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Book and New Media Reviews
July 2001

Total Skin: The Definitive Guide to Whole Skin Care for Life

Author Affiliations


Arch Dermatol. 2001;137(7):976. doi:

This book can be judged by its cover subtitle, which immodestly but truthfully proclaims its mission. Quite simply, the text covers everything an intelligent layperson would want to know about dermatology. David Leffell, a Mohs surgeon and Professor of Dermatology and Surgery at Yale, has succeeded where others have stumbled.

The most remarkable achievement is the quality of the writing. Concise, clear, simple sentences are built with an energetic facility that draws the reader into the narrative. A sense of adventure pervades, and even the professional dermatologist cannot resist being spellbound. Skin is exciting! Although unpretentious and not given to big words, Leffell never sacrifices accuracy or oversimplifies. He wields his language with surgical precision, and, taking the instruction provided to Alice in Wonderland, is sufficiently disciplined to begin at the beginning, continue to the end, and then stop. Except for a brief insert of color plates, the book is devoid of photographs. Rather, the text is enlivened by small line drawings and skillfully rendered black-and-white sketches. These go beyond the requisite schematic cross section of the skin and include such wonders as a positive potassium hydroxide preparation and the appearance of sweat under the microscope. Interspersed here and there are personal and historical anecdotes that impart a sense of immediacy to the problems being discussed. Like an ideal parent, Leffell approaches the lay reader with a mixture of genuine concern, encyclopedic knowledge, and the judgment to sift the important from the less important. When necessary, he is willing to chide gently, agreeing for instance that denial is natural when confronted with a new growth. Amateur psychologist aside, he can tell the whole, ugly truth and does not hesitate to include a stark diagram entitled, "Melanoma thickness affects survival."

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