Introduction to skin disease Flashcards
Primary Lesions
- Nodule
- Papule
- Macule
- Patch
- Vesicle
- Bulla
- Pustule
- Plaque
- Erythema
Secondary Lesions
- Scale
- Excoriation
- Lichenification
- Crust
- Atrophy
Nodule
- solid raised lesion >3mm in diameter, contains no fluid
Papule
- small solid raised lesion e.g closed comedone
Macule
- a flat coloured lesion, not raised e.g freckle
Patch
- large flat coloured lesion. Differs from macule in size
Vesicle
- small, fluid filled lesion <1cm e.g vesicles in allergic contact dermatitis
Bulla
- fluid filled, raised > 1cm
Cyst
- soft, raised, encapsulated lesion filled with semi-solid or liquid contents. Deeper and more significant than a pustule
Pustule
- vesicle filled with fluid and leucocytes
Plaque
- large, flat-topped, raised lesion. Edges can be distinct as in psoriasis or blend as in eczematous dermatitis
Erythema
- redness of skin due to capillary dilatation
Scale
- collection of cells which have separated from the epidermis
Excoriation
- injury caused by scratching when the epidermis or dermis are removed
Lichenification
- distinctive thickening of skin characterised by accentuated skin-fold markings
Crust
- dried exudate of body fluids that may be yellow (serous exudate) or red (haemorrhagic exudate
Atrophy
- an acquired loss of substance e.g. dermal or epidermal
Examining skin lesions
Inspection of the lesion(s) should consider the following:
Distribution
Extensor: extensor surfaces including elbows and knees, e.g. psoriasis
Flexural: Affecting skin folds, e.g. atopic eczema
Follicular: Affecting areas with increased numbers of sebaceous glands, e.g. acne
Type, shape, colour and size of primary lesion (and presence of any secondary lesion)
Configuration of the lesion, e.g.
Discrete: individual lesions, clearly separated from one another, e.g. mole
Linear: lesions in the shape of a line (e.g. excoriations)
Annular: ring-like lesions, e.g. tinea corporis
Generalised: may suggest systemic aetiology
If a pigmented lesion, need to consider screening for signs suggestive of malignant melanoma, e.g. using the ABCDE criteria
Palpation: e.g. for temperature, tenderness (consider infection control)
Skin lesion history taking
Evolution of symptoms
How and when developed (how long ago)
Changed over time?
Associated symptoms
Itch, malaise, systemic symptoms, pain, etc.
Current or recent medications
Especially recent changes suggesting drug-induced cause
Ongoing or previous illness (medical hx.)
Some may have skin manifestations
History of allergies
Food, drug, chemicals, occupation, etc.
Exacerbating or relieving factors
treatment, weather changes, etc.
Presence of photosensitivity
Family history, e.g. skin disease, atopy, etc.
