Nursing Health Assessment: Skin Lesions Types

Macule

Flat, circumscribed area that is a change in color of the skin, less than 1 cm in diameter. Examples: Freckles, flat moles (nevi), petechiae, measles, scarlet fever. (Primary Lesion)

Papule

Elevated, firm, circumscribed area less than 1 cm in diameter. Examples: Wart (verruca), elevated moles, lichen planus, cherry angioma, neurofibroma, skin tags. (Primary Lesion)

Plaque

Elevated, firm, and rough lesion with a flat surface greater than 1 cm in diameter. Examples: Psoriasis, seborrheic and actinic keratoses, eczema. (Primary Lesion)

Wheal

Elevated irregular-shaped area of cutaneous edema; solid, transient, with variable diameter. Examples: Insect bites, urticaria, allergic reaction, lupus erythematosus.

Nodule

Elevated, firm, circumscribed lesion, deeper in dermis than a papule, 1 to 2 cm in diameter. Examples: Dermatofibroma, erythema nodosum, lipomas, melanoma, hemangioma. (Primary Lesion)

Vesicle

Elevated, circumscribed, superficial lesion not extending into the dermis, filled with serous fluid, less than 1 cm in diameter. Examples: Varicella (chickenpox), herpes zoster (shingles), impetigo. (Primary Lesion)

Bulla

Vesicle greater than 1 cm in diameter. Examples: Blister, pemphigus vulgaris, lupus erythematosus. (Primary Lesion)

Pustule

Elevated, superficial lesion similar to a vesicle but filled with purulent fluid. Examples: Impetigo, acne, folliculitis, herpes simplex. (Primary Lesion)

Cyst

Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous layer filled with liquid or semisolid material. Examples: Sebaceous cyst, cystic acne. (Primary Lesion)

Excoriation

Loss of the epidermis; linear, hollowed-out, crusted area. Examples: Abrasion, scratch, scabies. Secondary Lesion.

Fissure

Linear crack or break from the epidermis to the dermis, may be moist or dry. Examples: Athlete's foot, cracks at mouth corners, chapped hands. Secondary Lesion.

Crust

Dried drainage or blood, slightly elevated, variable size and color. Secondary Lesion.

Scale

Thin or thick flake of skin varying in color; usually secondary to desquamated, dead epithelium
Ex. Dandruff

Secondary Lesion

Erosion

Loss of part of the epidermis, depressed, moist, glistening, following rupture of a vesicle or bulla. Secondary Lesion.

Ulcer

Loss of epidermis and dermis, concave, varies in size. Examples: Pressure ulcer, stasis ulcers, syphilis chancre. Secondary Lesion.

Atrophy

Thinning of the skin surface and loss of skin markings; skin appears translucent and paperlike. Secondary Lesion.

Petechiae

Tiny, flat, reddish-purple, nonblanchable spots in the skin, pinpoint to pinhead size, less than 0.5 cm in diameter. Vascular Lesion.

Purpura

Flat, reddish-purple, nonblanchable discoloration in the skin greater than 0.5 cm in diameter resulting from hemorrhage of blood into skin. Vascular Lesion.

Ecchymosis (Bruise)

Reddish-purple, nonblanchable spot of variable size caused by trauma to blood vessels resulting in bleeding under tissue. Vascular Lesion.

Angioma

Benign tumor consisting of a mass of small blood vessels, varying from small to large. Examples: Cherry angioma, hemangioma. Vascular Lesion.

Annular Lesion

Ring-shaped skin lesion configuration. Example: Ringworm.

Arcuate Lesion

Partial ring skin lesion configuration. Example: Syphilis.

Bizarre Lesion

Irregular or geographic pattern not related to any underlying anatomic structure. Example: Factitial dermatitis.

Circinate Lesion

Circular skin lesion configuration.

Confluent Lesion

Skin lesions that run together. Example: Childhood exanthems.

Discoid Lesion

Disc-shaped skin lesion without central clearing. Example: Lupus erythematosus.

Discrete Eczematoid Lesion

Lesions remain separate; inflammation with tendency to vesiculate and crust.

Generalized Grouped Lesion

Skin lesions clustered together. Example: Herpes simplex.

Iris Lesion

Circle within circle; bull's-eye skin lesion pattern. Example: Erythema multiforme.

Eczematous Dermatitis

Most common inflammatory skin disorder, including irritant contact, allergic contact, and atopic forms.

Folliculitis

Inflammation and infection of the hair follicle and surrounding dermis.

Furuncle (Boil)

Deep-seated infection of the pilosebaceous unit.

Cellulitis

Diffuse, acute infection of the skin and subcutaneous tissue.

Tinea (Dermatophytosis)

Group of noncandidal fungal infections involving the stratum corneum, nails, or hair.

Psoriasis

Chronic and recurrent disease characterized by keratinocyte proliferation.

Rosacea

Chronic inflammatory skin disorder.

Herpes Zoster (Shingles)

Viral skin infection caused by reactivation of the varicella-zoster virus.

Herpes Simplex

Viral infection occurring as Type 1 (associated with oral infection) or Type 2 (associated with genital infection).

Tick-Borne Diseases

Infections such as Lyme disease, Rocky Mountain Spotted Fever, and Colorado Tick Fever that can lead to multisystemic failure.

Alopecia Areata

Sudden, rapid, coin-shaped loss of hair, usually from the scalp or face.

Scarring Alopecia

Hair loss caused by the replacement of hair follicles with scar tissue.

Traction Alopecia

Hair loss resulting from prolonged, tightly pulled hairstyles.

Hirsutism

Growth of terminal hair in women following a male distribution pattern on the face, body, and pubic areas.

Paronychia

Infection and inflammation of the paronychium surrounding the nail.

Onychomycosis

Fungal infection of the nail.

Ingrown Nails

Condition where the nail pierces the lateral nail fold and grows into the dermis.

Nail Avulsion

Injury where part or all of a nail is torn away or removed from the nail bed.

Subungual Hematoma

Trauma to the nail plate severe enough to cause immediate bleeding and pain under the nail.

Onycholysis

Loosening of the nail plate from the nail bed beginning at the distal groove.

Nail Clubbing

Structural change where fingertips enlarge and nails curve around fingertips like an upside-down spoon, becoming red and sponge-like; often associated with low blood oxygen and lung disease.

Koilonychia

Spoon-shaped, abnormally thin nails that lose convexity and become flat or concave; sign of hypochromic or iron-deficiency anemia.