Forme fruste
In medicine, a forme fruste (French
French language
French is a Romance language spoken as a first language in France, the Romandy region in Switzerland, Wallonia and Brussels in Belgium, Monaco, the regions of Quebec and Acadia in Canada, and by various communities elsewhere. Second-language speakers of French are distributed throughout many parts...

, “crude, or unfinished, form”; pl., formes frustes) is an atypical or attenuated manifestation of a disease or syndrome, with the implication of incompleteness, partial presence or aborted state. The context is usually one of a well defined clinical or pathological entity, which the case at hand almost — but not quite — fits.

An opposite term in medicine, forme pleine — seldom used by English-speaking physicians — means the complete, or full-blown, form of a disease.


According to gastroenterologist William Haubrich:
A patient may exhibit sudden, intense, epigastric pain and a rigid abdomen
In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

. He is thought to have a perforated peptic ulcer
Peptic ulcer
A peptic ulcer, also known as PUD or peptic ulcer disease, is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm...

. But at operation, only a penetrating ulcer is found, sealed off by adhesion
Adhesion (medicine)
Adhesions are fibrous bands that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connect tissues not normally connected.-Pathophysiology:...

 to the omentum
Greater omentum
The greater omentum is a large fold of parietal peritoneum that hangs down from the stomach...

 or anterior abdominal wall. Such a patient is said to have a forme fruste of acute free perforation as a complication of his peptic ulcer disease.


The Latin phrase frustra esse means "to be mistaken" or "to be confused". As a technical term in French, the cognate
In linguistics, cognates are words that have a common etymological origin. This learned term derives from the Latin cognatus . Cognates within the same language are called doublets. Strictly speaking, loanwords from another language are usually not meant by the term, e.g...

 fruste has been used in two related ways. First, as an antiquarian
An antiquarian or antiquary is an aficionado or student of antiquities or things of the past. More specifically, the term is used for those who study history with particular attention to ancient objects of art or science, archaeological and historic sites, or historic archives and manuscripts...

’s term it refers to a coin, medal or ancient stone on which figures and characters can no longer be recognized due to wear. Secondly, it was employed in natural history
Natural history
Natural history is the scientific research of plants or animals, leaning more towards observational rather than experimental methods of study, and encompasses more research published in magazines than in academic journals. Grouped among the natural sciences, natural history is the systematic study...

 to denote mollusk shells whose striations, grooves or tips were worn down. By extension, this sense could be applied to sculpture, pottery, or other objects of great antiquity.

It was in this sense of “indistinctness due to wear or through long use” that the great French internist Armand Trousseau
Armand Trousseau
Armand Trousseau was a French internist. His contributions to medicine include Trousseau sign of malignancy, Trousseau sign of latent tetany, Trousseau-Lallemand bodies , and the truism, "use new drugs quickly, while they still work."-Biography:A native of Tours, Indre-et-Loire, Armand Trousseau...

 (1801–67) first employed the term in connection with an obscured form of Graves' disease
Graves' disease
Graves' disease is an autoimmune disease where the thyroid is overactive, producing an excessive amount of thyroid hormones...

, which he described as a “…maladie dite fruste par l’absence du goitre et de l’exophthalmie” (“…disease said to be crude [i.e., indistinct] for its absence of goiter and exophthalmia”)

The sense of the term in medicine has slightly evolved to mean a “not fully developed form of an illness”, rather than simply an obscure form. Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...

 often used the term forme fruste in connection with incomplete or obscured cases of neuroses and psychoses and thus the literature of psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...

 is replete with it. (An equivalent term in German is minimalvariante, but Freud used the French version.)

List of "forme fruste" medical syndromes

  • "Lymphangioleiomyomatosis" appears as a forme fruste of tuberous sclerosis.
  • "Primary ciliary dyskinesia" appears as a forme fruste of cystic fibrosis.
  • "Forme fruste keratoconus", as opposed to "frank" keratoconus
    Keratoconus , is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual curve....

  • "Zona fruste", early name for zoster sine herpete (shingles without the rash)
  • "Forme fruste mitral regurgitation", mitral regurg due to fibroelastic deficiency with myxomatous changes (as opposed to fully formed degenerative changes seen in Barlow's disease).
  • "Forme fruste cleft lip", also known as microform. This is the stated cause of the scar on actor Joaquin Phoenix
    Joaquin Phoenix
    Joaquin Rafael Phoenix , formerly credited as Leaf Phoenix, is an American film actor. He was born in San Juan, Puerto Rico, and his family returned to the continental United States four years later...

    's upper lip
  • "Exercise-induced asthma" or cold-dry-air-induced, a form of intrinsic asthma, that could be present in individuals with no history of allergic asthma or another atopic disease.
  • "Chronic eosinophilic pneumonia" may be a forme fruste of Churg-Strauss syndrome
    Churg-Strauss syndrome
    Churg–Strauss syndrome is a medium and small vessel autoimmune vasculitis, leading to necrosis. It involves mainly the blood vessels of the lungs , gastrointestinal system, and peripheral nerves, but also affects the heart, skin and kidneys. It is a rare disease that is non-inheritable and...

  • "'Formes fruste of Churg-Strauss syndrome" have also been described as eosinophilic vasculitis
    Eosinophilic vasculitis
    Eosinophilic vasculitis is a cutaneous condition characterized by an inflammation of blood vessels and the presence of eosinophils....

     and/or eosinophilic granulomas in isolated organs without evidence of systemic disease
  • "'Formes fruste type of Calcaneonavicular Coalition", the mildest type of CN coalition prior to Fibrous, Cartilaginous, or osseous types.
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