Preface to the book The Photographic Atlas of Pediatric Diagnosis and Disorders
"The only way to do great work is to love what you do." ---- Steve Jobs
Passion for the practice of pediatrics and teaching has enabled us to assemble an atlas of images that is vast in its breadth and depth. They are presented herein for maximum utility using an interactive, multi-media approach through the presentation of close to 1000 vivid images, accompanied by a brief history of the actual patient seen in the accompanying images.
Of course, there is no substitute for direct patient-physician interaction. But this book is the next best alternative. Here, the diseased state is shown in all of its manifestations, not just its most common form. The purpose of this book is the visual teaching of pathology in pediatrics. Visual inspection is the first component of the physical examination and fundamental to diagnosis. It is important for students and clinicians to access the breadth of presentations of complicated illnesses, particularly since some of these disorders are only rarely encountered in the developed world. This posture on instruction enables the reader to acquire an important and implicit awareness that there are as many expressions of disease as there are patients who suffer from them. But that understanding those features most fundamental to each, will guide the astute physician to the correct diagnosis and treatment.
A few diseases are discussed in detail, in view of the specialized experiences of the authors, either with individual and unique patients or with specific diseases. One example is that of senior author Dr. Ralph Salimpour. Dr. Salimpour has treated over a thousand cases of tetanus and is considered a world authority. The text that accompanies images of this terrible affliction is thus as personal as it is clinical. Special attention is also paid to rickets, where Dr. Salimpour has the largest ever-published series concerning this ailment. And malnutrition, where Dr. Salimpour identified for the first time the significance of purpura in this avertable condition, is deliberated in some detail. With these and several other of the conditions herein portrayed and discussed where the authors' personal perspectives on the disease and its manifestations are intimate and exceptional, there is elaboration that is more familiar than commonly encountered in an academic textbook. We believe this feature supplements the distinctive nature of the Atlas.
And while diseases and their manifestations remain generally constant over time, the treatment modalities deployed to prevent and fight them change continuously. Our understanding of not just a particular disease, but of disease itself, of the basic sciences and their clinical applications, and of etiology and pathophysiology, constantly improve. With this advancement in knowledge, so changes the physician's armamentarium. But, symptoms and signs do not change. It follows that these images, which are the expressions of symptoms and signs, make the utility of this book to the clinician, enduring. It is the hope of the authors that the Atlas' clinical usefulness persists.
Several pictorial views of each condition, supplemented by online access to many more ever-increasing images, will enable the physician to gain an appreciation for the many ways that each disease state can present. The scholar who has read about herald patch in pityriasis rosea thus can see what many of these look like, what to look for in impetigo neonatorum, and why prune belly has earned its name. All of this is accompanied through illustrations that are vivid and in their aggregate, truthful.
For centuries, students and physicians have seen patients in hospitals and clinics. They have then referred back to their books to learn what condition the rash they had observed represented, why that thick calf boasted no power, why that child's rigs were swollen or questioned the awkward positioning of the febrile baby's extremities. This functional Atlas is a practical and effective approach to answering their questions, enhancing the diagnostic armamentarium of physicians.
It is the authors' hope that this Atlas will, as well, inspire a new generation of physicians---scientists to further ask and to gather even better diagnostic information. And ultimately, of finding novel ways of presenting that information to the reader. For as long as the eyes see before the mind reads, we believe this Atlas will serve as a useful tool for the physician, making him or her a more astute diagnostician.
Pedram Salimpour, MD, MPH Pejman Saliimpour, MD, FAAP Ralph R. Salimpour, MD, DCH, FAAP
Reviews
"I recently received a copy of the book, Photographic Atlas of Pediatric Disorders and Diagnosis, which has not left my desk and which I have looked at every day. It is an outstanding contribution to our literature, beautifully illustrated and with very focused and helpful text accompanying each picture or group of pictures. Additionally, the quality of the paper is superb and the size of the book is one that surely will be appreciated by every reader or potential reader." - N. Paul Rosman, MD
The Salimpours provide a resource for those of us who are visual learners in the Photographic Atlas of Pediatric Disorders and Diagnosis (Ralph R., Pedram and Pejman Salimpour).
This book will serve those who see children from low income countries (LICs). It happened so often to me at UCLA – students and physicians returned from a medical mission to a LIC and told me they had cared for children with disorders they had never seen before, or in extremes they could not have contemplated. I wanted a source of pictures that would expose them to these conditions and this is it.
Some atlases provide visual documentation for specific subspecialties, but the Salimpours designed their Photographic Atlas to be inclusive and organized it for easy reference. The complete contents of the physical volume are available on-line, therefore providing searchable access on your computer or hand-held device, and moving this visual learning and reference technology into the 21st century.
Not all of the topics in the Photographic Atlas are limited to LICs, and some represent disorders seen more routinely in pediatric populations in countries at all income levels. But even for these more routine topics, the photographs are comprehensive and striking.
The book provides the backstory to this compendium. Photographer and first author, Ralph Salimpour, was born in Iran in the 1930s to a 15 year-old mother. He survived a number of childhood diseases, including ascariasis, three episodes of dysentery, malaria, tuberculosis and typhoid fever, and measles and tetanus took the lives of two of his siblings. His joint passions of pediatrics and photography continued for six decades on three continents, and he describes this Atlas as “the photo album of my career.” He and his family fled to the United States in 1979, and two of his four grown children, Pedram and Pejman, are pediatricians and co-authors with him on this book.
Armed with this backstory, we have greater insight into the material and motivation, and why it is “as personal as it is clinical.” The Salimpours intend to educate us about these disorders to assure that we recognize them and avoid unnecessary morbidity and mortality.
Many students and physicians are providing care in LICs through medical missions, or are seeing children who are new immigrants or for some other reason have not had access to adequate care. They can now be armed with the images from this book in its physical form and on-line.
Disclaimer: I did not contribute to this book. I was shown Dr. Ralph Salimpour’s photographs when I was executive chair of Pediatrics at UCLA and I encouraged him to write a book. I am acknowledged, along with Dr. Lee Miller, vice chair for education in Pediatrics at UCLA for “recognizing the value of such an Atlas in the armamentarium of the medical educator and of the physician.” The Salimpours thanked me with a copy of the book.
Edward RB McCabe, MD, PhD Senior Vice President and Chief Medical Officer March of Dimes Foundation