Derminology Flashcards
Primary Lesions
A physical alteration of the skin considered to be caused directly by the disease process
Macule lesions characteristics
flat, less than .5 cm
Patch (lesion) characteristics
Flat, >0.5 cm
Papule (lesion) characteristics
Raised, domed or flat-top, less than .5 cm
Pustule (lesion) characteristics
Raised, domed, less than .5 cm
Nodule (lesion) characteristics
Raised, domed, >0.5 cm
Plaque (lesion) characteristics
Raised, flat-top, >0.5 cm
Vesicle (lesion) characteristics
Blister, less than .5 cm
Bulla (lesion) characteristics
Blister, >0.5 cm
Erosion (lesion) characteristics
- Denudation (stripped of covering) of epidermis
- Non-scarring
Ulcer (lesion) characteristics
- Denudation (stripped of covering) of dermis
- Scarring
Wheal
edematous (condition characterized by excess watery fluid collecting in cavities of body); transient plaque
Secondary Features
changes due to external factors, such as scratching, trauma, infection, or changes caused by healing
Scale
- Thickening of the stratum corneum
- Adherent
- White, fine
- Yellow, greasy
- Hyperkeratotic
Crust
- Dried endogenous material
- Serous
- Hemorrhagic
- Honey-colored
Excoriation
Linear erosions from scratching
Lichenification
- thickening of the skin with accentuation of skin markings
- occurs with CHRONIC scratching or rubbing
Fissure
Linear crack in the skin
Petechiae
- Pinpoint red-brown macules due to intradermal hemorrhage
- Non-blanching
Palpable Purpura
- Intradermal hemorrhagic papules and plaques
- Non-blanching
Non-blanching
Lesions do not fade with direct pressure
Epidermal atrophy
- “Cigarette paper” wrinkling
- Red brown color
- Telangiectasias (visible blood vessels)
Dermal atrophy
- Skin surface is depressed
- May or may not be associated with epidermal atrophy
Off-white (hypopigmented)
Decreased pigment
White (depigmented)
Complete loss of pigment
Erythematous (red)
Inflammation or vascular (blood vessels)
Brown/black
Melanin (pigment)
Blue
Melanin (pigment) deposited deeper in skin
Yellow
Sebaceous (oil gland) tissue or intracellular lipids
Ovoid (shape)
Oval
Targetoid
Resembles a bullseye
Annular
Round with central clearing
Linear
May occur due to external factors or with conditions that follow developmental skin lines
Polycyclic
Annular lines are coalescing
Sharply circumscribed
Sharp cutoff between normal and affected skin
-Suggests a more superficial process
Diffuse (ill-defined)
- Edges are blurred
- Suggests a deeper process, such as inflammation of the fat (panniculitis)
Scalloped
- When the blisters break, the edges are in close proximity and they leave behind a scalloped border
- This is very helpful in making diagnosis of HSV infection
Geometric
- Most rashes are round in shape
- Square eruptions or those that follow a pattern of an external object suggest contact dermatitis
Serpiginous
-Wavy, snake-like border
Stellate
- Angulated edges
- May suggest process is due to scratching or a condition affecting the underlying vasculature
Blaschkoid
-Swirling patterns due to post zygotic mutation of melanocytes or keratinocytes
Christmas tree
Long axis of the plaques follows line from superior and medial to inferior and lateral, mimicking the branches of a Xmas tree
Dermatomal (Zosteriform)
- Linear bands that start and end at the midline on the trunk
- Reflect the nerve supply to the skin
- Herpes zoster (shingles) is unilateral and occurs in a band-like configuration
Koebnerized
Koebnerization is a linear collection of lesions arising from external trauma
-Classically occurs in psoriasis
Reticulate (Retiform)
- Net-like pattern
- It may reflect the underlying vascular supply to the skin
Photodistribution
Involves sun exposed skin
Spares behind the ears, under the chin and the anterior neck (shaded areas)
Seborrheic Distribution
- Scalp
- Brows
- Glabella (b/t brows)
- Alar creases (creases of the nose)
- Chin
- Postauricular sulcus (behind ears)
- Sternal chest
- Axillae
- Groin
Indurated
Firm to palpation
Fluctuant
Compressible denoting underlying fluid or pus
Burrow
Wavy or linear track typical of scabies infection
Impetiginized
- Presence of honey-colored crust
- Used to describe wounds secondarily infected with Staph
Necrotic
- Black, adherent crust called eschar
- Suggests overlying tissue is dead
Pedunculated
Narrower at the base of the lesion
Translucent (pearly)
- Shiny and see through
- Typical of basal cell skin cancers
Umbilicated
Central depression
Classic for mollluscum
Verrucous
Rough, warty surface
