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Top 10 Bad Derm Terms

<p><span>It's time to discard some poor </span><span>dermatology </span><span>terms.</span></p>

It's time to discard some poor dermatology terms.

While there seems to be a slow, gradual shift away from inaccurate or confusing terms in dermatology, all too often they continue to appear in print. Some are historic, some are misleading, and some are just plain bad. So here, without further ado, are the top 10 bad derm terms.


10. Juvenile melanoma. Although this one has nearly disappeared in favor of "Spitz nevus" or even better, "epithelioid and spindle cell nevus," it still appears on occasion. I've had one patient who said his child was given this diagnosis and it scared him to death, right up until he did the research himself and realized it is benign.

9. Malignant melanoma. This is still very frequently used, and admittedly, the alliteration is rather nice. It was originally used to distinguish it from #10 (above). However, all melanomas have the potential for malignancy (cancerous, threatening to life, tend to metastasize), so the term is redundant. Plus, it sounds scary. Which would you rather have as a diagnosis, melanoma in situ or "malignant melanoma"?

8. Pseudolymphoma. Any disease name with "pseudo" as a modifier should be dispensed with. A disease either is or isn't. This is another one that sounds unnecessarily scary. Plus, "cutaneous lymphoid hyperplasia" really gets the message across.

7. Eponyms (in general). Quick, what is Giannotti-Crosti syndrome? No clue? How about papular acrodermatitis of childhood? Now there is a good descriptive name of a disease.

6. Lupus vulgaris. This condition is not lupus; it is leprosy. That name is just confusing. Tuburculosis luposa isn't much better, and both are misleading. Leprosy terminology could have a whole section on its own.

5. Location-based names such as Rocky Mountain spotted fever and Lyme disease. These sort of eponyms can give places bad reputations, especially since these are diseases spread by blood-sucking arthropods. The most common location of RMSF is the Eastern United States, and Lyme disease occurs lots of places other than Lyme, Connecticut, where it was first described.

4. Ringworm. While this is a lay term for tinea corporis, it deserves mention since it is so common. The "ring" part is fine, but the "worm" part just sounds gross. How about "ring-fungus"?

3. Bowenoid papulosis. Named for dermatologist John Templeton Bowen, this condition is not Bowen disease (see #7) and is a confusing term. On the positive side, it does sound better than "penile verruca."

2. Non-melanoma skin cancer. This is a newer term, but is poorly descriptive since it uses a negative that lumps together cancers that aren't even related to what is being described (other than also occurring in the skin). That makes no sense. "Keratinocyte carcinoma" fits the bill when one means basal and squamous cell carcinoma.


And the number one bad derm term is…

1. Mycosis fungoides. This means "mushroom-like fungal disease" as described by French physician Jean-Louis-Marc Alibert in 1806. It is used for something that is not caused by fungus and only very rarely has a mushroom-type appearance. Why does this still appear all over dermatology literature? "Cutaneous T-cell lymphoma" describes the condition perfectly, should be solely used for this disease, and MF immediately and unceremoniously discarded.

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