"Pseudo" Nomenclature in Dermatology: What's in a Name?

Abstract

In the bewildering array of scientific nomenclature in the medical field, it is important to use correct terminology, know their aberrations and the reason behind a specific terminology. This paper is an attempt towards compiling all the pseudo-nomenclatures coined in dermatology, in order to make it easier to retain and recollect these pseudo names, signs, morphology, diseases, and conditions. It is also imperative to know the true entities that these pseudo names masquerade as, so as to understand the explanation for assigning the term 'pseudo' to these conditions. A total of 52 pseudo-terms have been compiled here in reference to dermatology. Most of these pseudo-nomenclatures were coined due to some clinical or histopathological resemblance to the true conditions, while some were premature conclusions drawn from a flawed understanding of the basic nature of the condition. Clear understanding of each of these terms and the explanation behind them being pseudo will enable a dermatologist to avoid misdiagnosis and needless confusion.

Keywords: Pseudo epitheliomatous hyperplasia; pseudo scleroderma; pseudo-Nikolskiy's sign.

Figure 1

(a) Positive Nikolskiy's sign elicited in peri-lesional skin of pemphigus vulgaris. (b) Pseudo-Nikolskiy's sign seen in a patient of toxic epidermal necrolysis

Figure 2

True isomorphic phenomenon of Koebner, seen in lichen planus

Figure 3

(a and b) Positive Darier sign in urticaria pigmentosa

Figure 4

True lesar trelat sign seen in a patient of adenocarcinoma stomach

Figure 5

Pseudo-rhagades seen in peri-oral skin in a patient of porphyria

Figure 6

Pseudo-vesiculations seen in a patient of Sweet syndrome

Figure 7

Light microscopic view (×10) showing branching pseudohyphae in a KOH mounted slide of vaginal discharge from a patient of vulvovaginal candidiasis

Figure 8

Pseudo-epitheliomatous micaceous and keratotic balanitis

Figure 9

(H and E, ×10) view of tuberculosis verrucosa cutis showing pseudo-epitheliomatous hyperplasia i.e., irregular, asymmetrical invasive epidermal proliferation into dermis. (Courtesy: Dr. Asha Kubba, Delhi Dermapath Laboratory, New Delhi.)

Figure 10

(H and E, ×10) view of seborrheic keratosis showing a distinct pseudohorncyst in the thickened epidermis. (Courtesy: Dr. Asha Kubba, Delhi Dermapath Laboratory, New Delhi.)

Figure 11

Pseudo-folliculitis seen in beard area (also known as pseudo folliculitis barbae)

Figure 12

Small yellowish papules in linear pattern seen in neck folds of a patient of pseudo-xanthoma elasticum

Figure 13

“Footprints in the snow” appearance, seen in pseudopelade of Brocq

Figure 14

(a) Scleroderma seen in a patient of systemic sclerosis with ‘salt and pepper’ pigmentation. (b) Pseudo-scleroderma seen in a patient of eosinophilic fasciitis

Figure 15

Pseudo-acanthosis seen in posterior nuchal fold in an obese female