Primary Skin Lesions by Aseem

PRIMARY SKIN LESIONS

Dr Aseem SharmaDermatology Resident

MACULE (L: Spot)

Flat

Non-palpable

Alteration in Color

No Change in Texture

MACULE

Hypopigmented VITILIGO TUBEROUS

SCLEROSIS Hyperpigmented NEUROFIBROMATOSIS

EPHELIDS MONGOLIAN SPOTS Erythematous VIRAL / DRUG RASH Pupurae THROMBOCYTOPENIC

PURPURA

MACULE

MACULE

MACULE

PAPULE (L. pimple)

• Small

• Solid

• Elevated lesions

• < 01 cm dia

PAPULE

• Epidermal hyperplasia/ Extraenous infiltrates

• SHAPE ACUMINATE (Follicular LP) DOME-SHAPED (M. contagiosum) FLAT TOPPED (Lichen Planus) PAPULO-SQUAMOUS (Guttate Psoriasis)

PAPULE

• COLOUR

WHITE (M. contagiosum) VIOLACEOUS (L. Planus) YELLOWISH (Xanthomatosis) FLESH COLOURED (A. sebaceum) BLUISH-BLACK (Malignant Melanoma)

PAPULE

PAPULE

PAPULE

PAPULE

PLAQUE

• Solid• Plateau-like elevation• Large Surface Area• Coalescence/ Enlargmenent

PLAQUE

• Psoriasis Vulgaris

• Lichen Simplex Chronicus

• Borderline Tuberculoid Leprosy

PLAQUE

PLAQUE

PATCH

• Large Macule OR Plaque ??

• Rarely used

NODULE (L: small knot)

• Solid• Raised• Round• 3D growth of Papule• Diff from papule in Depth

• Tumour

NODULE

• Epidermal (Nodular BCC/ Keratoacanthoma)

• Dermal (Dermatofibroma)

• Subcutaneous (Lipoma/ Eythema Nodosum)

NODULE

NODULE

NODULE

TUMOUR

WHEAL• ‘Urticaria / Hives’• Evanescent• Elevated Lesion• With Erythema and Edema• Blanching

• Dermographism (25%)• Angioedema

WHEAL

Transient Vascular Reaction in Dermis

Vasodilation / Increased Capillary permeability

Extravasation of fluid from Capillaries

Edema

WHEAL

DERMOGRAPHISM

ANGIOEDEMA

VESICLE (L: bladder)/ BULLA (L: bubble)

• Elevated lesion

• Contains Clear Fluid

• < 0.5 cm dia = VESICLE

• > 0.5 cm dia = BULLA

VESICLE/ BULLA• Levels

Stratum Corneum - Impetigo Contagiosum - Pemphigus Foliaceus

Stratum Spongiosum - Contact Dermatitis - Pompholyx Stratum basale - Pemphigus Vulgaris

Dermo-Epidermal Junction - Bullos Pemphigid - Dermatitis Herpetiformis

VESICLE/ BULLA

VESICLE/ BULLA

VESICLE/ BULLA

VESICLE/ BULLA

PUSTULE• Raised lesion

• Elevated

• Fluid-filled lesions

• WBCs + Debris +/- Bacteria

PUSTULE

• Pyoderma• Halogenoderma• 2° to Vesicular lesions (Herpes Zoster/

Varicella)• Acne Vulgaris

• Pustular Psoriasis

PUSTULE

PUSTULE

PUSTULE

CYST

• Sac containing liquid/ semisolid material• ‘Resilient feel’

TYPES

- KERATINOUS Squamous ep Epidermis - PILAR Multilayered ep Hair Follicle

CYST

CYST

ABSCESS

• Elevated lesion• Collection of pus under skin• Lack well-defined lining• Surrounding skin changes

ABSCESS

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