Jean F. Hewitt, Monique Pelisse, and Bernard Jean Paniel; eds. 212 pages. London: McGraw Hill Book Company; 1992. $145.00.

A need exists in the literature for a practical text on vulvar diseases. The diagnosis of various vulvar diseases is usually made by visual inspection and subsequent biopsy. To be useful, a text on vulvar disease should have good descriptions of these diseases, followed by appropriate photographs. Few other current texts addressing the subject of vulvar disease have the appropriate visual aids to help the reader understand or get an impression of the spectrum of presentation of the various disease processes. This text offers a relatively comprehensive view of vulvar disease with an extensive accumulation of color photographs of these problems. This textbook not only contains photographs of a wide variety of diseases, but also offers treatments for these problems, thereby fulfilling a great need in the current literature. In addition, it is well written despite its translation. This text is useful for all who treat vulvar disease and serves as an excellent book for those who wish to have a reference text available for the occasional vulvar problem.

The initial chapter deals with the normal vulva and includes discussions of normal embryology, anatomy, and physiology. The second chapter discusses general signs and symptoms of vulvar disease. The book then progresses in a most logical fashion, with subsequent chapters specifically addressing each type of vulvar abnormality. These chapters include parasitic infections, congenital malformations, trauma, dystrophies, benign and malignant tumors, and vulvar abnormalities caused by systemic disease. Excellent color plates accompany almost every specific diagnosis. Each diagnosis is described and is generally followed by predisposing factors, clinical symptoms, pertinent laboratory tests, and treatment. Most of the diagnoses are described briefly and accurately, and the prescribed treatments are generally up-to-date and appropriate. The text itself has been translated from the French, and the prose occasionally circles the point, rather than addressing it directly.

In summary, this is a well-written, expensive, and superbly illustrated textbook for anyone who treats vulvar disease. Its one strength over all other texts in the current literature is the range and quality of the visual aids. The authors are known experts in the field of vulvar diseases. This book can serve the general internist who treats the occasional vulvar problem as well as the gynecologist or dermatologist who may already be familiar with these problems. I recommend this book to all professionals who may treat vulvar diseases.