ENI - Lesions Flashcards
Define primary skin lesion
Develops as a direct result of disease processes
Define secondary skin lesions
Develop as a consequence of patient’s activities
Compare secondary lesions and secondary pyoderma
- Lesion: due to patient’s actions
- Pyoderma: bacterial infection which is complicating an underlying skin disease e.g. allergy and demodicosis. Presents with primary lesions e.g. papules and pustules
What may linear lesions indicate?
External trauma or lesions associated with blood vessel, dermatome or congenital malformation
What may annular lesions indicat?
Peripheral spreading of disease (e.g. pyoderma or dermatophytosis)
What do symmetrical lesions indicate?
Systemically mediated disease (often endocrine)
Describe macules
- Primary lesion
- Circumscribed flat area of change in colour less than 1cm diameter
- Pigment loss or excess, erythema, haemorrhage
When are erythematous macules often seen?
Inflammatory disease of superficial dermis e.g. allergies
What is a patch?
Same as a macule but larger than 1cm diameter
What are petechiae?
Pinpoint macules caused by haemorrhage
What are ecchymoses?
Patches caused by haemorrhage of more than cm diameter
What are cutaneous haemorrhages often indicative of?
- Thrombocytopaenia
- Defects in coagulation
- Vasculitis
Describe papules
- Primary lesion
- Small solid elevation of skin less than 1cm diameter
- Local accumulation of inflammatory cells
- Flea allergy dermatitis, canine pyoderma
Describe plaques
- Primary lesions
- Large elevation of skin, sometimes formed by papules coalescing
- e.g. eosinophilic plaque in some cats with allergic skin disease
Describe nodules
- Primary lesions
- Solid elevation of skin greater than 1cm diameter
- Usually extends into deeper skin layers
What may nodules result from?
- Neoplasia (skin cells, or metastatic)
- Inflammatory cell accumulation (chronic granulomatous inflammation associateed with infectious or sterile processes)
- Less commonly, tissue dysplasia or hyperplasia with mineral deposition
What tests are useful in nodular diseases?
- Needle aspiration and cytology
- Excisional biopsy and histopathology
- Excisional biopsy and culture
Describe cysts
- Primary lesion
- Cavity with an epithelial lining
Describe tumours
- Primary lesion
- Large mass involving skin structure
- Often relates to neoplasia buut can be used in inflammatory disease
Describe pustules
- Primary lesion
- Small circumscrimbed elevation of epidermis containing pus
- In dogs usually Staphylococcus intermedius
- May be a feature of sterile, immune-mediated diseases e.g. pemphigus foliaceus
Describe vesicles
- Primary lesion
- Small circumscribed elevation of epidermis containing clear fluid less than 1cm
Describe bullae
- Primary lesions
- Circumsribed elevation of epidermis containing clear fluid larger than 1cm diameter
Outline some causes of vesicles
- Balloon degeneration of keratinocytes e.g. FMD
- Loss of cohesion between cells in or just below epidermis due to antibody response directed at proteins in cellular attachment e.g. bullous pemphigoid
- Cell mediated cytotoxicity leading o a loss of structural integrity of epidermal cells e.g. erythema multiforma
Describe wheals
- Primary lesion
- Localised mast cell degranulation within skin
- Urticaria
- Circumscribed raised lesion consisting of dermal oedema
- Most common in horses
Give some causes of wheals
- Stings
- Venoms
- Insect bits
- Drug reactions
- Allergic reactions
- Physical factors e.g. pressure, cold exercise
Describe scales
- Primary lesion
- Accumulation of loose cornified fragments of epidermis
- Ectoparasites and other chronic skin inflammation may lead to scaling
Describe how scaling occurs
- Normally desquamation of cells from stratum corneum occurs so that cells are not seen
- Accumulation of loose cornified fragments of epidermis
- Often due to increased epidermal turnover
- may reflect priamry defects of keratinisation e.g. idiopathic seborrhoea