Terminology

Question 1

Macule

Answer 1

a small flat lesion with a change in color but no elevation, depression, or change in texture. It has a discernable border with the normal skin surrounding it. Descriptors include the sharpness of borders (sharply vs poorly demarcated) and the character of the borders (eg, smooth, scalloped, geographic, angular, stellate, etc).

Question 2

Patch

Answer 2

a flat lesion that is larger than a macule. Boundary between macule & patch is 5mm or 10mm.

Question 3

Papule

Answer 3

a discrete firm lesion that is elevated above surrounding skin. Descriptors include flat-topped, dome-shaped, conical, acuminate, follicular, umbilicated, pedunculated, hyperkeratotic, lichenified (often in combination).

Question 4

Plaque

Answer 4

is a papule with a diameter >5mm or 10mm. It can be a single large papule or a cluster of coalescing papules. Descriptors include those for papule plus linear, arcuate, annular, & more.

Question 5

Nodule

Answer 5

discrete, palpable, usually round or oval lesion of the skin >1cm in diameter. Applies to processes involving any or all levels of the skin. Can be benign or malignant. Can involve any tissue of the skin. Nodules are often spherical and involve both depth & elevation. Can be soft (eb, lipoma), firm (keloid), or hard. Descriptors include lobulated, spherical, lens-shaped.

Question 6

Tumor or mass

Answer 6

an even larger solid lesion that also can be either benign or malignant

Question 7

Wheal

Answer 7

(also called hives or urticaria) a plaque caused by temporary edema in the upper dermis. Usually flat-topped and no epidermal change (eg scale or lichenification). Can vary in size & shape. Color is often light pink but may be bright red, even very pale, or red along margins and pale in the middle. This is not due to pigmentary change but to degree of dilation of blood vessels in the superficial dermis. Wheals blanch upon pressure. Descriptors include round, annular, arcuate, polycyclic, with round or arcuate configurations. Should be distinguished from angioedema, massive edema involving the entire dermis & subcutaneous tissues.

Question 8

Vesicle

Answer 8

a small, circumscribed, usually elevated, fluid-filled lesion

Question 9

Bulla(e)

Answer 9

a large vesicle >5mm (or 10mm). May attain diameters of several cms. Descriptors include tense vs flaccid/fragile; hemorrhagic.

Question 10

Pustule

Answer 10

a circumscribed, elevated lesion containing purulent material. Some regard this as a secondary lesion, specifically a vesicle whose contents evolve from serum → pus.

Question 11

Cyst

Answer 11

A palpable, compressible nodule with distinct borders. On palpation, it seems to be spherical with fluid or semi-solid contents.

Question 12

Comedo

Answer 12

(plural = comedones): Dilated orifice to a hair follicle filled with a plug made of keratin & sebum. Closed comedones are whiteheads; open comedones are blackheads.

Question 13

Cutaneous horn

Answer 13

discrete, hard or keratotic papule with an outward projection that is greater than the lesion’s diameter at its base. Generally cylindrical with same diam from base to end.

Question 14

Telangiectasia

Answer 14

permanent dilation of superficial blood vessels, nonpalpable

Question 15

Petechiae

Answer 15

Tiny purpuric macule, about 1mm (or smaller) in diameter,

Question 16

Pupura

Answer 16

Non-blanching discoloration of skin due to blood vessel damage that permits blood to escape, either in large amounts or as small numbers of red blood cells. Color may range from bright red to reddish-purple to puplish-black (when surrounding tissue is necrotic) or rust-colored (when lesions are several days to weeks old). Often flat (macular or patch) but may be elevated if blood vessels are inflamed (palpable purpura is regarded as a sign of vasculitis). Does not apply to congenital vascular birthmarks.

Question 17

Angioma or Hemangioma

Answer 17

Elevated lesion (papule or plaque) made of blood vessels. Can be congenital or acquired.

Question 18

Ecchymosis

Answer 18

Large lesion of purpura, may be palpable

Question 19

Telangiectasia

Answer 19

a dilated superficial blood vessel that blanches on pressure

Question 20

Atrophy

Answer 20

thinning of the epidermis or dermis or both, that usually causes a depression in the skin. Epidermal atrophy usually causes a shiny, easily wrinkled surface to the skin. Dermal atrophy often produces a slight depression in the skin and allows one to see blood vessels

Question 21

Burrow

Answer 21

an irregular, linear tunnel found in the uppermost part of epidermis. It is usually slightly raised and bordered by red, itchy skin. Caused by scabies

Question 22

Erosion

Answer 22

a superficial denudation of the skin, usually implying focal loss of the epidermis. Usually oozing or moist. Does not lead to scarring

Question 23

Excoriation

Answer 23

scratch mark that removes the epidermis, leaving a linear erosion. There is usually serous or bloody exudate

Question 24

Crust

Answer 24

Crust

Question 25

Eschar

Answer 25

Thick, usually black, crust over an ulcer or necrotic tissue.

Question 26

Fissure

Answer 26

Linear or elongate, wedge-shaped (“canyon-shaped”) splits or cracks extending into dermis.

Question 27

Pustule

Answer 27

discrete elevated vesicle or bulla of skin, usually small, containing purulent exudate composed of inflammatory leukocytes (pus), with or without cellular debris. May be superficial, deep-seated, follicular, grouped, etc, and may arise secondarily from a vesicle.

Question 28

Scar

Answer 28

a lesion composed of dense fibrotic tissue covered by an intact epidermis. Indicates a healed (or healing) injury from any sort of process (trauma or disease). Scars may be small (papules) or large (plaques); elevated or depressed (or level with the surrounding skin); firm or atrophic.

Question 29

Scale

Answer 29

a thin flakes (or flaking layers) of epithelium that is separated from the underlying intact skin proper. Scales are mostly composed of the uppermost layer of the epidermis the stratum corneum.

Question 30

Striae

Answer 30

A special type of atrophy where dermis or epidermis (or both) has been stretched, weakened, and thinned. Usually reveals fine pink or silver lines.

Question 31

Ulcer

Answer 31

circumscribed loss of tissue extending through the epidermis and into the dermis (or even deeper into subcutaneous fat). Ulcers are deeper than erosions. Since the dermis is involved, these heal with scars. Ecthyma is the term for an ulcer caused by a bacterial pathogen.

Question 32

Acral

Answer 32

Involving extremities (hands, feet, ears, etc)

Question 33

Annular

Answer 33

Ring-shaped with central clearing

Question 34

Arcuate

Answer 34

Arc-shaped (incomplete circles)

Question 35

Blanching

Answer 35

A reddish hue caused by dilated dermal blood vessels that is reversed or suppressed with direct pressure

Question 36

Confluent

Answer 36

Running together

Question 37

Contiguous

Answer 37

Touching or adjacent

Question 38

Discrete

Answer 38

Distinct and separate

Question 39

Discoid

Answer 39

round (without central clearing); nummular

Question 40

Diffuse

Answer 40

Scattered, widely distributed (= diffuse)

Question 41

Eczematous

Answer 41

Eruption characterized by red, itchy, scaling (or crusting), & oozing

Question 42

Generalized

Answer 42

Scattered, widely distributed (= generalized)

Question 43

Grouped

Answer 43

Arranged in clusters. Individual lesions may be discrete or contiguous

Question 44

Guttate

Answer 44

Abundant, small, drop-like lesions

Question 45

Herpetiform

Answer 45

Grouped vesicles on a red base (resembling herpes simplex)

Question 46

Iris

Answer 46

Arranged in concentric circles giving a targetoid or bull’s-eye appearance

Question 47

Lichenification

Answer 47

Thick, rough epidermis accentuating normal skin lines, due to rubbing or friction.

Question 48

Linear

Answer 48

Arranged in a line

Question 49

Livedoid

Answer 49

Subtle bluish netlike macular appearance due to that follows blood vessels

Question 50

Localized

Answer 50

In a limited area

Question 51

Nummular

Answer 51

Coin-shaped; round without central clearing

Question 52

Pedunculated

Answer 52

An exophytic lesion that has a stalk

Question 53

Petechial

Answer 53

Small non-blanching purpuric macules, usually multiple lesions, all

Question 54

Polycyclic

Answer 54

Coalescing annular lesions. Circles that have fused together

Question 55

Reticulate

Answer 55

Netlike

Question 56

Serpiginous

Answer 56

Snake-like, creeping

Question 57

Sessile

Answer 57

An exophytic lesion (usually papule or nodule) that has base wider than elevation

Question 58

Stellate

Answer 58

Star-shaped (a circumscribed lesion with sharply-demarcated angular borders)

Question 59

Symmetric

Answer 59

Balanced on both sides

Question 60

Targetoid

Answer 60

Arranged in concentric circles giving an iris-like or bull’s-eye appearance

Question 61

Telangiectatic

Answer 61

Referring to dilated terminal capillaries

Question 62

Umbilicated

Answer 62

having a central dell or depression (usually refers to a papule).

Question 63

Vegetating

Answer 63

lushly growing, proliferating process, usually with exophytic features. May be soft or hard.

Question 64

Verrucous

Answer 64

with a wart-like, keratotic surface

Question 65

Zosteriform

Answer 65

Resembling shingles, following a unilateral dermatome

Question 66

Hypopigmentation

Answer 66

decrease in normal pigment and therefore lighter colored than surrounding skin

Question 67

Depigmentation

Answer 67

complete loss of melanin-derived pigment, which leaves the skin porcelain white

Question 68

Hyperpigmentation

Answer 68

darkened skin due to excessive melanin deposits in epidermis, dermis, or both