DEPARTMENTS: Language of Dermatology
What's in a Name? Eponyms in Dermatology
Eponym's are ubiquitous in the literature of dermatology and in clinical practice. This column will feature some of the common eponyms and a few of the obscure eponyms used in dermatology. Both the novice and the expert should find interest in this collection. Eponyms are defined in Taber's Cyclopedic Medical Dictionary (Venes, 2009) as a name for anything (disease, organ, function, and place) adapted from the name of a particular person or, sometimes, a geographical location (e.g., Haverhill fever and Lyme disease). They are most commonly related to the person who first observed and reported on the phenomenon or the location where a particular disease was first encountered.
This installment will start with signs. Signs are defined as a thing that can be seen, heard, measured, or felt by the diagnostician. The presence of certain signs can be used to confirm or deny the diagnostician's impressions of the disease suspected of being present (Venes, 2009).
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- ASBOE-HANSEN SIGN - In pemphigus vulgaris, the intact blister extends when pressure is applied to the roof of the blister. This sign is similar to Nikolsky's sign (Yee, 2009).
- AUSPITZ' SIGN - In psoriasis, slight scratching or curetting of a scaly lesion reveals punctate bleeding points within the lesion. This sign suggests psoriasis but is not specific (Yee, 2009).
- CROWE'S SIGN - Axillary or inguinal freckling is seen in 20%-50% of patients with neurofibromatosis type I (Yee, 2009).
- DARIER'S SIGN - In mastocytosis (urticaria pigmentosa), a brown macular or a slightly papular lesion becomes a palpable wheal after rubbing vigorously with the blunt end of an instrument, such as a pen. The wheal is caused by the release of histamines by the mastocytes. Note that the wheal may not appear for 5-10 minutes after stimulation (Yee, 2009).
- DIMPLE SIGN - In dermatofibroma, lateral compression with thumb and index finger produces a depression or "dimple" (Yee, 2009).
- HUTCHINSON'S SIGN - In herpes zoster ophthalmicus, a vesicular rash at the nasal tip indicates involvement of the external nasal branch of cranial nerve 5. This is associated with an increased incidence of ocular involvement (Yee, 2009).
- Hutchinson's sign - A pigment in the paronychial area is suggestive of subungual melanoma. Of historical interest, both of the above signs were named after the English surgeon, Sir John Hutchinson (Yee, 2009).
- NIKOLSKY'S SIGN - Also associated with pemphigus vulgaris. Apparently normal epidermis next to the blister may be separated at the basal layer and rubbed off when pressed in a sliding motion (Yee, 2009).