February iotaderma (#229)

IOTADERMA #230 Medicine uses many sources for naming diseases and clinical manifestations. For example, from the world of tools, there are the ‘‘saw sign,’’ the ‘‘nail sign,’’ the ‘‘hammer sign,’’ and the ‘‘screw sign.’’ Dermatology uses the ‘‘rope sign.’’ What is this skin finding, and in what disease is it found? Robert I. Rudolph, MD, FACP Answer will appear in the JAAD Online section of the April 2013 issue of the Journal.

FEBRUARY IOTADERMA (#229) What is morsicatio? Answer: Morsicatio (also known as ‘‘morsicatio buccarum’’ or ‘‘linea alba buccalis’’) is a condition in which there is chronic biting of the buccal/oral mucosa. The resultant traumatic injury is completely benign, and the characteristic clinical findings manifest as a whitish, ‘‘shredded’’ appearance of the buccal or labial mucosa, most frequently at the occlusal line. This biting habit and its findings are commonly encountered, and it is noted most frequently in nervous, anxious, or ‘‘type A’’ persons. Like most habit tic processes, the cure is obvious—in this case, stop biting at the cheeks or lips—but difficult for the patient to actually discontinue! REFERENCES Dermatology Information System (DermIS) web site. Morsicatio buccarum. Available from http://www.dermis.net/dermisroot/en/26294/diagnose.htm. Accessed September 30, 2011. Glass LF, Maize JC. Morsicatio buccarum et labiorum (excessive cheek and lip biting). Am J Dermatopathol 1991;13:271-4.

Robert I. Rudolph, MD, FACP

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