Skin Exam

Question 1

primary lesion descriptors?

Answer 1

Macule: flat, non-palpable, 1 cm in diameter
 Papule: elevated or depressed, palpable, 1 cm in diameter (differs from nodule because of broad and flat surface)
 Nodule: palpable, >1 cm in diameter (differs from plaque because of rounded surface)
 Vesicle: fluid-filled blister, 1 cm in diameter
 Pustule: pus-filled blister
 Wheal: edematous papules and plaques that are characteristic
of hives
 Telangiectasia: dilated blood vessels
 Purpura: area of hemorrhage; can be flat or elevated
 Petechiae: pinpoint purpura

Question 2

secondary lesions terminology?

Answer 2

 Scale: accumulation of stratum corneum
 Crust: dried serum, pus, or blood
 Lichenification: epidermal thickening with accentuation of
skin markings
 Induration: dermal thickening causing firm feeling
 Excoriation: linear erosion caused by scratching
 Erosion: open area with partial or full loss of epidermis
 Ulcer: open area with loss of part of dermis
 Fissure: linear ulcer

Question 3

color terminology?

Answer 3

***Do not use “erythematous” as it is not specific enough
 Light pink, bright pink, salmon-pink, pink-red
 Brick red, bright red, red-purple, dusky red
 Hyperpigmented, tan, light-medium-dark brown
 Hyopigmented, depigmented, blanched, white
 Violaceous, lilac, purple
 Yellow-orange

Question 4

configuration terminology?

Answer 4

Configuration (shape of individual lesions or arrangement of multiple lesions)
 Round
 Nummular: coin-shaped
 Geographic: irregularly-bordered like a continent
 Polycyclic: multiple round lesions coalesced together
 Serpiginous: wavy lines
 Annular: ring-like with central clearing
 Arcuate: curved
 Linear: straight line
 Targetoid: like a bulls-eye with at least 3 zones of color (contrast with annular which only has 2 zones)
 Polygonal: resembling a polygon
 Reticulate or retiform: net-like
 Stellate: star-shaped

Question 5

distribution terminology?

Answer 5

 Generalized: involving the entire body
 Sun-exposed or photo-distributed: on places that are typically exposed to the sun
 Acral: affecting distal limbs
 Blaschkoid: following Blaschko’s lines (ectodermal development lines)
 Dermatomal: following skin areas supplied by a single spinal nerve
 Symmetrical: equally affecting both sides of the body
 Unilateral: affecting only one side of the body
 Intertriginous: within body folds