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The Language of Dermatology
The Language of Dermatology
Skin is a living canvas, and the best dermatologists have an appreciation of its art. With thousands of skin diseases and hundreds of ways to describe them, dermatologists have become adept at the language of dermatology.
When describing skin, turning visual findings into meaningful terms is a key step in communication. In describing art or skin, precision is important, as the listener begins to visualize what is being described. For a dermatologist, a term such as "macule" or "patch" starts the listener down a visual path. Additionally, precise language is an important part of communicating with a patient. After all, they can usually see their skin condition as well, so have their own impressions of it.
Patients often mistake simple terms. They say; “Doc, I admit it, I’ve been itching the area.” Of course, they mean they’ve been scratching the area. Almost invariably, I find myself correcting them, not because I don’t understand what they are trying to say, but to keep our communication clear. “Itch” is the sensation, and “scratch” is the action. I joke “so, you are both itchy and scratchy?”
Dermatologists also make language errors. A common one is “sole of the foot.” Everyone knows where the sole is located. Here, “of the foot” is redundant, like saying “nose of the face.” If you are a dermatologist that intermingles philosophy or faith in your practice, perhaps you should specify which sole/soul you are addressing. However, it could be argued that no one knows the soul’s location, and one of the least likely places it is found is the foot. Same with “palm of the hand.” In this case, confusion with a tropical tree that bears coconuts is unlikely. So, just say sole or palm. e.g. “Your palm itches?”
Doctors often use the word “lesion.” This is a nearly useless term, since saying “lesion” is like saying “thing.” It only means that there is some thing on the skin, and no visualization can begin on the part of the listener. Much better, of course, is a specific term such as macule, papule, plaque, scale, etc.
Other terms are used by patients but not often by dermatologists. Both “balm” and “salve” originate from Middle English around the 12th to 13th century. Dermatologists seem to prefer the more modern (14th century Middle English) term “ointment.” Salve is an unctuous sticky substance applied to the skin. It can also be used as a transitive verb; a remedial or soothing influence or agent: “to salve a wound.” Balm is shortened from “balsam” referring to balsam tree oil. However, it is difficult to ask a patient if they’ve been using “the balm” with a straight face.
Patients often use the word “scab,” but it is rarely said by dermatologists. Perhaps dermatologists dislike it because of its negative connotation. A “scab” is also a derogatory term for someone who breaks a picket line, and is Australian slang for a freeloader. We dermatologists prefer the more elegant “crust.”
It seems that dermatologists, like art critics, prefer terms that have a refined sound to them. This isn’t really snobbery. After all, language is important to us, and we don’t want to sound like some sort of scab.
Patients often mistake simple terms. They say; “Doc, I admit it, I’ve been itching the area.” Of course, they mean they’ve been scratching the area. Almost invariably, I find myself correcting them, not because I don’t understand what they are trying to say, but to keep our communication clear. “Itch” is the sensation, and “scratch” is the action. I joke “so, you are both itchy and scratchy?”
Dermatologists also make language errors. A common one is “sole of the foot.” Everyone knows where the sole is located. Here, “of the foot” is redundant, like saying “nose of the face.” If you are a dermatologist that intermingles philosophy or faith in your practice, perhaps you should specify which sole/soul you are addressing. However, it could be argued that no one knows the soul’s location, and one of the least likely places it is found is the foot. Same with “palm of the hand.” In this case, confusion with a tropical tree that bears coconuts is unlikely. So, just say sole or palm. e.g. “Your palm itches?”
Doctors often use the word “lesion.” This is a nearly useless term, since saying “lesion” is like saying “thing.” It only means that there is some thing on the skin, and no visualization can begin on the part of the listener. Much better, of course, is a specific term such as macule, papule, plaque, scale, etc.
Other terms are used by patients but not often by dermatologists. Both “balm” and “salve” originate from Middle English around the 12th to 13th century. Dermatologists seem to prefer the more modern (14th century Middle English) term “ointment.” Salve is an unctuous sticky substance applied to the skin. It can also be used as a transitive verb; a remedial or soothing influence or agent: “to salve a wound.” Balm is shortened from “balsam” referring to balsam tree oil. However, it is difficult to ask a patient if they’ve been using “the balm” with a straight face.
Patients often use the word “scab,” but it is rarely said by dermatologists. Perhaps dermatologists dislike it because of its negative connotation. A “scab” is also a derogatory term for someone who breaks a picket line, and is Australian slang for a freeloader. We dermatologists prefer the more elegant “crust.”
It seems that dermatologists, like art critics, prefer terms that have a refined sound to them. This isn’t really snobbery. After all, language is important to us, and we don’t want to sound like some sort of scab.
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