History, examination and classification of skin lesions

Question 1

How would you describe the following?

Answer 1

Atrophy - thinning of the skin

Question 2

How would you describe the following?

Answer 2

Papule - small, palpable, circumscribed lesion <0.5cm

Question 3

How would you describe the following?

Answer 3

Macule - flat, circumscribed non-palpable lesion

Question 4

How would you describe the following?

Answer 4

Bulla - Large fluid-filled blister

Question 5

How would you describe the following rash?

Answer 5

Petechial rash - pinpoint macule of blood in the skin - <3mm diameter

Question 6

How would you describe the following rash?

Answer 6

Crusted - Dried Serum/exudate on the skin

Question 7

How wouldyou describe the following skin lesion?

Answer 7

Plaque - Large, flat-topped elevated, palpable lesion

Question 8

How would you describe the following?

Answer 8

Ecchymosis - Large confluent area of purpura

Question 9

How would you describe the following?

Answer 9

Purpura - macule/papule of blood in the skin which does not blanch on pressure (>3mm diameter)

Question 10

How would you describe the following?

Answer 10

Erosion - denuded area of skin (partial epidermal loss)

Question 11

How would you describe the following?

Answer 11

Pustule - yellowish/white pus filled lesion

Question 12

How would you describe the following?

Answer 12

Excoriation - scratch mark

Question 13

How would you describe the following?

Answer 13

Fissuring - deep linear crack or crevice

Question 14

How would you describe the following?

Answer 14

Telangiectasia - Abnormal visible dilatation of blood vessels

Question 15

How would you describe the following?

Answer 15

Lichenification - Thickened epidermis with prominent normal skin markings

Question 16

How wouldyou describe the following?

Answer 16

Ulceration - deeper denuded area of skin (full epidermal and dermal loss)

Question 17

How would you describe the following?

Answer 17

Vesicles - small fluid filled blisters

Question 18

How would you describe the following?

Answer 18

Nodule - Large papule (>0.5 cm)

Question 19

How would you describe the following rash?

Answer 19

Weal - Itchy raised “nettle-rash” like swelling due to oedema

Question 20

What are Kobner Phenomena?

Answer 20

Skin lesions which develop at site of the injury

Question 21

What specific aspects would you want to ask about tin the history for skin diseases?

Answer 21

• Time course of rash
• Distribution of lesions
• Symptoms (e.g. itch or pain)
• Family history (especially of atopy and psoriasis)
• Drug/allergy history
• Past medical history
• Provoking factors (e.g. sunlight or diet)
• Previous skin treatments.

Question 22

What investigations would you consider in someone with a skin lesion?

Answer 22

• Swabs/Blister fluid samples
• Skin scrapes
• Nail smapling
• Wood’s light
• Blood tests - Serology, autoantibodies
• Patch test
• Biopsy
• Urine
• Dermatoscopy - pigmented lesion examination

Question 23

What examining a skin lesions, what would you want to look at?

Answer 23

• Shape
• Pattern
• Border
• Surface
• Elevation
• Colour
• Temperature
• Evolution
• Distribution