Dermatologic Trivia

1

The suffix -itis has come to mean inflammation. What is inflamed in “pruritis?”

Nothing. The word is pruritus , not pruritis . It is derived from the Latin prurire , “to itch.” Pruritus is commonly misspelled; please learn how to spell it correctly.

Bernhard JD. Itch: Mechanisms and Management of Pruritus. New York: McGraw-Hill; 1994.

2

What is the difference between pruritus and itch?

There is none; the words are clinically interchangeable. Their International Classification of Diseases, Tenth Revision (ICD-10), codes are the same (L29.9), as were their ICD-9 codes (698.9) and all of the previous codes back to the Dawn of ICDs.

3

What is a Dąbska tumor and who was Dąbska?

Also known as an endovascular papillary hemangioendothelioma, Dąbska tumors are thought to be a subtype of hobnail hemangioendotheliomas that exhibit indolent behavior. Maria Dąbska was a Polish pathologist—and a member of the Polish Home Army who fought the Nazis during the failed Warsaw Uprising of 1944. Dąbska tumors and Spitz nevi are the only two neoplasms named after female physicians. Hobnails are tack-like metal inserts placed into the soles of shoes to add traction. They have small metal projections that dig into terrain, similar to how to nuclei in hemangiomas project into the vessel lumens.

Schwartz RA, Janniger EJ. On being a pathologist: Maria Dąbska—the woman behind the eponym, a pioneer in pathology. Hum Pathol . 2011;42(7):913–917.

4

There are only two prescription medications on the market with single-syllable brand names and both are relevant to dermatology. What are they?

Yaz (ethinyl estradiol and drospirenone, acne) and Taltz (psoriasis)

5

Where was sirolimus discovered and what is it used to treat?

Sirolimus (rapamycin) was discovered on Easter Island (also known as Rapa Nui to the native Polynesiasns, hence the name RAPAmycin) when Streptomyces hygroscopicus bacteria grown from a sample was found to have antifungal properties in culture media. It was isolated from bacterial cultures of S. hygrascopicus . It has been used in dermatology to treat angiofibromas in tuberous sclerosis and certain types of vascular malformations.

Sehgal SN. Sirolimus: its discovery, biological properties, and mechanism of action. Transplant Proc . 2003;35(3 suppl):7S–14S.

6

What is St. Anthony’s fire?

St. Anthony’s Fire is an eponym primary used for erysipelas. St. Anthony was an 11th-century Egyptian monk who was thought able to both inflict and cure this condition. Considerable confusion exists with regard to the true disease thought to embody his powers, as both ergot poisoning and bubonic plaque have been called St. Anthony’s fire.

Asensi V, Asensi JM. Saint Anthony's fire. JAMA Dermatol . 2016;152(7):850.

Long V. The myth of erysipelas: fire, water, and blood. JAMA Dermatol . 2017;153(1):48.

7

What is “the clap” and where did the name come from?

Gonorrhea. The origins of the word “clap” and its introduction into English slang are unclear, but it is thought to be a shortened form of “ les clapiers ” and was first recorded in the 1300s. Some claim that “Les Clapiers” was a neighborhood in Paris known for prostitution, while others suggest the term means “rabbit hutch,” or another word for the small buildings where prostitutes often serviced clients. The term “gonorrhea” itself comes from gonos- (Greek: semen) and -rrhea (Greek: flow).

Lee KC, Ladizinski B. The clap heard round the world. Arch Dermatol . 2012;148(2):223.

Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev . 2014;27(3):587–613.

8

What other disease in dermatology is named after rabbits?

Carcinoma cuniculatum is a rare presentation of squamous cell carcinoma of the foot, usually occurring in chronic ulcers. The “cuniculatum” portion of the term comes from the numerous sinuses and tracts that often occur within these lesions. Cuniculum means “rabbit warren” in Latin. Going even further down the proverbial rabbit hole, a warren is a network of interconnected passageways and can be used figuratively to describe buildings and cities.

Coldiron BM, Brown FC, Freeman RG. Epithelioma cuniculatum (carcinoma cuniculatum) of the thumb: a case report and literature review. J Dermatol Surg Oncol . 1986;12(11):1150–1155.

9

What are “cooties?”

The term “cooties” refers to lice and originally appeared in English during World War I, where pediculosis (human head lice due to Pediculus capitis ) or body louse ( Pediculus corporis ) proliferated widely. The term “cootie” has unclear etymology but may be related to the term * utu (meaning “louse”) in one of a variety of southeast Asian languages such as Malay or Māori.

Taylor SJ. Got Cooties? Try P.D.Q. Hoosier State Chronicles ; 2015. https://blog.newspapers.library.in.gov/got-cooties-try-p-d-q/ . Accessed 25 February, 2019.

10

What is the definition of a “biologic” medication?

The Food and Drug Administration (FDA) defines a “biologic” as any agent that is derived from or created entirely by a living organism. Colloquially, it refers to antibody-based medications but could refer to anything from insulin to packed red blood cells to vaccines to gene therapy!

U.S. Food & Drug. What Are “Biologics”—Questions and Answers . 2018. https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cber/ucm133077.htm .

11

What does the word pityriasis mean in conditions such as pityriasis alba, pityriasis rosea, pityriasis versicolor, and pityriasis rubra pilaris?

It originates from the Greek word pituron , meaning bran, which refers to conditions that cause branlike scaling of the skin (but not the kind you would want in your morning cereal!).

12

What does the X in “histiocytosis X” mean?

It expresses the common etiologic link among the three clinical forms of the disease: eosinophilic granuloma, Hand-Schüller-Christian disease, and Letterer-Siwe disease. When Louis Lichtenstein coined the name histiocytosis X in 1953, he chose the X to represent the then-undetermined cause of the disorders. He wrote that the suffix X “has the advantage of brevity and, by implication, emphasizes the necessity for an intensive search for the etiologic agent.” We now know that the common link is a proliferation of Langerhans cells, as reflected in the current name for histiocytosis X: Langerhans cell histiocytosis. Much about the disorder is still unknown, so perhaps Langerhans cell histiocytosis deserves to keep an X-designation. Maybe we should we call it LCH-X?

Lichtenstein L. Histiocytosis X. Arch Pathol. 1953;56:84–102.

13

Several names are used for the disease caused by Bartonella bacilliformis : bartonellosis, verruga peruana, Peruvian warts, Oroya fever, and Carrión disease. Who was Carrión?

Daniel Carrión studied the relationship between the disfiguring, but seemingly benign, cutaneous disease verruga peruana and the often-deadly disease Oroya fever. As part of a student research competition in 1885, the 26-year-old medical student inoculated himself with the blood of a patient with verruga peruana. Carrión soon developed the malignant form of Bartonella infection, Oroya fever, characterized by high fevers, severe myalgias, and profound hemolytic anemia. He postulated that the two conditions were related, but his experiment sadly ended fatally. A few decades later, his theory was proven correct, and now Carrión is the hero of the Peruvian medical profession.

Pamo OG. Daniel Carrion's experiment: the use of self-infection in the advance of medicine. J R Coll Physicians Edinb. 2012;42:81–86.

14

What other illnesses are caused by Bartonella species?

Cat-scratch disease is caused by B. henselae , and trench fever is caused by B. quintana . Some conditions caused by various Bartonella species (including B. henselae and B. quintana ) are most common in immunocompromised individuals, particularly those with advanced human immunodeficiency virus infection. These conditions include bacillary angiomatosis, peliosis hepatis, and a form of culture-negative endocarditis.

15

We all know about Lyme disease and its association with Borrelia infection, but what are some other Borrelial infections that occur in humans?

B. burgdorferi, B. afzelii, B. garinii —Lyme disease, cutaneous “borrelioma,” acrodermatitis chronic a atrophicans (spp. afzelii )

B. recurrentis , B. hermsii , B. parkari , and the more recently discovered B. miyamotoi —Tick-borne relapsing fever

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