Book Review: Pathology of the Skin, With Clinical Correlations. 3rd ed.

Daniel Toweill, MD


Am J Clin Pathol. 2008;129(4):666 


McKee P, Calonje E, Granter S. Pathology of the Skin, With Clinical Correlations. 3rd ed. Philadelphia, PA: Mosby, 2005, 2112 pp, $429.00.

To the great benefit of the profession, high-quality reference texts in pathology have become relatively commonplace, but a few books distinguish themselves in such a way as to be considered truly outstanding. The third edition of Pathology of the Skin With Clinical Correlations is one such book. McKee, Calonje, and Granter, along with 8 contributing authors, have written a 2-volume text that in more than 2,000 pages covers the spectrum of dermatopathologic diagnoses with encyclopedic detail. It is not merely a text of histopathology, however. The greatest strengths of the book lie in the degree of clinical correlation provided for each of the diseases discussed and in the many high-quality clinical illustrations included for most of the entries. The illustrations number more than 5,000, many of them new in this edition, and almost all are of the utmost quality. This is an important point because the practice of dermatopathology depends greatly on correlation with clinical features. Having such excellent histopathologic and clinical illustrations in the same text is a tremendous benefit to readers. Sufficient illustrations are provided for each diagnostic entity to demonstrate the range of histologic manifestations—an invaluable aid in the diagnosis of unusual lesions.

Readers familiar with the second edition of the book will note significant reorganization and several entirely new chapters covering diseases of the hair follicles, nails, oral mucosa, and genital skin. Another welcome addition is a chapter describing the cutaneous effects of adverse drug reactions. A number of newly described entities are included, reflecting recent advances in the field of dermatopathology. The text is organized in a consistent and logical manner and is well indexed, providing rapid access to specific information. Each entry opens with a discussion of the clinical features of the disease, which is followed by review of the pathogenesis and histologic features. Most of the entries then cover the differential diagnosis, an essential consideration in a field in which similar histologic features not uncommonly may suggest a range of possible clinical diagnoses. The entries are complete but concise and readable.

The first volume begins with a discussion of normal skin structure and function, which is followed logically by chapters on disorders of keratinization and inherited and autoimmune subepidermal blistering diseases. The majority of the first volume then covers inflammatory conditions and is organized broadly into the various inflammatory reaction patterns. A separate chapter discusses infectious diseases of the skin and includes several uncommon diseases, as well as diseases that are more commonly encountered in practice. The second volume is devoted primarily to neoplastic disease and covers the gamut from epithelial neoplasms to lymphoproliferative disorders. Melanocytic neoplasms are covered in some detail, emphasizing the differential considerations in this notoriously challenging area of dermatopathology. Separate chapters are devoted to adnexal neoplasms of the hair follicles, sebaceous glands, and sweat glands. The chapter on lymphoproliferative diseases and related disorders includes helpful discussions and illustrations of the use of immunohistochemical studies in this area. The book is rounded out with chapters on idiopathic connective tissue disorders, disorders of pigmentation, and diseases of collagen and elastic tissue.

Relevant genetic and molecular features are discussed in at least a cursory manner. Readers needing additional details may choose to follow up in a primary reference, and an up-to-date list of references is conveniently provided following each topic. Some topics include tables highlighting important clinical associations or histopathologic features. Two CDs are also provided with the book and include images that can be used for presentation purposes.

It is difficult to review such a book without seeming overly enthusiastic. The book will be equally useful to dermatopathologists and dermatologists and is a worthy addition to any pathology library. This is a masterfully written and beautifully illustrated text that will undoubtedly be kept close to the microscope.


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