacy” (Table 8, page 79).2 From the Australasian perspective, it is hard to fault the guidelines. Perhaps unusual in many similar types of handbooks, it has drawn on both the disciplines of dermatology and infectious disease. One possible omission for those interested in travel and wilderness medicine in more tropical regions of the world would be a chapter on common parasitic and infectious diseases encountered during travel or expeditions. These might include conditions such as larva currans from Strongyloides sp. and eschars from scrub typhus, noting also that many of these conditions also occur in Australia. Another possible omission is that poisonous flora is not well addressed and stinging plants and trees and poisonous plants can present a hazard, even in wilderness areas of Australia. Although it is understood why colour plates have not been included to save cost, some of the topics, such as skin cancer, nail disorders, genital skin diseases and many other areas, lend themselves to spot diagnoses, especially if they included some of the cutaneous manifestations of travel and tropical diseases. More in-depth handbooks, such as the recently published Handbook of Dermatology: A Practical Manual,3 would be a useful purchase in addition to this guidelines handbook, which is directed more towards being a rapid therapeutic guidelines reference. Therapeutic Guidelines: Dermatology is not a substitute for training and experience in dermatology. It is also not meant to be a comprehensive textbook of dermatology, especially as there have been several good dermatology books published relatively recently, including one relevant to Australasia.4 The handbook does however provide an exceptionally useful and fairly comprehensive clinical reference on most aspects of dermatology for the informed health professional, particularly those who are working or will be working professionally in dermatology, general practice and related areas. The book will also appeal to general physicians and other health professionals, who have an interest in dermatology, as well as students and academics involved in dermatology training courses. Therapeutic Guidelines: Dermatology has little competition in the guidelines field and is an important guidelines reference handbook in Australasia.
