Elementary lesions and general derma terms

Question 1

Macule or patch

Answer 1

A circumscribed area of change in skin color, can have increased or decreased pigmentation. Not palpable or raised

Macules < 1cm
Patch >1cm

Question 2

Papule

Answer 2

A palpable, superficial, solid lesion, <1 cm in diameter. They are usually but not always elevated, although they are always palpable.

Superficial means they are in the epidermis, epidermal/dermal junction, or superficial dermis.

Question 3

Vegetation

Answer 3

Multiple small closely packed elevations or papules

Question 4

Exanthema

Answer 4

A rash consisting of papules

Question 5

Lichenoid exanthem

Answer 5

A grouped papular rash

Question 6

Birt-Hogg-Dube syndrome

Answer 6

Papules from tumor cells

Question 7

Cimicosis

Answer 7

Papules formed by bed bug bites

Question 8

Plaque

Answer 8

Palpable, cellular infiltration in the papillary dermis, larger than 1 cm diameter

Papillary dermis - most superficial layer of dermis, contains the dermal papillae weaved under the rete ridges of epidermis

Question 9

Epidermal papule/plaque

Answer 9

Same as papules or plaques, but the cellular infiltrate is confined to the epidermis

Condyloma acuminatum, verruca vulgaris

Question 10

Nodule

Answer 10

Cellular infiltration in the reticular dermis and subcutaneous tissue. (reticular dermis -lower layer of dermis, dense irregular connective tissue). – semmelweis

A palpable, solid, round or ellipsoidal lesion that is larger than a papule. May involve epidermis, dermis, or subcutaneous tissue. Results from inflammatory, neoplastic, or metabolic deposits. – Fitzpatrick.

Question 11

Tuber

Answer 11

Cellular infiltration in the reticular dermis and subcutis.

Highly elevated lesions
Firm on palpation
Infiltrated by granuloma or tumor cells
Frequent caseation, ulceration, and scarring.

Examples:
Cutaneous tuberculosis
Cutaneous sarcoidosis
Mycosis fungoides

Question 12

Gumma

Answer 12

tuber caused by tertiary syphilis

Question 13

Urtica, Wheal

Answer 13

Circumscribed edema of the dermis

papillary dermal edema

Question 14

Vesicles

Answer 14

Cavity within the epidermis or under the basal cell layer of epidermis, containing serous or hemorrhagic fluid, vesicle >1cm

The cavity does not have an epithelial wall.

Question 15

Bullae

Answer 15

Cavity within the epidermis or under the basal cell layer of epidermis, containing serous or hemorrhagic fluid, bulla > 1cm

The cavity does not have an epithelial wall.

Question 16

Pustule

Answer 16

Same as a vesicle or bulla, but the fluid inside is pus, and it may be in any layer of the skin. Fluid may also be hemorrhagic and purulent.

Question 17

Patch

Answer 17

Macule larger than 1cm

Question 18

Scale

Answer 18

Flakes of stratum corneum

Question 19

Crust

Answer 19

Dried exudate, blood, pus

Question 20

Erythema

Answer 20

Red discoloration that disappears when pressed.

Caused by vascular dilation and inflammation.

Question 21

Purpura

Answer 21

A red discoloration that does not disappear on pressure.

Caused by extravasation of blood cells.

Question 22

Ecthyma

Answer 22

Crusting that is accompanied by necrosis of the deeper tissues.