Medical Science Dermatology

Macule

Flat

circumscribed area

change in color of the skin

<1cm

Papule

elevated

firm

circumscribed

<1cm

Patch

Flat

nonpalpable

irregular macule (not circumscribed)

>1cm

Plaque

Elevated

firm and rough texture

>1cm diameter

Wheal

Elevated

irregular-shaped area

Solid

transient

Variable in size diameters

Transient

Short-term

Nodule

Elevated

firm

circumscribed

deeper than papule (into dermis than Papule)

1-2cm in diameter

Tumor

Elevated

soild lesion

sometimes no demarkation/ hard to see

Deeper into dermis

>2cm

Vesicle

Elevated

circumscribed

filled with serous fluid

<1cm diameter

superficial

Bulla

type of vesicle

>1cm diameter

Pustule

Elevated

superficial lesion

filled with purulent fluid

Superficial lesion

lesion that does not affect deeper tissue laters (only epidermis)

Cyst

Elevated

Circumscribed

encapsulated ( in dermis or subQ layers)

liquid or semisolid

vegetation

Elevated

irregular growth

verrucous (keratototic or dried surface) vs. Papillomatous (normal epidermis covering)

Scale

Thin plates of separated and dried cornified epithelium cells hanging onto epidermis

flakely appearance

irregular

thick/thin

dry/oily

different sizing

Cornified

tissue that dry and hardens

Keratonic

overgrowthof skin (keratin)

Hyperkeratosis

Thickened

elevated

Lichenification

Rough

thickened epidermis

secondary lesion formed form persistent rubbing or skin irritation

pink/redenned

Keloid

Irregular-shaped

elevated

progressively enlarging (beyond boundaries of initial wound)

more common in darker complexions

excoriation

Loss of epidermis

depressed

linear

hollowed out

mechanical injury

a scratch

Abrasion

type of excoriation due to friction

depressed

caused from friction, skin abraded on another surface

skin rubbed off in an area

Fissure

linear crack/break

depressed

epidermis-dermis

Erosion

Loss of epidermis

depressed

moist, glistening

after rupture of vesicle/bulla

depressed

opposite of elevated, a dip into something

Ulcer

Loss of epidermis and dermis

concave

different sizing

Crust

Dried serum/blood/purulent fluids

slightly elevated

black/brown/red/straw

a scab (eschar)

Atrophy

thinning of skin an loss of skin marking

typically meaning wasting away of tissue

skin will appear translucent and paperlike

Morphology

Shape

border/margins

texture

size

Characteristics of skin lesions

morphology (border/margin, texture, size, shape)

color/ pigmentation

distribution/anatomical location

arrangement

associated manifestation (tenderness, temperature, drainage, bleeding. presence of secondary lesions)

Sizing

measure in cm

if multiple lesions, you can give range of sizing

Border/margin types

discrete

indistinct

active

irregular

border raised from center

advancing

Discrete

lesions are completely separated

Indistinct

Lesions’ borders are merged together/connected

Active

lesion is inflamed

advancing

lesion is growing in size

Shape types

Round/discoid

oval

annular

target/iris

Arcuate

annular

ring shaped lesion

Arcuate

arch shape, not complete ring

Distribution

Symmetric vs. asymmetric

Localized

Regional

§Extensor surfaces

§Flexor surfaces

§Sun-exposed areas

§Hair-bearing areas

§Acral

§Intertriginous

§Photodistributed

§Dermatomal/Zosteriform

Generalized

Localized

Lesions only in a small area of body

Regional

Lesions in a segment of the body

Generlaized

Lesions on most surfaces of body

Extensor surfaces

posterior side of joints (backside of elbow for example)

Flexor surfaces

anterior surface of joints

Sun-exposed areas

Typically the head (wilkison’s triangle)

-back of ears

nosolabial folds

spared from photo-distributed lesions because these areas typically are exposed naturally to more sunlight/uv light and therefore are resistant to certain lesions

Hair-bearing areas

locations of hair growth

Acral

locationed on extremities

Intertriginous

area where body rubs together

Photodistributed

Areas of body that sun can reach

Dermatomal/Zosteriform

Areas of body that share the same nerve connection to spinal cord

arrangment

Grouped

discrete/isolated

linear

Dermatomal/zoseriform

Serpiginous

Reticular

morbilliform

stellate

polycyclic

Serpiginous

wave or snake-like (serpent)

Reticular

lace/ net-like

morbilliform

when lesions and grown together and become confluent

Stellate

star-shaped

Polycyclic

interlocking circles

Associated manifestations

§Drainage

§Bleeding

§Central clearing

§Desquamation

§Keratotic

§Punctation

§Vascualar lesions (Telangiectasias)

§Tenderness

§Warmth 

central clearing

center of lesion is normal skin

Desquamation

dry/peeling skin

punctation

pattern of small red bumps

vascular lesions (Telangectasis)

vessels and capillaries become visible

Primary Lesion

Something you are born with, originate on prior healthy skin and have causation (disease ect.). Usually raised. Caused automatically (almost).

Secondary Lesion

Something you acquire/ a wound from trauma. can be changes from a primary lesion!! (mostly external factors). Usually depressed!