Primary Secondary Skin Lesions 2003

Dr Chaitanya Vemuri

Primary Skin LesionsMaculePatchPapuleNoduleTumorPlaqueVesiclePustuleBullaeWhealTelangiectasiaAbscessPetechiae, purpura & ecchymosis

MaculeA flat, colored

lesion, <2cm in diameter, not raised above the surface of surrounding skin

Freckle – prototype of pigmented macule

Macule

patchA large(>2cm)flat

lesion with a color different from surrounding skin

Differs from macule only in size

PapuleA small, solid lesion,

<0.5 cm in diameter, raised above the surface of surrounding skin & hence palpable

Eg: white head in acne

Papule

NoduleA large ( 0.5 – 5.0

cm ), firm lesion raised above the surface of surrounding skin.

Differs from papule only in size

TumorA solid,raised

growth >5cm in diameter

PlaqueA large >1cm, flat

topped raised lesion, edges may either be distinct ( in psoriasis ) or gradually blend with surrounding skin ( in eczematous dermatitis )

VesicleA small, fluid filled

lesion, <0.5 cm in diameter, raised above the plane of surrounding skin. Fluid is often visible and the lesion are translucent

Vesicles in Allergic Contact Dermatitis

PustuleA vesicle filled with

leukocytes The presence of

pustule does not necessarily signify the the existance of infection

AbscessA localised

collection of pus in a cavity, more than 1 cm in diameter

bullaA fluid filled, raised,

often a translucent lesion >0.5cm in diameter

WhealA raised,

erythematous, edematous, papule / plaque, usually representing short-lived vasodilatation and vasopermeability

Eg: utricaria

telangiectasiaA dilated superficial

blood vessel.

Petechiae, purpura & ecchymosisPetechiae – pinhead-sized macules of

extravascular blood in the dermis.Petechiae are flat.The larger ones are referred to as purpuraIf bleeding involves deeper structures then it

is an ecchymosis

BurrowA linear or cuvillinear papule, caused by

burrowing scabies mite

ComedonesA plug of keratin and sebum wedged in

dilated pilosebaceous orifice.

Secondary Skin LesionsScale CrustExcoriationErosionFissureSinusScarAtrophyStriaeLichenification

ScaleA flake arising from

stratum corneum d/t excessive accumulation.

Eg: psoriasis

CrustDried exudate of

body fluids (blood / serous fluid)

Which might be either yellow ( serous crust )

red ( h’agic crust )

UlcerAn area of skin from

which the whole of epidermis & atleast the upper part of dermis has been lost

ExcoriationLinear, angular

erosions that may be covered by crust and are caused by scratching.

Erosion Area of skin

denuded by complete or partial loss of epidermis.

No associated loss of dermis

Fissure A slit- shaped deep

ulcerEg: irritant

dermatitis of hands

Sinus A cavity or channel

that permits the escape of pus or fluid

Scar A change in the skin

secondary to trauma or inflammation

Sites may be erythematous, hypopigmented or hyperpigmented depending upon their age /character.

Scar

Atrophy A accquired loss of

substance .In skin, this may

appear as a depression with intact epidermis ( loss of dermal /subdermal tissues )

Or appear as sites of shiny, delicate, wrinkled lesions ( epidermal atrophy )

Striae A streak like, linear ,

atrophic, pink, purple or white lesion d/t changes in connective tissue

Eg: cushings syndrome, pregnancy induced

Lichenification A distinctive

thickening of skin that is characterized by accenuated skin-fold markings.