Primary Lesions Summary

  • 1. Macule: Flat circumscribed area of change in skin color
  • 2. Papule: small circumscribed elevation of the skin
  • 3. Nodule: Solid, circumscribed elevation of the skin whose greater part is beneath skin surface (felt more than seen)
  • 4. Plaque: flat topped palpable lesion (gathering of papules)
  • 5. Vesicle: collection of clear fluid (<5mm in diameter)
  • 6. Bulla: like vesicle, but > 5 mm
  • 7. Wheal: Transient, slightly raised lesion with pale center and pink margin. Seen in urticaria.
  • 8. Purpura: Visible collection of blood under the skin e.g. Vasculitis
  • 9. Telangectasia: Dilated capillaries visible on skin surface
  • 10. Burrow: Tunnel in the skin (e.g. Scabies)

Primary skin lesions

Macule

  • (L. macula, “spot”)
  • A macule is flat; if you can feel it, then it is not a macule.

Macule Examples

Patch

  • Patches are flat but larger than macules
  • If it’s flat and larger than 1 cm, it is a patch

Patches Examples

Papule

  • A papule is a circumscribed palpable elevation of the skin less than 1 cm in diameter
  • Dermal (drug eruption, lipid deposits), epidermal (warts, molluscum), or both (lichen planus)

Plaque

  • A slightly raised lesion greater than 1 cm in diameter
  • Papules confluence (psoriasis)
  • Patch thickening (mycosis fungoides the lymphoma of the skin)

Plaques Examples

Nodule

Palpable solid deep lesion (depth > diameter)

  • Epidermal
  • Dermal

Vesicle

  • A raised lesion less than 0.5 cm in diameter containing clear fluid

Bulla

  • A vesicle that is greater than 0.5 cm in diameter is known as a bulla.

Pustule

  • A pustule is a raised lesion less than 0.5 cm in diameter containing yellow fluid, which may be sterile as in acne and pustular psoriasis, or infected.

Sterile pastules; ABCD - seen in acne, psoarsos, bacterial staph, commidone?

Wheal

  • A wheal is a transient, itchy, pink or red swelling of the skin, often with central pallor.

Cyst

palpable soft sac containing fluid.

  • Epidermal
  • Dermal

Telangiectasia

  • Dilatation of capillaries gives rise to this skin condition.

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