Secondary lesions\

Question 1

Erosion

Answer 1

Horizontal loss of part or all of the epidermis. Does not involve the dermis.
Erosions heal without a scar.

Superficial erosion – in the subcorneal layer, not penetrating the basal layer.

Deep erosion – the base of the erosion is the dermal papillae.

Question 2

Ulcer

Answer 2

Lesion that extends into the dermis or deeper layers, may extend through to subcutaneous layer.
Always occurs secondary to a primary pathology.

The pathology that gives rise to the ulcers is usually seen at the border or the base of the ulcer.

Ulcers always heal with scar formation.

Question 3

Excoriation

Answer 3

An erosion or ulcer that is caused specifically by scratching.

Question 4

Fissure

Answer 4

Verical cleft in the skin.
Usually develop on chronic plaques, and covered by hemorrhagic crusts.
Develop spontaneously, ie wounds or surgical wounds are not fissures

Question 5

Crusts

Answer 5

Form when serous fluid, blood, or purulent exudate dries on the skin surface. Mixed with epithelial and/or bacterial cell debris.

Question 6

Fistula

Answer 6

Abnormal connection between a hollow space and another organ or the skin surface.

Question 7

Scales, Squames

Answer 7

Scaling, aka peeling or desquamation, shedding the outermost layer of the skin.

Composed of flakes of stratum corneum. Large flakes are called pityriasisiform. They can be adherent or loose.

Question 8

Lichenification

Answer 8

A less well defined large plaque where the skin appears thickened and the skin markings
are accentuated.

An increase in skin lines, wrinkles, and creases, due to chronic inflammation and rubbing.

Question 9

Atrophy

Answer 9

Partial or complete wasting away of the skin. Can involve any layers

Thinning and transparency of the epidermis with cigarette paper-like wrinkles. Lesion is sunken or depressed. Loss of connective tissue of the dermis.

Question 10

Scar

Answer 10

Fibrous regeneration of tissue from wound repair.
Can be hypertrophic scars that are hard and thicker or atrophic scars that are soft, with thinning of all the layers of the skin.
Keloid scars: scars that are excessively hypertrophic and extend well beyond the borders of the original lesion.

Scars form after ulcers, excoriations, fissures, and wounds, but not after erosions.