Download Basics of Skin Lesions - Yengage

DR. MALCOLM PINTO
ASSISTANT PROFESSOR
YENEPOYA MEDICAL COLLEGE
YENEPOYA UNIVERSITY
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Layers of the skin
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Types of skin lesions
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Functions of the skin
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Basics in history taking
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Morphology
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Configuration
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Distribution
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Primary lesions
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Secondary lesions
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Special lesions
Primary
lesion
Definition
Macule
Flat, circumscribed, change in colour/texture of skin
w/o surface elevation /depression (Non palpable)<1 cm
Well-demarcated, circumscribed, change in colour of
the skin >1 cm
Patch
Macules
Patches
Primary lesion
Papule
Plaque
Definition
Circumscribed, solid, raised lesion <0.5 cm
Circumscribed, solid, plateau-like lesion >0.5 cm
Plaque
Papule
Primary lesion
Definition
Nodule
Solid raised lesion, > 0.5 cm diam + deeper
component
Cyst
Encapsulated lesion with epithelial inner lining
containing liquid or semisolid material
Nodule
Primary lesion
Definition
Nodule
Solid raised lesion, > 0.5 cm diam + deeper
component
Cyst
Encapsulated lesion with epithelial inner lining
containing liquid or semisolid material
Primary lesion
Vesicle
Bulla
Definition
Circumscribed, Fluid filled, raised lesion <0.5 cm
Circumscribed, Fluid filled, raised lesion >0.5 cm
Primary lesion
Vesicle
Bulla
Definition
Circumscribed, Fluid filled, raised lesion <0.5 cm
Circumscribed, Fluid filled, raised lesion >0.5 cm
Primary lesion
Definition
Pustule
Well-circumscribed, elevated lesion containing
visible purulent exudate
Abscess
Localized accumulation of pus in the dermis/
subcutaneous tissues
Primary lesion
Definition
Pustule
Well-circumscribed, elevated lesion containing
visible purulent exudate
Abscess
Localized accumulation of pus in the dermis/
subcutaneous tissues
Primary lesion
Wheal
Telangiectasia
Definition
Evanescent , edematous , plateau-like elevations
of various sizes
Persistent dilatation of dermal capillaries, visible
as fine, bright-red streaks or in a net-like pattern
Primary lesion
Wheal
Telangiectasia
Definition
Evanescent , edematous , plateau-like elevations
of various sizes
Persistent visible dilatation of dermal capillaries,
visible as fine, bright-red streaks or in a net-like
pattern
Primary
lesion
Purpura
Definition
Reddish discoloration of skin or mucous membrane,
non- blanchable due to extravasation of red blood cells
Petechiae : < 0.3 cm
Purpura
: 0.3–1 cm (3–10 mm)
Ecchymoses: > 1 cm
Secondary skin lesions
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Scale
Crust
Eschar
Erosion
Ulcer
Fissure
Excoriation
Lichenification
Secondary lesion
Definition
Scale
Laminated masses of keratin  resulting in
perceptible flakes on the skin surface
Hardened deposits resulting from drying of
serum, blood or purulent exudate on the
surface of the skin (F)
Crust
Secondary lesion
Definition
Scale
Laminated masses of keratin  resulting in
perceptible flakes on the skin surface
Crust
Hardened deposits resulting from drying of
serum, blood or purulent exudate on the
surface of the skin (F)
Secondary
lesion
Fissure
Erosion
Ulcer
Definition
Linear, sharply defined , deep cleft through the
epidermis or into the dermis
Loss of all or portions of the epidermis
Full thickness loss of continuity of epidermis plus some
portion of the dermis associated with molecular death
Secondary
lesion
Fissure
Erosion
Ulcer
Definition
Linear, sharply defined , deep cleft through the
epidermis or into the dermis
Partial, Focal loss of superficial epidermis
Full thickness loss of continuity of epidermis plus some
portion of the dermis associated with molecular death
Secondary Definition
lesion
Excoriation Punctate or linear abrasion produced by mechanical
means, usually involving only the epidermis
Eschar
Black, hard crust resulting from tissue necrosis of the
epidermis and/or dermis
Secondary
lesion
Lichenification
Definition
Thickening of the epidermis, hyperpigmentation
and accentuation of skin markings in response to
prolonged rubbing
Secondary
lesion
Lichenification
Definition
Thickening of the epidermis, hyperpigmentation
and accentuation of skin markings in response to
prolonged rubbing
Secondary
lesion
Pokiloderma
Definition
Pigmentation (Hypo/ Hyper), atrophy,
telangiectasia
Secondary
lesion
Sclerosis
Induration
Definition
Diffuse / circumscribed induration of the skin (dermal
fibrosis)
Firm and thick skin due to dermal involvement
Secondary
lesion
Sclerosis
Induration
Definition
Diffuse / circumscribed induration of the skin (dermal
fibrosis)
Firm and thick skin due to dermal involvement
Secondary
lesion
Atrophy
Definition
Loss of tissue characterized by the loss of normal skin
markings
Special lesion
Definition
Burrow
Wavy, Slightly raised, brownish, tortuous, thread
like tunnel in the epidermis that houses scabies
mite: Sarcoptes scabiei var hominis
Special Lesion
Definition
Comedone
Papule plugging sebaceous follicle , containing
sebum and cellular debris
Papule with a dilated central opening filled with
blackened keratin (open comedo or blackhead)
Open
Special Lesion
Definition
Milia
A tiny white cyst lined by epithelium containing
lamellated keratin
Special Lesion
Definition
Target Lesion
These are less than 3 cm diameter
3 zones; Central zone of dusky erythema/purpura
Middle paler zone of oedema
Outer ring of erythema with a well-defined edge
Special Lesion
Definition
Alopecia
Loss of hair from a normally hairy area
•
Generalised : all over the body
•
Widespread : involving large areas or extensive
•
Localized : Restricted to one/ some area or the
body
•
Flexural : Body folds like groin, neck, behind ears,
popliteal and antecubital fossa
TERMS USED TO DESCRIBE
DISTRIBUTION
( The pattern of spread of lesions)
•
• Extensor : knees, elbows, shins
• Pressure areas : Sacrum, buttocks, ankles, heels
• Symmetrical : similar distribution on both sides of
the midline
• Asymmetrical : dissimilar distribution on both sides
of the midline
• Photosensitive : over areas exposed to the sun
• Acral : pertaining to peripheral parts
TERMS USED TO DESCRIBE
CONFIGURATION
( Pattern or shape of grouped lesions)
• Discrete : individual lesions separated from
each other
• Confluent : Lesions merging together
• Linear : In a line
• Annular : Like a circle or a ring
• Target : Group of rings inside each other (
concentric)
• Discoid/ Nummular : Like a coin