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At the outset the authors make it clear that this atlas has a radically different viewpoint compared to other atlases of cutaneous nerve distribution. Specifically, they mapped cutaneous sensation from the periphery towards the center. For the cutaneous distribution of any given nerve, they mapped the most distal extent first, then moved proximally mapping medial and lateral boundaries until they approached the most proximal limit. This makes clinical sense because sensory neuropathies typically present distally and progress proximally.

The clinical emphasis of the atlas is also obvious because it is based on maps obtained from over two thousand Neuropathic Pain Patients (NPP), nearly double the number of patients mapped for the first edition of this atlas. This large sample of NPPs was validated by the contributions of several distinguished collaborators from around the world. There are also about a hundred clinical anatomy references. The astute observer will note variations in the maps of many of these references with each other and with this atlas. This is because the cutaneous distribution of sensory nerves varies among patients. To make this atlas valuable even though these distributions vary, the authors have chosen to illustrate the “largest territory of cutaneous distribution of the nerves.” Therefore, in a given patient, the distribution of a cutaneous nerve can be expected to fall within the boundaries outlined in this atlas. These maps cannot be precise, but at least the outer margins are given and this will be of value to the practitioner who sees these patients. 

In addition to the territory of innervation, maps for different sensations are also presented. For example, pain is perceived at lower thresholds than touch so the territory for pain sensation will typically be larger. This is due to the facts that receptors with different stimulus modalities are involved in receiving these sensations and different fibers conduct the impulses. In spite of these differences, touch (as defined by detection of a 0.7 gram weight applied to the skin) is diminished in the same territory where pain is perceived. 

Although the maps for all territories of the body are clearly designed, one of the most useful features of this atlas is the summary of the maps of the intercostal nerves. This provides the clinician with an image that is easy to grasp and apply to numerous clinical situations. Also, many of the drawn maps are supplemented with photographs that make the distribution of the cutaneous nerves quite unambiguous. Furthermore, some judiciously-chosen tables provide valuable references for busy clinicians. Finally, indexes of the anatomical territories and the tables at the end of the atlas provide a ready guide to any cutaneous nerve of interest. 

Stephen W. Carmichael, Ph.D., D.Sc. 
Professor Emeritus of Anatomy and Orthopedic Surgery 
Mayo Clinic, Rochester, MN, USA