1
Q
complete morphologic description of a given skin lesion/condition must include
A
- type of lesion (primary or secondary)
- color/shape/texture
- configuration
- distribution/location
2
Q
Primary Lesions
A
- direct result of pathologic process
- macule
- patch
- papule
- plaque
- nodule
- tumor
- vesicle
- bulla
- pustule
- cyst
3
Q
Macule
A
- small spot; not palpable; < 1cm
- flat
4
Q
Patch
A
- large spot; not palpable; > 1cm
- arises de novo or through coalescence of macules
- flat
5
Q
Papule
A
- small bump; superficial, elevated, < 1 cm
- raised
6
Q
Plaque
A
- large bump; superficial, elevated, > 1 cm
- arises de novo or through coalescence of papules
- raised
7
Q
Nodule
A
- significant deep component, small bump < 1 cm
- Has Depth, Palpable
8
Q
Tumor
A
- significant deep component, large bump > 1 cm
- not neoplasm
- Has Depth, Palpable
9
Q
Vesicle
A
- small bubble, fluid-filled, usually superficial, < 0.5 cm
- fluid-filled
10
Q
Bulla
A
- large bubble, fluid-filled, can be superficial or deep, > 0.5 cm
- vesiculobullous lesions are almost always clinically important
- fluid-filled
11
Q
Pustule
A
- pus-containing bubble; often categorized as follicular or nonfollicular (wrt hair follicle)
- follicular: generally indicative of local infection
- folliculitis: superficial, generally multiple
- furuncle: deeper form of folliculitis
- carbuncle (“boil”): deeper, multiple follicles coalescing
- nonfollicular: may indicate systemic infection
12
Q
Cyst
A
- a sac containing fluid or semisolid material (cells or cell products)
13
Q
Specific Primary Lesions
A
- wheal/hive
- burrow
- comedone
- atrophy
- keloid
- fibrosis
- petechiae
- telangiectasis
- milium
14
Q
Wheals, Hives
A
- short-lived (<24 hours) edematous, well-circumscribed papules or plaques seen in urticarial
15
Q
Burrow
A
- small threadlike curvilinear papule
- virtually pathognomonic of scabies
16
Q
Comedone
A
- can be open (whitehead) or closed (blackhead)
17
Q
Atrophy
A
- thinning of epidermal and/or dermal tissue
18
Q
Hypertrophic scar, keloid
A
- hypertrophic scars
- do not overgrow original wound boundaries
- keloids
- more exuberant in growth (extending beyond wound boundaries) and more chronic in nature
19
Q
Fibrosis, Sclerosis
A
- dermal scarring/thickening reactions
20
Q
Petechiae, Purpura, Ecchymosis
A
- red cells outside the vessel walls; non-blanchable
21
Q
Telangiectasis
A
- dilated superficial dermal vessels
22
Q
Millium
A
- a small superficial cyst containing keratin (usually < 1-2 mm in size)
23
Q
Secondary Lesions
A
- result of alteration or evolution of a primary lesion (e.g. rubbing, scratching, necrosis)
- scale
- crust
- excoriation
- lichenification
- maceration
- fissure
- erosion
- ulcer
24
Q
Scale
A
- accumulation or excess shedding of stratum corneum
- very important characteristic in differential diagnosis à presence implies epidermis is at least involved in the process
- typically present in conditions with epidermal inflammation à psoriasis, tinea, eczema
25
Crust
* dried exudate (i.e. blood, serum, pus) on skin surface
26
Excoriation
* loss of skin due to scratching or picking
27
Lichenification
* an increase in skin lines/creases produced by chronic rubbing
28
Maceration
* raw, moist, wet tissue
29
Fissure
* a linear crack in the skin
* often very painful
30
Erosion
* superficial open wound, loss of epidermis or mucosa only
* usually heals without scarring
* open wound
31
Ulcer
* deeper open wound with partial or complete loss of dermis or submucosa
* usually heals with scarring
* open wound
32
Integument
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