BOOK REVIEW
Lever’s Histopathology of the Skin, 10th ed
David E. Elder, Rosalie Elenitsas, Bernett L. Johnson,
Jr, George F. Murphy, and Xiaowei Xu, editors,
2008, Baltimore, Lippincott, Williams & Wilkins.
1408 pages. $335.00. ISBN: 978-0-781-77363-8.
A new edition of the classic has just been released.
As with previous editions, this is an authoritative text
written and edited by some of the most respected
dermatopathologists in the world. The new edition
continues the tradition of scholarship and practicality
that have made the text one of the best-known names
in medical publishing. The images are entirely in
color, except for the superb appendix of electron
micrographs which remains (appropriately) in splen-
did black and white.
For those of us weaned on Lever’s Histopathology
of the Skin, the release of a new edition is a major
event. The original, written by Walter Lever, was
published in 1949. This classic was a 449-page book
with 221 illustrations, including eight in color. One of
the key features of the volume’s success was the
concise yet complete clinical information provided
about each entity. Since then, the book has under-
gone many updates. Descriptions of the clinical
findings and pathogenesis have remained key fea-
tures of each edition, and several dermatology res-
idency programs began each year’s curriculum with a
cover to cover review of Lever, focusing only on the
clinical descriptions—essentially using the text as a
concise textbook of clinical dermatology. For most of
the current generation of dermatologists, the histo-
pathologic portions of the text severed as the basis
of their dermatopathology curriculum during
residency.
J AM ACAD DERMATOL
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The text has continued to evolve and improve.
The most significant change occurred with the eighth
edition, when editorship of the book transferred to
David Elder and his associates at the University of
Pennsylvania. The book became a multiauthored
text, yet the editorial team ensured even and com-
prehensive coverage of each topic. The tenth edition
represents an update of the previous two editions,
retaining the classic organization of the book. While
many dermatopathology texts group entities by his-
tologic reaction patterns, Lever’s Histopathology of
the Skin is organized by clinical categories, such as
papulosquamous diseases and connective tissue
disease. The greatest strength of this organization is
that entities are very easy to find, and diseases that
may present with several different inflammatory
patterns can be discussed in a single chapter. The
downside is that disorders with a common reaction
pattern are spread between several chapters. For
instance, disorders that present with interface der-
matitis appear in the chapters on papulosquamous
disease, connective tissue disease, and treponemal
disease. Both patterns of organization have their
strengths, and any teaching curriculum that includes
both approaches will be the stronger for it.
This new edition of Lever’s Histopathology of the
Skin is a strong update of a classic. A copy belongs
on every dermatologist’s and every pathologist’s
bookshelf.
Dirk Elston, MD
Danville, Pennsylvania
doi:10.1016/j.jaad.2009.01.043
JULY 2009 171