Skin Lesion Terminology and physical exam

Macule

Small flat spot up to 1 cm

General skin examination order

Inspect and palpate the: color, moisture, temperature, texture, mobility and turgor, and lesions

color

Indicator of overall health linked to oxygenation

• jaundice

• pallor

• cyanosis

• melanin

• carotene (yellow)

• errythemic

• very fair, fair, olive, light brown, brown, dark brown ,black brown

Moisture

is the skin clammy or is patient diaphoretic (sweaty) is the skin dry

Temperature

Use dorsal side of your hands to check general temperature, be sure to make note of temperature of rash if present

mobility and turgor

mobility- ease of which the skin lifts up when you pinch

turgor is the speed it returns to place after pinching

EVALUATE SKIN LESION ORDER

Location, size, shape,

• color, (uniform, vs varied pigmentation, )

lesion type

- border

• regular or irregular

• circumscribed or poorly circumscribed

Texture

rough scaly or smooth, generalized or localized

Border

Poorly vs well circumscribed

Papule

superficial, elevated lesion up to 1 cm

Palpation

Soft, firm, indurated (hard) or fluctuant (fluid filled) , tenderness, temperature

Vesicle

Serous, fluid-filled lesion up to 1 cm

Pustule

Pus-filled 1 cm or less

Patch

Flat spot 1 cm or larger

Nodule

Marble-like lesion larger than 0.5 cm, often deeper and firmer than a papule

Bulla

Serous-filled lesion 1 cm or larger

Plaque

Superficial elevated lesion. 1 cm or larger

Wheal

Irregular, transient, superficial area of localized skin edema

Erosion

Nonscarring loss of superficial epidermis. Surface is moist but does not bleed.

Ulcer

Deeper loss of epidermis and dermis. may bleed or scar

Excoriation

linear or punctate erosions caused by scratching

Scale

Thin flake of dead exfoliated epidermis

Crust

Dried residue of skin exudates such as serum, pus or blood

Fissure

A linear crack in the skin often resulting from excessive dryness

Lichenification

Visible and palpable thickening of the epidermis and roughening of the skin with increased visibility of the normal skin furrows

Scar

Connective tissue that arises from injury (hypertrophic vs. atrophic), excess collagen production after an injury.

Atrophy

thinning of the dermis or epidermis causing depression in the skin

Keloid

Hypertrophic scarring that extends beyond the border of the initiating injury

Atrophy

Thinning of the dermis or epidermis causing depression in the skin

Petechiae

Small flat red lesions caused by intradermal hemorrhage (<3mm) non-blanchable

Purpura

Purplish-red hemorrhagic area in the skin (>3mm) non-blanchable, related to clotting disorders and thrombocytopenia

Telangiectasia

Fine, irregular dilated blood vessels that blanch w/ pressure

Ecchymosis

Bruise, bluish-purple, caused by leakage of blood from ruptured vessels (trauma), vascular lesions, caused by trauma,

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