felt to be ‘‘grave and patients invariably die.’’1 Onecomes to the conclusion that there was likely astrong referral bias one century ago, and thatpatients with minor ailments would not be seeingtheir physicians. Dr Ackerman and colleaguescorrectly point out that the ancient concept of MFas a fatal disease has hindered our understandingthat both small- and large-plaque parapsoriasis areMF.

Part II starts with Sanchez and Ackerman’s 1979article that published criteria for the histologicdiagnosis of patch stage MF.2 The subsequentdiscussion of the literature provides compellingarguments for why flat lesions of MF include para-psoriasis en plaques, parakeratosis, variegata, xan-thoerythroderma perstans, and poikilodermavasculare atrophicans. This is followed by a critiqueof articles on clinical morphologies of MF, such asguttate dermatosis/digitate dermatosis, Woringer-Kolopp disease (pagetoid reticulosis), alopecia mu-cinosa, bullous MF, pustular MF, hypopigmentedMF, hyperpigmented MF, tumoral MF, Sezary syn-drome, and granulomatous slack skin. Readers willlearn the difference between follicular mucinosis asa histopathologic reaction pattern and alopeciamucinsosa as a manifestation of MF. In the nextsection, histopathologic variants, such as infundib-ular MF, interstitial MF, and Koebner phenomenonare discussed, along with the genetics and briefdiscussion of immunophenotype in MF. As mostdermatopathologists know, Dr Ackerman elo-quently writes ‘‘Although studies genetic of MFhave been undertaken for only the last 20 years,they have provided much information useful, but inregard to diagnosis, the method most accurate con-sistently is correlation clinicopathologic with thefindings histopathologic assessed in sections stainedby hematoxylin and eosin’’ (p. 277). The book endswith a critique of some of the old and currentclassification systems of cutaneous lymphoma inregards to MF, along with a synthesis and briefwarning about an impending ‘‘epidemic of MF.’’The ‘‘epidemic of MF’’ implies that an increasedincidence will be noted when diagnosticians becomemore adept at the diagnosis of flat lesions of MF.

I would hope that future editions would improvethe printing process and the picture layout to max-imize fine detail and image size. Some of the imageswere smaller than they needed to be and the color onthe printed page was not always true to life.

In conclusion, this book and accompanying atlasare a valuable asset for any dermatologist, patholo-gist, or oncologist involved in the management ofcutaneous lymphoma. The text is well written, has anoutstanding bibliography, and critiques the majority

of seminal articles on MF. Readers will gain a thor-ough knowledge of MF, both in historical context andin regards to current advances. Dr Ackerman’s ex-tensive and unparalleled experience and familiaritywith this topic enlighten each discussion. I amconfident that you will enjoy reading this text asmuch as I did.

Klaus Frederick Helm, MDHershey, Pennsylvania

REFERENCES

1. Bazin E. Lecons sur le traitement des maladies chroniques en

general affections de la peau en particular pa l’emploi compare

des eaux minerals de l’hydotheapie et des moyens phamaceu-

tiques. Paris: Adrein Delahaye, 1870. pp. 425, 436-8. Cited in:

Ackerman AB, Denianke K, Sceppa J, Asgari M, Milette F,

Sanchez J, editors. Mycosis fungodies: perspective historical

allied with critque methodical for the purpose of illumination

maximal. Atlas and text. New York: Ardor Scribendi; 2008. pp.

122-3.

2. Sanchez JL, Ackerman AB. The patch stage of mycosis

fungoides. Criteria for histologic diagnosis. Am J Dermatopa-

thol 1979;1:5-26.

doi:10.1016/j.jaad.2008.05.014

J AM ACAD DERMATOL

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360 Book reviews

Histopathologic diagnosis of adnexalepithelial neoplasms. Atlas and text.A. Bernard Ackerman and Almut Boer. New York,2008, Ardor Scribendi. 209 pages. $95.00. ISBN:978-18933-573-10.

I recall sitting in the very back of the lecture hallduring medical school while the professor intro-duced the morning’s topic of a convoluted neuroan-atomic pathway with the apology, ‘‘The problem is,that life is not simple.’’ Odd that this platitude shouldstay with me all these years; still, it comes to mind, yetagain, when confronted with the histopathology ofadnexal neoplasms. A shame that Drs Ackerman andBoer were not lecturing that day, for they succeedadmirably in illuminating the labyrinthine pathwayof this topic.

The text is divided into 12 sections, largelyaccording to patterns of differentiation. The authorsemploy an algorithmic method whereby specificneoplasms are presented in the context of relatedentities. The diagnostic distinctions are crisp. Thetext is appropriately spare. Illustrations, while inblack and white, are generous and of excellentquality. Given the extensively ramifying diagnostictree inherent in this field, the authors are to becommended for the thoughtful consideration ofdifferential diagnoses.

Nothing is perfect. The authors present severalnon-facts as fact. Human papillomavirus is not

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Book reviews 361

proven as the cause of trichilemmoma; indeed, thedata suggest otherwise. It is not universally acceptedthat proliferating pilar cysts are malignant. Theauthors have chosen a syntax in which adjectivesare routinely placed after the nouns they modify. Thefollowing bullet point relating to sebaceoma is anexample of what ensues: ‘‘e not a component ofMuireTorre syndrome, which is manifested in theskin as carcinomas only, to wit, ones sebaceousmostly but, episodically, ones keratoacanthomatous,i.e., squamous-cell carcinomatous of one type.’’ Thatstructure is a distraction.

Those points aside, the authors are to be congrat-ulated for their clear vision, sharp presentation, andextensive illustration. I recommend this book to allwith an interest in dermatopathology. While neuro-anatomy and the histopathology of adnexal neo-plasms are far from simple, the authors clarify thelatter in a way only experts are able.

Thomas Horn, MDNewton, Massachusetts

doi:10.1016/j.jaad.2008.04.008