I used it with care, so there are no noticeable scratches. There are some lines drawn with a marker. I've used it for studying a few times, so please refrain from purchasing if you are looking for a perfect item. The number of classes was small, so I didn't use it very often, and it's in good condition. "Family Nursing" Misako Kojima / Naoko Hoshi Price: ¥2600 #MisakoKojima #Misako_Kojima #NaokoHoshi #Naoko_Hoshi #Book #Nature/Medical_Science/Health