B o o k r e v i e w s I I I I l i I I I

Basics of food allergy, ed. 2 James C. Breneman, M.D., Springfield, IL, 1984, Charles C Thomas, Publisher. 425 pages. $49.75.

The concept of food allergy being instrumental in dermatologic conditions with the exception of chronic urticaria has been difficult for most der- matologists to accept. In his second edition of Ba- sics of Food Allergy, James C. Breneman, M.D., emphasizes basic immunologic alterations in the standard Gell-Coombs classification of allergic re- actions as being operative.

The book is well written and contains ample references. It stresses the difficulty in accurately diagnosing food allergy because more than one organ system is involved. Thus the sections on management are mainly directed to the generalist. Specific reference to skin diseases appears briefly in Chapter 7.

] found the discussion on the new cutaneous patch tests with DMSO (DIMSOFT procedure) in- teresting. Dried powdered foods suspended in DMSO are applied to the skin in the customary patch testing manner. Immediate and delayed read- ings are observed. The tests showed 69% sensi- tivity in diagnosis of urticaria and eczematous skin reaction in a small study. Unfortunately, the author does not elaborate on the specifics in preparation of these allergens.

The technic of using elimination-type diets is well known and discussed in a practical manner for the clinician. Chapter 19, entitled "Little Known Facts About Foods," is especially inter- esting and contains lists of hidden sources of food allergens with cross-sensitivities of multiple food products. These lists may be readily copied for patient use.

I would recommend this as a well-written gen- eral reference source to the physician interested in food allergy. Whether or not foods play a specific role in dermatoses other than chronic recurrent urticaria and dermatitis herpetiformis still remains to be proved.

Earl J. Rudner, M.D., Southfield, MI

Diseases of the nails and their management R. Baran, M.D., and R. P. R. Dawber, M.A., M.B., Ch.B., F.R.C.P., editors, Oxford, 1984, Blackwell Scientific Publications. 469 pages. $92.50.

Baran and Dawber are two noted European der- matologists who have developed a special interest in the nail. They, along with eight other physicians (one from the United States), have combined their talents to produce a comprehensive publication on the nail. As wil;h all books, it has its strong points and its weaknesses.

Some favorable points include the quality of most photographs, tables, and illustrations. The sections on hereditary and congenital nail disor- ders, leukonychia, and infectious agents affecting the nail are particularly noteworthy. The research and detail in many sections are extensive. Cross- referencing in the text is helpful for the most part.

Several technical points detract from the book. In a number of cases cross-reference pages are delineated as "000." Occasional incorrect spell- ing and malalignment of a sentence or table appear. In one case two identical paragraphs appear back to back. At times, it is difficult to tell which ref- erence applies to which statement. This makes further follow-up of those statements difficult. In- frequently, references appear to be accidentally omitted.

This book costs $92.50, which might hinder the average physician dealing with nail disorders from buying it, since the text is so specialized. To sum- marize, it is a good, comprehensive book on the nail. Untold hours of research and planning must have gone into its production.

C. Ralph Daniel 111, M.D., Jackson, MS

Skin problems of the amputee S. William Levy, M.D., St. Louis, 1983, Warren H. Green, Inc. 293 pages. $49.95.

The amputee presents a unique problem for the orthopedist, the prosthetist, the family practi- tioner, the internist, etc. The area receiving the

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