Aggressive squamous cell carcinoma developing in a giant epidermal cyst of the abdomen

Mono-letter mnemonics in dermatology A mnemonic is a device or code that helps an individual to memorize key information about something. Many people are using mnemonics in teaching as they have been proven to be a successful learning aid. Recently, we have reviewed the use of mnemonics in dermatologic disorders. Many websites and books compile lists of mnemonics; thus, there may be more than one mnemonic for a given disorder. It is left to the individual to select one that he or she prefers. It is not uncommon for individuals to devise their own methods of remembering facts by constructing a word, song, picture, or incident. Self-made mnemonics are often particularly effective, as the time and creative energy devoted to their development result in increased recall. We wish to point out in this brief communication that using a word or phrase for mnemonics may at times become outdated, similar to a new edition of a book which replaces a previous one. Mnemonics, too, must accommodate new information so that students can reap the maximum benefit from this useful learning aid. Problems can arise when new information is added, because the addition of a letter to the existing word or phrase will ultimately change the composition of a mnemonic that has been in vogue for some time. For instance, the five painful tumors of the skin have been grouped nicely into the word “Bengal” (blue rubber bleb nevus, eccrine spiradenoma, neurilemmoma/neuroma, glomus tumor, angiolipoma/angioleiomyoma/angiosarcoma, and leiomyoma), or the phrase “blend an egg”, but now, with the potential addition of cutaneous endometriosis/calcinosis cutis and osteoma cutis, its use may be rendered obsolete. The new mnemonic for painful cutaneous nodules is BENGAL CO, where “CO” refers to the first letter of the last two tumors mentioned. In addition, a word or phrase that may be of interest to individuals in some countries, and easily recalled by them, might not be of interest elsewhere or may be difficult for persons in other places to recall. We wish to highlight that one good technique that can be used in framing mnemonics is a mono-letter. With this technique, it is possible to avoid the unnecessary inclusion of letters that change the meaning of the word, it can be used globally and internationally, and it is easily remembered because of its acceptability. This has been welcomed by other specialties. The letters may be employed in independent words or in words contained in a large statement. An example of the latter is the memorable description of Dowling–Degos disease by Wilson-Jones and Grice: demonstrating dusky dappled disfigurements and dark dot depressions, and disclosing digitate downgrowths delving dermally. Here, we list some of the “mono-letter” mnemonics that can be used as an aid in teaching dermatology: “a” in Addison’s disease [asthenia, areola pigmentation, arterial hypotension, alimentary abnormality (anorexia, symptoms of acute abdomen), anxiety, axillary and pubic hair thinning]; “d” and “m” in pellagra [dementia, diarrhea, dermatitis, death, meats (mostly fats), molasses, meal (corn)]; “l” in a dermatopathology pattern with superficial and deep perivascular infiltrates with lymphocytes predominant [ light eruption (polymorphus), lupus erythematosus, lymphocytic infiltrate of Jessner + deep figurate/gyrate erythema, Lyme disease, lues (syphilis) (+ plasma cells), lymphoma, leukemia, leprosy, indeterminate type (+ histiocytes)]; “p” in telogen effluvium (pregnancy, protein depletion, pills, propranolol, pyrexia, parturition, psychic stress); “p” in lichen planus (purple, polygonal, planar or flat, papules, pruritic, persistent, penile); “s” in superficial chronic glossitis [smoking, spirit (alcohol), spices, syphilis, sharp objects (trauma), sepsis (chronic debilitating diseases)].