Dermatologists in clinical practice will find the Atlas of Hair and Nails an important addition to their medical library. The book is well organized, easy to read, and beautifully illustrated with excellent clinical photographs. In addition, it includes helpful recommendations for differential diagnosis.

Chapters are on the whole well written and cogent. The chapters "Developmental and Hereditary Disorders," "Dermatological Diseases That Affect the Nail," and "Nail Signs of Systemic Disease" are replete with fascinating photographs, diagnostically helpful tables, and abundant references.

The chapter on fungal infections is somewhat long but worth the effort. The authors, Piet De Doncker, director of Dermatological Research for Janssen (Beerse, Belgium), and Gerald E. Pierard, Professor of Dermatopathology at the University of Liege, Belgium, correctly state that culture and microscopic examination are pivotal to proper treatment of onychomycosis; however, these doctors do not have to deal with the Clinical Laboratory Improvement Act (CLIA). For US dermatologists to obtain and read their own fungal cultures, they must be affiliated with a level 1 CLIA laboratory, subject to biannual inspection and licensure. This unpopular federal act has prohibited many dermatologists from reading fungal cultures and reduced the number of cultures obtained. Physicians who comply with CLIA level 1 certification can grow cultures and read fungal cultures in the office but may only report "positive" or "negative" results for dermatophyte or yeast. In order to identify the fungal colony by genus and/or species, the doctor's office must (1) be certified as a level 2 laboratory and (2) submit quarterly documentation that the physician/laboratory director has passed a test identifying "unknown colonies" as proof of quality assurance. Because of this regulation, many dermatology residents no longer devote significant time to this important aspect of clinical dermatology. In addition, some managed care companies do not adequately reimburse for fungal culture and potassium hydroxide tests performed in the office, encouraging dermatologists to send specimens to off-site laboratories. Some specimens do not transfer well and the results are inconsistent. Notwithstanding this bureaucratic discrepancy, the section on the treatment of nail fungus is very good and the references are helpful.