Clinical and basic immunodermatology

Article Outline

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This volume is a welcome addition to the somewhat sparsely populated list of current texts in immunodermatology. The importance of the immune system in the mechanisms underlying or contributing to the pathogenesis of many skin diseases has long been recognized, and any perusal of current journals reveals a seemingly exponential growth in the body of information in the field. The editors and the numerous expert contributors have valiantly addressed the task of presenting key new findings in the context of previous knowledge and clinical disease. The first of the four sections of this book comprises 11 chapters that include overviews of the major components of systemic and cutaneous immunology. It is clear at the outset that the authors assume that the reader possesses at least a foundational knowledge and understanding of the field. This section opens with a thorough discussion of the production and function of the cytokines and chemokines that mediate the numerous functions of the immune system, which are increasingly being examined for their potential therapeutic benefit in many diseases. The section continues with reviews of several key aspects of innate and specific immunity, with particularly informative chapters on the function of T lymphocytes and their numerous subsets, and photoimmunology. A topic notable for its absence is genetics—particularly a discussion of genetic association and predisposition toward disease. Some specific information is found in the clinical sections of the book; for example, the chapters on psoriasis and atopic dermatitis include short explanations of genetic analyses and the detection of candidate disease susceptibility genes and gene polymorphisms.

The other sections, which comprise the majority of the volume, are focused on the immunologic aspects of skin diseases and immunotherapeutic modalities. The list of diseases discussed verges on the encyclopedic, but emphasis is placed on the most common diseases, including inflammatory skin diseases, infections, and malignancies. This section also includes a concise overview of HIV/AIDS and its cutaneous manifestations, and a useful chapter on drug eruptions and underlying immune mechanisms. Autoimmune diseases and immunodeficiency and other immune-associated skin diseases are afforded their own section; the discussions of the bullous diseases are particularly well written. The chapter on primary immunodeficiencies is both instructive and concise. Finally, the immunopharmacology section of this text is excellent, providing timely information on approved and emerging biologic response modifiers and traditional adjuvant and antiinflammatory agents.

Despite some inevitable differences in style between contributing authors, this text is easy to read and understand. Relatively few clinical photographs are included, but there are many excellent explanatory diagrams that enhance the text, and the uniform style of these illustrations lends well to the continuity of concepts. Each chapter begins with a useful outline of key points to be discussed and concludes with an exhaustive bibliography for those who wish to explore a topic in greater depth.

This text, in conjunction with current primary literature, should be an excellent teaching tool for dermatology residents and fellows, and a valuable reference resource for clinicians. A paperback edition of this volume has also recently been published.