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                BOOK REVIEW

                Written by two dermatologists from the University of
                KwaZulu-Natal’s Nelson R Mandela School of Medicine, the
                much-needed 2nd edition of the Atlas of Skin Conditions in HIV/AIDS
                is now available. Immunocompromise in HIV cases results in a large
                variety of skin findings that significantly differ in quality and
                extent from those in immunocompetent people.

                
                

                Acknowledging the fact that dermatological problems are often a
                challenge to clinicians, this is an important area demanding an
                easy-to-use atlas to identify the most common diseases. As HIV
                treatment increasingly becomes a condition to be treated at a general
                primary health care level, this becomes even more pertinent.

                
                

                To meet the needs of the clinician, the atlas is put together in a
                way that makes it a pleasure to use quick reference for clinical
                findings. The book’s chapters are structured by type of skin
                eruption rather than nosological disease entity, which adds to the ease
                with which a specific clinical presentation can be found. These groups
                of skin conditions are ‘Blisters’, ‘Papulosquamous
                conditions’, Papules and nodules’, ‘Ulcers’,
                ‘Nails’, ‘Oral lesions’,
                ‘Miscellaneous’ and ‘Antiretroviral therapy’.
                Only the chapter on ‘Antiretroviral therapy’ attempts a
                more systemic approach, based on the causation rather than the clinical
                presentation, when it lists a range of conditions that might erupt
                under antiretroviral treatment. These conditions are presented in the
                two sections ‘Immune reconstitution inflammatory syndrome’
                (IRIS) and ‘Cutaneous manifestations of antiretroviral
                drugs’.

                
                

                For each condition, on the left page there are high-quality colour
                pictures displaying the skin condition. This is complemented by a brief
                description of the condition and its treatment on the opposite page.
                This includes a hands-on treatment recommendation with standard dosages
                and durations for the treatment and explicitly including both EDL
                (Essential Drugs List for primary health care) and non-EDL items.

                
                

                With its user-friendly structure, this atlas is a valuable addition
                to the standard reference in a consultation room in public sector
                facilities. It is comprehensive enough to include the more common
                conditions, while at the same time concise enough to serve as a quick
                reference during or in between consultations. On the wish-list for
                future editions would be an update of the primary health care EDL
                reference, as the book refers to the 1998 edition of this list. Having
                been published before the new antiretroviral treatment guidelines came
                into effect in 2010, a future edition should possibly also present
                clinical examples of the skin presentation of the abacavir
                hypersensitivity syndrome (which is only mentioned in the text), as
                this drug is now part of the paediatric first-line regimen and skin
                eruptions following the initiation of this drug are a major point of
                concern. Similarly, tenofovir, which is now part of the adult
                first-line regimen, is not mentioned in the book but would probably
                have shown its dermatological side-effects (if any) by the time the
                next edition appears.

                
                

                Dirk Hagemeister

                Paarl

            

            
                
                    A Clinical Atlas of Skin Conditions in HIV/AIDS: An Illustrated Management Guide for Health Care Professionals. By Ncoza Dlova and Anisa Mosam. 

                    2nd ed. Pretoria: HPMG, 2009. Pp. 100. ISBN 1-875098-40-2.