Skin lesions

The Primary LesionsMacule Papule Nodule Tumor Plaque

Vesicle Bullae

Pustule Wheal Burrow

Telangiectasia

MACULEA macule is a change in the color of

the skin. It is flat, if you were to close your eyes and run your

fingers over the surface of a purely macular lesion, you could not

detect it. A macule greater than 1 cm. may be referred to as a patch.

Examples of macules include freckles and flat moles.

PAPULEA papule is a solid raised lesion that

has distinct borders and is less than 1 cm in diameter. Papules may have a variety of shapes in profile (domed,

flat-topped, umbilicated) and may be associated with secondary features

such as crusts or scales

Papules are associated with such conditions as warts, syphilis, psoriasis, seborrheic and actinic keratoses, lichen planus, and skin

cancer

NODULEA nodule is a raised solid lesion

more than 1 cm. and may be in the epidermis, dermis, or subcutaneous tissue

keratinous cysts, lipomas, fibromas

TUMORA tumor is a solid mass of the skin or subcutaneous tissue; it is larger

than a nodule. (Please bear in mind this definition does not at all

mean that the lesion is a neoplasm.)

VESICLEVesicles are raised lesions less than

1 cm. in diameter that are filled with clear fluid.

These lesions may be the result of sunburns, insect bites, chemical

irritation, or certain viral infections, such as herpes.

BULLAEBullae are circumscribed fluid-filled lesions that are greater than 1 cm.

in diameter

PUSTULEPustules are circumscribed

elevated lesions that contain pus. They are most commonly infected (as in folliculitis) but may be sterile

(as in pustular psoriasis

A pustule is usually the result of an infection, such as acne, imptigeo,

or boils

Wheal. A skin elevation caused by swelling that can be itchy and usually disappears soon after

erupting. Wheals are generally associated with an allergic

reaction, such as to a drug or an insect bite

WHEALA wheal is an area of edema in the

upper epidermis

Telangiectasia. Small, dilated blood vessels that appear close to the

surface of the skin. Telangiectasia is often a symptom of such

diseases as rosacea or scleroderma

TELANGIECTASIATelangiectasia are the permanent

dilatation of superficial blood vessels in the skin and may occur as isolated phenomena or as part of a generalized disorder, such as

ataxia telangiectasia.

BURROW Burrows are linear lesions

produced by infestation of the skin and formation of tunnels (e.g., with infestation by the scabitic

mite or by cutaneous

The Secondary LesionsScale Crust

Atrophy Lichenification

Erosion

Excoriation Fissure

Ulceration Scar

Keloids Petechiae, Purpura, and

Ecchymoses

Scale. A dry, horny build-up of dead skin cells that often flakes off

the surface of the skin. Diseases that promote scale include fungal

infections, psoriasis, and seborrheic dermatitis

Crust. A dried collection of blood, serum, or pus. Also called a scab, a

crust is often part of the normal healing process of many infectious

lesions. Erosion. Lesion that involves loss of

the epidermis.

EXCORIATIONExcoriations are traumatized or

abraded skin caused by scratching or rubbing

FISSUREA fissure is linear cleavage of skin

which extends into the dermis.

Atrophy. An area of skin that has become very thin and wrinkled.

Normally seen in older individuals and people who are using very

strong topical corticosteroid medication

Scar. Discolored, fibrous tissue that permanently replaces normal skin after destruction of the dermis. A very thick and raised scar is called

a keloid

KELOIDSKeloids are an exaggerated

connective tissue response of injured skin that extend beyond the edges of the original wound.

Lichenification. Rough, thick epidermis with exaggerated skin

lines. This is often a characteristic of scratch dermatitis and

atopic dermatitis

Ulcer. Lesion that involves loss of the upper portion of the skin

(epidermis) and part of the lower portion (dermis). Ulcers can result

from acute conditions such as bacterial infection or trauma

PETECHIAE, PURPURA, AND ECCHYMOSES

Three terms that refer to bleeding that occurs in the skin are petechiae,

purpura, and ecchymoses. Generally, the term "petechiae" refers to smaller

lesions. "Purpura" and "ecchymoses" are terms that refer to larger lesions. In

certain situations purpura may be palpable.

In all situations, petechiae, ecchymoses, and purpura do not blanch when pressed. If there is

any question, press on the lesions carefully with a glass slide. Don't break the slide or cut the patient