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May 1985

Regional Dermatology: A System of Diagnosis

Arch Dermatol. 1985;121(5):682. doi:10.1001/archderm.1985.01660050132035

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Regionally speaking, this book stands dermatologic teaching on its ear. Despite the author's assertion that "basically, all skin diseases look alike," lesional morphology is recognized as the foundation of clinical diagnosis; distribution can only serve as an ancillary (and often misleading) bit of information. Though one might appreciate the utility of atlases devoted to structurally or functionally distinctive anatomic areas, basing a system of diagnosis primarily on distribution is quixotic if not perverse.

Epistemology aside, the book is flawed in most other respects. The clinical descriptions are perfunctory. The selection of diseases is idiosyncratic. (Why are xeroderma pigmentosa discussed in four separate sections but leukocytoclastic vasculitis not mentioned once?) There are so many factual errors that reading the text becomes a test of one's credulity. (Erythrasma is not fungal, lymphogranuloma venereum is not viral, nor does a scabetic infection confer immunity.) The therapeutic recommendations are atavistic. The black and white

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