The church spire sign.

We are pleased to introduce in this issue of Clinics in Dermatology a new section entitled "Art in Dermatology," which explores the interface between the visual arts and dermatology. This contribution focuses on the architectural structure known as a church spire that sits atop a church tower and has lent its name to a dermatologic sign. Key phrases play an important role in clinical dermatology and dermatopathology. The "church spire sign" is a descriptive term used to describe epidermal changes of hyperkeratosis, acanthosis, and elongated projections (papillomatosis) in various cutaneous disorders. Zvonimir Zambal (1922-1993) coined the term "church spire sign" in a contribution he published in 1965 with Hans Gotz (1915-1997). The term was adopted promptly by the dermatology community and was applied in 1966 by Emery Kocsard (1912-2005) and his colleague Franjo Ofner (1913-1973) in stucco keratosis. We describe the beautiful church spires of the Bamberg Cathedral located in Bamberg, Germany and compare its architectural appearance with the dermatopathology features seen in the church spire sign.