Animals eponyms in dermatology.

The world of Dermatology is flooded with inflexions among clinical conditions and signs and syndromes; making it interesting, but a tougher subject to remember. Signs and syndromes have always fascinated residents, but simultaneously burdened their minds, as these attractive names are difficult to remember. This work was undertaken to review dermatological conditions and signs based on commonly encountered daily words and objects like animals, etc. Fifty dermatological conditions were found to be based on animal eponyms. For example, the usage of animal terminology in dermatology like leonine facies is present in leprosy, sarcoidosis, mycosis fungoides (MF), and airborne contact dermatitis (ABCD).

What was known?

Various dermatological conditions and signs and syndromes are known, sounding same as commonly used words like fruits, foods, animals, and human parts. Information is available on various misnomers, pseudo, triads, and name signs in dermatology. No compiled data is at hand available, describing various conditions under the above mentioned headings.

Introduction

Dermatology is a tough branch to master, not just due to its ever growing knowledge base, but also because sometimes the minute clinical details help in differentiating between disorders which may differ widely in etiopathogenesis and treatment.

Simpler associations with things of daily use can aid tremendously in memorizing the disorders; it can be a useful and an effective educational adjunct. An eponymous and toponymous association helps in remembering the things for a longer time and gradually becomes a part of our memory box. An electronic and manual search of standard dermatology textbooks: Fitzpatrick's Dermatology in General Medicine 7th ed., Rook's Textbook of Dermatology 8th ed., IADVL Textbook of Dermatology 3rd ed., Lever's Histopathology, and various others was done.

We here, list the complied data of conditions based on animal names in dermatology. However, no explanations for the pathophysiology and other details have been taken in it as it is beyond the scope of this article.

Animal Eponyms

Alligator boy: Synonymous with lamellar itcthyosis.[1] Typical plate-like large, dark brown or grey colored firmly adherent scales are present. Scales characteristically give phenotypic resemblance to alligator [Figure 1a].

Figure 1

(a) Alligator boy. (b) Fish-like scales

Bird-like facies: Small face, thin beaked nose, and recessed chin giving a bird-like facies is seen in patients of Progeria [Figure 2].[2]

Figure 2

Bird-like facies

Bovine popular stomatitis: Occupational disease transmitted from muzzles, presenting as solitary or few lesions confined to hands and forearms.[3]

Buffalo hump: Chronic glucocorticoid intake leads to excess abnormal deposition of fat over the back.[3]

Bulldog jaw: Syphilitic stigmata, the normal mandible appears longer and bigger.[4]

Butterfly rash: Confluent symmetric erythematous rash centered over the malar eminence and nasal bridge, characteristically sparing the nasolabial fold giving a butterfly appearance. It is seen in lupus erythematosus and pellagra [Figure 3].[2]

Figure 3

Butterfly rash

Butterfly sign: Butterfly-shaped area (upper central back) of sparing in patients with severe generalized pruritus.[5]

Cat bite sign: Radiological feature of congenital syphilis.[5] Localized well-defined bony destruction of medial portion of the proximal tibial metaphysis.

Cat scratch disease: Caused by Bartonella henselae and B. clarridgeiae.[3] Primary skin lesions appear 3-5 days after cat scratch, and may last for several weeks.

Cat tongue sign: Carpet tack-like spines on the undersurface of characteristic hyperkeratotic scale of discoid lupus erythematosus.[3]

Caterpillar bodies: Seen on histopathology examination of porphyria cutanea tarda (PCT), appears as eosinophilic, elongated, wavy structures in lower and mid epidermis, and lies parallel to the basement membrane zone.[3]

Caterpillar dermatitis: Toxins in hair of caterpillars may produce severe pain, local pruritic erythematous macules, and wheals depending upon the species and on contact with skin.[3]

Chicken skin/Moroccan leather appearance: Multiple, small (2-5 mm) yellow-orange papules of rhomboidal or irregular shape, bounded by normal skin, coalesce to form larger plaques. Pebbly-surfaced skin observed in pseudoxanthoma elasticum.[6]

Crowe's sign: Axillary or inguinal freckling in neurofibromatosis type 1 (NF1).[2]

Elephantiasis neurofibromatosa: Diffuse neurofibromatosis of the nerve trunks associated with skin and subcutaneous tissue overgrowth [Figure 4].[7]

Figure 4

Elephantiasis neurofibromatosa

Elephantine psoriasis: Persistent thick scaly plaque of psoriasis.[8]

Elephantiasis nostras verrucosa (ENV):[9] Persistent and chronic lymphedema leads to characteristic changes of profound hyperkeratosis, lichenification, and permanent dermal fibrosis with verrucous, papillomatous, and tumor-like nodules [Figure 5].

Figure 5

Elephantiasis verrucosis nostras

Faun tail nevus: Cutaneous stigmata for underlying spinal dysraphism,[10] present as a tuft of long, soft, silky hair [Figure 6].

Figure 6

Faun tail nevus

Fish like scales: Icthyosis[11] is derived from Greek word ichthys, meaning “fish”. Icthyosis is a group of disorders in which altered epidermal cell kinetics and differentiation results in clinical appearance of scales [Figure 1b].

Fish mouth wounds: Gaping wounds produced in patients of Ehler–Danlos syndrome on minor trauma.[2]

Fish odor syndrome: Trimethylaminuria; an offensively smelling tertiary amine, that is, trimethylamine giving rotting fish smell to breath, sweat, and urine.[12]

Fish tail deformity: Splaying of the base of distal phalanx as a result of new bone formation in patients with psoriatic arthritis.[13]

Fox–Fordyce disease: Apocrine miliaria.[2] Multiple skin colored to pigmented, dome-shaped, itchy follicular papules; predominantly affecting the axillae. Condition is named after George Henry Fox and John Addison Fordyce.

LAMB syndrome: It includes Lentigines, A trial myxoma, Mucocutaneous myxoma, and Blue nevi.[11]

Leopard skin: Fine, thin, dry skin with mottled pigmentation, and leukoderma seen in Berlin syndrome[7]. Onchocerciasis.[14]

LEOPARD Syndrome: Lentigines, Electrocardiographic abnormalities, Ocular hypertelorism, Pulmonic stenosis, Abnormal genitalia, Retarded growth, and sensineural Deafness.[11]

Leonine facies: A deeply furrowed ‘lumpy’ face with prominent superciliary arches resembling that of a lion. Classically seen in lepromatous leprosy.[15] May be present in sarcoidosis, air borne contact dermatitis,[16] mycosis fungoides, amyloidosis, leishmaniasis.

Lizard skin: Thickened, wrinkled, dry dermatitis skin seen in onchocerciasis[3] is known as lizard skin.

Lobster claw deformity: One of the major components of ectrodactyly-ectodermal dysplasia-clefting syndrome[7] Syndactyly with oligodactyly, median clefts of the hands and feet, and opposable fingers lead to a so-called ‘lobster claw’ appearance.

Millipede burns: Brownish pigmentation or burn, which may progress to intense erythema and vesiculation caused by a toxic liquid secreted by millipede.[3]

Moth-eaten alopecia: Acuminate follicular papular lesions of secondary syphilis leads to moth eaten alopecia.[4]

Monkey facies: Monkey facies with characteristic loss of the buccal fat pads. It is a characterstic of marasmus.[2]

Oyster-shell crusts: Also known as rupia. They are lamellated, elevated, brown, black or green masses, as in late syphilis.[3]

Panda sign: Nevus of ota persists in the periorbital area after laser treatment while clear from other sites.[7]

Plucked chicken appearance: Yellowish papules on the side of the neck in patients of pseudoxanthoma elasticum.[2]

Pseudoparalysis of parrot: Feature of early prenatal syphilis.[4]

Raccoon eyes/owl-eye sign: Accentuated, erythematous, scaly periorbital lesions in neonatal lupus erythematosus.[1117]

Rat mite itch: It is intense pruritus dermatitis caused by tropical rat mite.[3]

Rodent ulcer: Basal cell carcinoma may deeply invade and destroy the underlying tissue, representing the rodent ulcer.[13]

Russell's sign: Calluses, small lacerations or abrasions on the dorsum of the hand overlying the metacarpophalangeal and interphalangeal joints, acts as a clue to bulimia nervosa.[3]

Salmon patch: A pink blanching patch over forehead.[2]

School of fish appearance: Arrangement of Haemophilus ducreyi on gram stain, causative agent for chancroid.[18]

Silver–Russell syndrome: Characterized by short stature, skeletal asymmetry, small incurved fifth finger, altered sexual development, and Café au lait macules (CALM).[19]

Snail track: Mucous patches of syphilis may coalesce to form snail track ulcer.[20]

Spider angioma: Variable sized spiders with central raised body and generally pulsatile on diascopy.[21]

Toad skin: Synonym for Phrynoderma which is a type of follicular hyperkeratosis typically seen in vitamin A deficiency.[2]

Tiger tail pattern: Alternate light and dark band patterns of hair shaft of Trichothiodystrophy on polarized-light examination.[22]

Ugly duckling sign: Nevi in an individual generally tend to share a similar appearance, so one that does not share the same characteristics should be considered for biopsy.[3]

Zebra bodies: Characterstic electron-dense bodies seen in Fabry's disease on electron microscopy in endothelial cells, pericytes, and fibroblasts.[3]

Zebra-like hyperpigmentation: Consists of congenital abnormalities and a patterned melanocytic hyperpigmentation of the trunk and extremities.[3]

Conclusion

Memorizing the fine details of the subject can become a herculean task, unless one adopts innovative methods that aids to memory like, linking commonly encountered objects and experiences to these rote facts. Correlating daily use things like animals, etc., with dermatological signs and conditions can make this cumbersome job of remembering things much easier.

What is new?

We have tried to provide a compiled list of all dermatological conditions and signs and syndromes which are pronounced same as various commonly used words like animals. Till date, no literature in books or articles is available compiling all the conditions in dermatology under the above mentioned headings. This comprehensible conversation will definitely help residents in remembering dermatology in an easier way while doing their daily activity.