BOOK REVIEWS Skin bioengineering: Techniques and applications in dermatology and cosmetology; volume 26 (Current Problems in Dermatology) P. Eisner, A. O. Barel, E. Beradesca, B. Gabard, and 1. Serup, editors. Basel, 1998, Karger. 250 pages. $216.50. This is a clearly written, hard-bound manual designed to introduce the reader to new and emerging skin bioengineering techniques. The book is volume 26 in the Current Problems in Dermatology series published in Switzerland by Karger Publishing House. Like its North American counterparts, such as Dermatology Clinics or Clinics in Dermatology, the volume is dedicated to one topic of skin bioengineering and has 5 well-known and respected editors and many authors. The book is subdivided into 4 sections. The first section, entitled "Advances in Skin Bioengineering Techniques," deals with either new emerging techniques or modification or improvement of the old ones. The most fascinating chapter in this section describes optical coherence tomography. Similar to skin magnetic resonance imaging, optical coherence tomography was initially used by ophthalmologists before it found its way to dermatology and provides noninvasive high-resolution images that have axial resolution of 15 !lm and depth of penetration of up to I mm. This technique will clearly be widely used in the next century both in cosmetic science for dermatologic research and perhaps in clinical dermatology. Other interesting chapters in this section describe cutaneous microdialysis and the first reported successful proton magnetic resonance spectroscopy images (however, the data on proton magnetic resonance spectroscopy are very preliminary and the authors do not have peak assignments). My only suggestion for this section would be to include a chapter on telemedicine. The second section addresses disease monitoring. It primarily focuses on high-frequency ultrasound monitoring of disease activities in psoriasis, scleroderma, and occupational diseases. Unfortunately, this section ignores cutaneous oncology, magnetic resonance imaging, epiluminescence, and laser Doppler perfusion imaging. The third section deals with cosmetic product testing. I think this section is extremely useful for cosmetic scientists and dermatologists interested in cosmetology. I found the chapter on climatic influences affecting cosmetic skin parameters informative. It appears that skin physiologic changes affected by climate cannot be compensated for by acclimatization in air-conditioned laboratories. Journal of the American Academy of Dermatology
The final section deals with design and legal aspects of skin bioengineering. The Sixth Amendment to the Cosmetic Directive passed by the European Parliament that gradually bans the use of animals in cosmetic industry testing and established the European Center for the Validation of Alternative Methods was a major boost for the prestige and acceptance of European cosmetic scientists and skin bioengineers. As pointed out in the last chapter of the book, the cosmetic industry claims in Europe, such as antiaging, hydration, skin firmness, and skin smoothness, are now validated by bioengineering instruments in correlation with self-appraisal performed by human volunteers. I highly recommend this book to the dermatologist who wants to learn about new advances in skin bioengineering. Furthermore, this manual is obviously a must for cosmetic industry scientists. However, this book does not replace the slightly outdated, but still comprehensive, encyclopedic work edited by 1. Serup and G. B. E. Jemec (Handbook of noninvasive methods and the skin. Boca Raton FL: CRC Press; 1995). As far as skin bioengineering is concerned (except for telemedicine and a few other areas), US dermatology is lagging behind that of the European community where knowledge of skin bioengineering is required for dermatology board certification (in Germany) (Kligman AM. The future of bioengineering: a dermatologist's perspective. Skin Res Technol 1995; I :2-3). My hope is that as the United States continues to lead the world in computer science, digital imaging, and bioengineering fields, we as dermatologists will apply these advances to clinical practice and dermatologic science.
Alexander Zemtsov, MD, MSc Muncie, Indiana
Textbook of dermatological surgery John Louis Ratz, MD, Roy Geronemus, MD, Mitchel Goldman, MD, Mary Maloney, MD, and R. Steven Padilla, MD, editors, Philadelphia, 1998, LippincottRaven Publishers. 647 pages. $185.00. No didactic program can properly replace the importance of surgical training and experience; however, textual information can begin to provide a good part of the background necessary to properly plan and perform dermatologic surgical procedures. Dr Ratz and his associate editors have assembled an impressive group of cutaneous surgeons, all of whom are dermatologists. This text appears to be targeted toward the general dermatology community. There are chapters detailing preoperative surgical considerations, June, Part 1, 1999
Journal of the American Academy of Dermatology June 1999
including patient selection, anesthesia, antisepsis, instrumentation, and photographic documentation. There follow several chapters that describe a multitude of surgical procedures. From the ordinary to the intricate, the procedures range from very basic surgery (removal of a cyst or lipoma) to advanced cosmetic surgery (rhytidectomy or blepharoplasty). Elementary surgical procedures such as excision, incision, and basic suturing are given considerable discussion. Subsequent chapters describe the basic concepts of flap and graft reconstructions. Other commonly performed procedures (cryosurgery, electrosurgery, nail procedures) are also described. In general, the authors do an admirable job of providing the background information required to consider doing these operations in a safe and effective manner. The editors have devoted considerable attention to the discussion of cosmetic surgical procedures. Topics delineated include blepharoplasty, facelift surgery, hair replacement surgery, phlebology, liposuction, and soft tissue augmentation. In addition, chapters on cutaneous laser applications are supplied. Most of the discussions detailing cosmetic surgical procedures are well presented, but the information is often more useful as required "background" reading rather than as a procedural manual capable of highlighting all the successes, pitfalls, and nuances of these particular surgical interventions. The photographs (all in black and white) within the textbook are of sufficiently good quality, and they adequately reflect topics discussed within the text. Line diagrams add considerable clarity to the procedural descriptions. The references cited within the text are current and important. As dermatologic surgery emerges from its adolescence, it becomes increasingly apparent that dermato-
logic surgeons have been (and will likely continue to be) leaders in the development of surgical procedures to manage cutaneous neoplasia, reconstruct the surgically altered face, and restore (or in cases, mimic) the esthetic ideals of youth and beauty. This text is written by many of the physicians who have been responsible for the meteoric rise of dermatologic surgery. Indeed, the expansion of the surgical experience of dermatologists may have contributed to one very modest "weakness" of this text. It is becoming increasingly difficult to capture all of the relevant aspects of dermatologic surgery within a single textbook. In recent years, there have been voluminous texts devoted entirely to procedures such as Mohs micrographic surgery, flap reconstructions, laser surgery, liposuction, and the other surgical procedures described within this text. Of course, such focused texts are typically liberated from the spatially confined restraints of the general dermatologic surgery text. By quickly launching from basic discussions of biopsy techniques and instrument selection into a very well-presented discussion of the complexities of the nicely executed rhytidectomy, the editors of this work are, in my opinion, slightly too zealous in their desire to chronicle the entire gamut of dermatologic surgery. Nonetheless, I think that this text is a valuable aid to the dermatologist who hopes to understand (and eventually, to perform) well designed and thoughtfully executed dermatologic surgical procedures. The text is unusually easy to read and comprehend, and I certainly believe that it will enhance even the most experienced dermatologist's knowledge. Jonathan L. Cook, MD Philadelphia, Pennsylvania
BOUND VOLUMES AVAILABLE TO SUBSCRIBERS Bound volumes of the Journal of the American Academy of Dermatology are available to subscribers (only) for the 1999 issues from the Publisher at a cost of $123.00 for domestic, $151.94 for Canadian, and $142.00 for international for volume 40 (January-June) and volume 41 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact Mosby, Inc., Periodical Subscription Services, 11830 Westline Industrial Dr., St. Louis, MO 63146-3318. USA: phone (800) 453-4351; (314) 453-4351. Subscriptions must be in force to qualify. Bound volumes are not available in place of a regular journal subscription.