Dermatitis-A contemporary approach in primary care practice

Author: Dr. Koushik Lahiri

Edition and year: 1^st edition, 2023 (162 pages and 12 chapters)

Publisher: Mind’s Lab Publishing, Thane, India.

Price: Rs. 1015/- on Flipkart

The book, printed on excellent quality paper is handy and carries 12 chapters, followed by a chapter in Appendix 1 on Abuse and Misuse of Topical Corticosteroids, and finally, Index. This book is basically targeted at general practitioners who have difficulties in the diagnosis and management of eczemas. The eczemas are essential to them as they form approximately 30% of skin diseases. The language is simple and lucid. Keeping in view the Indian scenario, commonly encountered dermatitis are covered. Each chapter is introduced with a case scenario and then a topic with proper attention to diagnosis and treatment. Relevant images of skin lesions for the type of dermatitis are incorporated in each chapter. The key practice points at the end of the chapter summarize the chapter and take-away points. My only wish is that these images could be more prominent and in focus to show distinctive features of dermatitis or eczema. The inclusion of perioral dermatitis (related to misuse of topical corticosteroids on the face) under dermatitis/eczema is a surprise to me. There is some discrepancy with relation to the meaning of acute eczema (resolved later on), scaling of the skin /desquamation and lichenification/skin thickening in Figure 2.1 on page 9 and age of occurrence of seborrheic dermatitis (infancy, adolescence, and adults). Seborrheic dermatitis presents as eczematous, itchy patches with mild scales (dandruff) or thick, greasy, yellow-coloured scales. The term eczematous should not be used liberally; instead, we should describe the lesions. A distinction needs to be drawn between allergic and irritant contact dermatitis, as patch testing is only indicated in allergic contact dermatitis. Patch testing and scoring systems are optional for the private practitioners. Adequate stress is given that moisturisers need to be applied before topical corticosteroids are used. General practitioners must be told when cases should be referred to the specialist. Judicious use of topical therapies, especially topical corticosteroids, is to be emphasized to them. The text part could have been reduced and replaced with more case scenarios with common differential diagnoses and treatment options limited to private practitioners. Dr. Koushik Lahiri, a world-renowned personality, has tried to touch upon a problematic topic of dermatitis that private practitioners often confuse with fungal infections and other dermatoses and thus use corticosteroid, antifungal and antibacterial combinations. His efforts through this book will prevent misuse of topical corticosteroids. I recommend this book to private practitioners and naïve dermatologists.