examining a skin lesion

Question 1

discrete lesion

Answer 1

individual lesions separated from one another

Question 2

confluent lesion

Answer 2

lesions that appear to be merging together (urticaria)

Question 3

linear lesions

Answer 3

lesions in the shape of a line (e.g. excoriations)

Question 4

discoid lesions

Answer 4

coin shaped lesions (e.g. discoid eczema, discoid lupus)

Question 5

target lesions

Answer 5

concentric rings of varying colour, resembling bullseye (e.g. erythema multiforme)

Question 6

annular lesions

Answer 6

ring-like lesions (e.g. tinea corporis)

Question 7

how might you describe colour of a lesions

Answer 7

1. erythematous lesions?
2. purpuric lesions? reddish/purple discolouration of the skin
3. hyperpigmented lesions (darker skin)
4. hypopigmented (melanin depletion or dysfunction)
5. depigmentation (vitiligo)

Question 8

macule

Answer 8

flat area

less than 1.5cm

Question 9

patch

Answer 9

flat area

more than 1.5cm

Question 10

papule

Answer 10

raised palpable area

less than 0.5cm

Question 11

nodule

Answer 11

raised palpable lesion

more than 0.5cm

Question 12

plaque

Answer 12

palpable flat lesion

usually greater than 1cm

Question 13

vesicle

Answer 13

raised

clear, fluid filled lesion

less than 0.5cm

Question 14

bulla

Answer 14

raised

clear, fluid filled lesion

greater than 0.5cm

Question 15

pustule

Answer 15

pus containing lesion less than 0.5cm

Question 16

abscess

Answer 16

localised accumulation of pus

Question 17

wheal

Answer 17

oedematous papule or plaque

caused by dermal oedema

Question 18

boil / furuncle

Answer 18

staphylococcal infection around or within a hair follicle

Question 19

carbuncle

Answer 19

staphylococcal infection of adjacent hair follicles (i.e. multiple boils / furuncles)

Question 20

secondary lesions

Answer 20

modification of primary lesions that occur due to trauma to, or evolution of, the primary lesion

Question 21

words to describe secondary lesions

Answer 21

1. excoriation
2. lichenification
3. scales
4. crust
5. scar
6. ulcer
7. fissure
8. striae (stretch marks)

Question 22

systemic examination of the hands and elbows: what are you looking for?

Answer 22

1. nail pitting
   - eczema, psoriasis, alopecia areata
2. onycholysis
   - psoriasis and fungal nail infection
3. koilonychia

Question 23

examine elbows for

Answer 23

1. psoriasis plaques
2. xanthomas (hyperlipidaemia)
3. rheumatoid nodules

Question 24

inspect scalp for hair loss

Answer 24

1. alopecia areata

2. alopecia totalis

Question 25

excessive hair growth

Answer 25

1. hirsutism - androgen dependent excess hair growth in females
2. hypertrichosis

Question 26

inspect scalp for

Answer 26

scalp psoriasis
- plaques of psoriasis located on scalp

seborrheic dermatitis

Question 27

describe mucous membranes

Answer 27

• inspect oral mucosa for relevant signs
• hyperpigmented macules (pathognomic for peutz-jegher syndrome)
• bullae

Question 28

further assessment and investigation

Answer 28

• other relevant examinations
• swabs, skins craping of lesions
• dermatoscopy of lesions
• perform a biopsy of the skin lesion