20080912

Mycosis fungoides (MF)

Mycosis fungoides (MF) is the most common clinicopathological subtype of primary cutaneous T-cell lymphoma.

The term “mycosis fungoides” was first used in 1806 by Jean-Louis Marc Alibert, a French dermatologist, when he described a severe disorder in which large necrotic tumours resembling mushrooms presented on a patient’s skin. However, the designation is a misnomer since no association with a fungus exists.

Seborrheic keratosis

The term is a misnomer because Seborrheic keratoses result from a proliferation of keratinocytes and are not related to sebaceous glands. Therefore, these keratoses should not be termed seborrheic.


Seborrheic keratoses are the most common benign tumor encountered in older individuals, present in 80-100 percent of people over age 50. The exact etiology is unknown, but cumulative exposure to sunlight is likely involved. Clinically, they are brown verrucous plaques with a stuck-on appearance. Although they can be found anywhere on the body excluding the palms, soles, and mucosal membranes, they are most often located on the trunk, dorsal hands, and face. Therefore, they are not limited to a seborrheic distribution.

Palisaded encapsulated neuroma

Palisading nuclei are not a prominent feature, therefore, the term palisaded is misnomer, Additionally, although it is well-circumscribed, it is not truly encapsulated.

Palisaded encapsulated neuroma is characterized by a solitary, asymptomatic, skin-colored papule located usually on the face of middle-aged individuals. It is thought to result from neural regeneration after trauma. Palisaded encapsulated neuroma is often misdiagnosed as basal cell carcinoma or intradermal nevus. Histologically, there are localized dermal lobules composed of interlacing Schwann cells with variable numbers of fine axons and myelin sheaths present.

Nevus depigmentosus

The term nevus depigmentosus is a misnomer because the lesions are hypopigmented, not devoid of pigment as the name would imply.
Nevus depigmentosus is a rare, nonprogressive congenital hypopigmented macule or patch that remains stable over time. It occurs sporadically and is likely caused by a defect in the development of fetal melanocytes. Included in the differential diagnosis are vitiligo and idiopathic guttate hypomelanosis. Histopathology is similar to that of normal skin except for a decrease in density of melanosomes but normal or only mildly decreased in numbers of melanocytes.

Tinea amiantacea

It is a misnomer to term this disease tinea because it is typically not associated with a dermatophyte infection.
Tinea amiantacea is a cutaneous disease that affects the scalp and is characterized by thick, asbestos-like scaling that results in hair follicles becoming bound down. Alopecia is often associated with this disorder and may be temporary or scarring. The etiology is unknown; however, previous reports suggest it may be a manifestation of psoriasis or seborrheic dermatitis.

Capillaritis

Capillaritis is a misnomer as there is no vasculitis involved.

Capillaritis is a pigmented purpuric dermatosis which is a group of chronic, purpuric, pruritic eruptions that usually occur on the lower extremities. Capillaritis is usually associated with chronic venous hypertension. This group of dermatoses shares characteristics, histologically demonstrating extravasation of red cells, variable hemosiderin deposition, and perivascular lymphocytic infiltrates without leucocytoclastic vasculitis.

Bullous congenital ichthyosiform erythroderma (BCIE)

The term is actually a misnomer because Bullous congenital ichthyosiform erythroderma is not a true form of erythroderma, although it does resemble erythroderma clinically.
Bullous congenital ichthyosiform erythroderma is a rare autosomal dominant disorder of keratinization caused by a genetic defect of the epidermal keratins, K1 and K10, which leads to impairment in the tonofilament network of differentiating epidermal cells. The disorder presents at birth with generalized erythema, blistering, and erosions, followed in time by hyperkeratosis. Erythroderma or exfoliative dermatitis describes generalized redness of the skin, usually more than 90 percent of the body surface area, with variable degrees of scaling caused by underlying dermatoses, drug reactions, malignancies, systemic diseases, infections and idiopathic disorders.

Malignant Otitis Externa

The term is misnomer because this condition is termed as malignant otitis externa because of itspropensity to cause complications and death.

This is an inflammatory disorder involving the external auditory canal,hence the term malignant otitis external is a misnomer. It is caused by Pseudomonas group oforganisms.

Commonly this condition affects elderly diabetics. It is very rare in children.

Lupus pernio

The term lupus pernio is a misnomer because the condition is not associated with lupus and has no association with pernio.

Lupus pernio is a rare but characteristic skin manifestation of sarcoidosis. The lesions are often deforming and appear as chronic, hyperpigmented or violaceous nodules or plaques of the nose, cheeks, ears, and central face. Histology shows sarcoidal granulomas .

Pernio, or chilblains, is a localized inflammatory lesion of the skin resulting from an abnormal response to cold. Pernio most commonly occurs in young women but may occur in older individuals or in children. Single or multiple erythematous-to-purplish, edematous plaques appear secondary to cold exposure and are accompanied by intense pain, itching, or burning .

Chicken pox

Chicken pox, which also is known by its Latin name of varicella, is a misnomer. The disease has nothing to do with chickens.

1.Chicken pox comes from the Middle French term "chiche pois" -- which means "chickpea."

"In the Middle Ages, people in Europe made the distinction between chicken pox and smallpox. The French called chicken pox 'varicella' but the English decided on a new word that referred to the size of a chickpea. The lesions on the skin were thought to be the size of chickpeas. 'Chichepois' eventually became 'chicken pox,'

The chicken pox virus itself is the second-largest known virus in the world and is about half the size of the smallpox virus. Of the 70 genes contained in chicken pox, only a few of the genes are important for the ability of the virus to infect people.

Cholesteatoma

The term cholesteatoma is actually a misnomer since the lesion is not a neoplasm and does not contain cholesterol.

The primary lesion in the differential diagnosis with cholesterol granuloma is cholesteatoma.

Granuloma faciale (GF)

Granuloma faciale (GF) is an uncommon benign chronic skin disease of unknown origin characterized by single or multiple cutaneous nodules, usually occurring over the face. Occasionally, extrafacial involvement is noted most often on sun-exposed areas.

The disease mimics many other dermatoses and can be confused with conditions, such as sarcoidosis, discoid lupus erythematosus, mycosis fungoides, and fixed drug eruption.

The name granuloma faciale is a misnomer, as granulomas are never present histologically.

The epidermis is unaffected. A grenz zone of uninvolved dermis is located beneath the epidermis. Below the grenz zone is a dense, polymorphous inflammatory infiltrate located most often in the papillary and mid dermis. The infiltrate consists of neutrophils, lymphocytes, eosinophils, monocytes, and, occasionally, mast cells. Vasculitic changes, including perivascular inflammation with nuclear dust and vessel wall damage, are often observed. Extravasated RBCs and hemosiderin deposition are found, which may contribute to the color of the lesions. Later, lesions may show considerable fibrosis around venules.

PNH

PNH is somewhat of a misnomer because the hemolysis is not necessarily nocturnal or paroxysmal. In fact, patients may recognize a low level of continuous hematuria..

It was called noturnal because the colour change was seen to be most dramatic in concentrated night time urine.

Malaria

Malaria is a misnomer. Drawn from the Italian mala aria, or "bad air," the name reflects the historical belief that the disease is caused by miasmas, or noxious exhalations from rotting matter or stagnant water.

In 1889, a tiny parasite was revealed as the disease-causing agent, and eight years later, the mosquito was identified as the parasite-carrying agent.

20080911

Nonfunctioning Pancreatic Endocrine Tumors


Nonfunctioning pancreatic endocrine tumors are more common, often larger, and more frequently malignant at the time of diagnosis. The term nonfunctioning is a misnomer, because these tumors may produce peptide hormones whose biologic actions are less clinically apparent.

In some instances, tumor-associated defects in post-translational processing may preclude the efficient synthesis and secretion of peptide hormones. Factors affecting prognosis include the presence of liver metastases, incomplete resection of the primary tumor, and poorly differentiated tumor cells.

Conscious ("Awake") Intubation

While emergency nonanesthetized intubations outside the operating room may be performed with minimal topical anesthesia and no sedation, the term "awake" intubation applied to nonanesthetized intubations in the operating room is usually something of a misnomer. After appropriate sedation, topical anesthesia, and nerve blocks, such intubations can be performed with minimal discomfort in the conscious patient.

Conscious intubation is performed when the clinician believes that it is the safest way to insert an endotracheal tube.

Indications include a history of difficult intubation, findings on history or physical examination that can make intubation difficult, and severe risk for aspiration or hemodynamic instability. The reasons for conscious intubation should be explained to the patient as time allows and documented in the chart. The primary consideration of safety should be emphasized. At times, surgeons (and other physicians) may be unhappy about their patients being subjected to such procedures because of unwarranted fear of patient discomfort and the time required. If the anesthesiologist has concluded that such intubation is indicated, the demands of such individuals must not take precedence over patient safety. The reasons for conscious intubation should be emphasized to the surgeon as well as to the patient because airway disaster, poor outcome, and litigation may follow airway mismanagement.

In the American Society of Anesthesiologists' closed claims study, adverse respiratory events including inadequate ventilation, esophageal intubation, and difficult tracheal intubation form the largest single class of injury

Carbicarb

Carbicarb is referred to as a "CO2 -consuming" buffer, which is a misnomer because it still generates CO2 , but less than NaHCO3 of equal effectiveness. Carbicarb increases P CO2 less and decreases intracellular pH less than an equimolar treatment with NaHCO3 alone.

This could be valuable in a clinical setting of compromised CO2 elimination. Despite the theoretic advantage, Carbicarb has not been shown to be superior to NaHCO3 in treatment of lactic acidosis.

Placental Migration

The mechanism of apparent placental movement is not completely understood. The term migration is clearly a misnomer, however, because invasion of chorionic villi into the decidua on either side of the cervical os persists.

The apparent movement of the low-lying placenta relative to the internal os probably results from inability to precisely define this relationship in a three-dimensional manner using two-dimensional sonography in early pregnancy. This difficulty is coupled with differential growth of lower and upper myometrial segments as pregnancy progresses. Thus, those placentas that “migrate” most likely never had actual circumferential villus invasion that reached the internal cervical os in the first place.

Achondrogenesis

The term achondrogenesis is actually a misnomer, as it implies that cartilage is not made. In this condition, cartilage is made but it is profoundly abnormal. A more correct term would be chondrogenesis imperfecta.

The term achondrogenesis refers to a diverse group of generally lethal chondrodysplasias characterized by a short trunk, severe micromelia, and a disproportionately large cranium. Achondrogenesis is the second most common lethal short-limb dysplasia.

Ectopia Cordis

Thoracoabdominal ectopia cordis is better known as the pentalogy of Cantrell and is in part a misnomer, given that the heart is not truly ectopic.

In pentalogy of Cantrell the heart is abnormally sited with the apex oriented down, but is positioned within the chest and therefore not ectopia cordis. Both cervical and abdominal ectopia cordis may occur without a sternal cleft. Abdominal ectopia cordis does not belong in this group of anomalies because the defect is diaphragmatic and does not involve the thorax or the anterior abdominal wall.