Lesion Recognition

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    Up to 1 cm in size
    • Papule: Due to infiltration of inflammatory cells
    • Example: flea bites, sarcoptic mange, bacterial folliculitis
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    Hint: purulent material
    • Pustule: small, circumscribed elevation- contain mostly neutrophils
    • Intraepidermal, follicular, non-follicular
    • Examples: bacterial infection, Pemphigus foliaceus
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    Hint: Many papules together
    • Plaque: Palpable, flat-top elevation
    • Formed by coalition of papules
    • Examples: Eosinophilic plaque in cats (cutaneous hypersensitivity)
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    Hint: Appear and disappear within minutes to hours
    • Wheals (Hives): Sharply circumscribed, raised lesion
    • Consists of edema
    • Examples: Urticaria, insect bites
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    Hint: <1cm in size
    • Macule: Flat, non-palpable, circumscribed discoloration <1 cm
    • No surface elevation or depression
    • Examples: Vitiligo, Lentigo, Acute erythema
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    Hint: >1 cm in size
    • Patch: Flat, non-palpable, circumscribed skin discoloration
    • No surface elevation or depression
    • Examples: Vertiligo, Lentigo, Acute erythema
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    Hint: contains fluid
    • Vesicle: Sharply, palpable, circumscribed, elevated lesion <0.5cm
    • Example: viral disease, autoimmune disease
    • Do impression smear to differentiate between PUSTULE and VESICLE
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    Hint: Bigger form of vesicle
    • Bulla: Sharply circumscribed, palpable, elevated lesion > 0.5cm
    • Contains fluid
    • Example: Autoimmune disease
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    Hint: will extend into dermis
    • Nodule: Solid, circumscribed, elevated lesion >1cm
    • Examples: Neoplasia (inflammatory cutaneous lymphoma), Granuloma
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    Hint: usually benign
    • Cyst: A nodule that contains fluid or semisolid  material
    • Examples: follicular cyst, infundibular cyst, Acne
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    Hint: sometimes called "Scab"
    • Crust: colleciton of cellular debris, dried exudate, inflammatory cells, blood
    • Regression from Primary lesions: pustules,vesicles, bulla
    • Example: later stage of Pemphigus foliaceus
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    Hint: can heal without scarring
    • Erosion: A partial loss of epidermis
    • Does NOT penetrate basement membrane
    • Examples: Erythema multiforme
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    Hint: big sister of erosion
    • Ulcer: A full loss of epidermis
    • Will penetrate BEYOND basement membrane
    • Heals with scarring in chronic cases
    • Lesion will usually bleed easier than erosion
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    Hint: caused by scratching
    • Excoriation: Linear erosion induced by scratching or trauma
    • Seen in puritic dermatoses
    • Examples: Atopic dermatitis, scabies, pyoderma
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    Hint: NOT caused by trauma
    • Fissure: Vertical loss of epidermis and dermis which sharply defined walls/crack in skin
    • Found in foot pads and nose
    • Example: Hepatocutaneous syndrome
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    Hint: you don't need one. Figure it out
    • Scar: A formation of new connective tissue (fibrosis)
    • Implies prior dermo-epidermal damage
    • Example: Cutaneous lupus erythematosus
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    Hint: Footprint of a pustule
    Epidermal collarette: circular ring of scales, small and does not expand
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    Hint: tree bark
    • Lichenification: Marked thickening of all layers of the epidermis
    • Resembles tree bark
    • Caused by chronic rubbing/scratching
    • Accentuation of skin lines
    • Examples: canine atopic dermatitis
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    Hint: stratum corneum
    • Hyperkeratosis: Increase in the thickness of the stratum corneum
    • Associated with low-grade trauma, secondary infection, other skin diseases
    • Example: Atopic dermatitis with malassezia dermatitis
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    Hint: caused by disease such as dermatophytosis
    • Spontaneous Alopecia: Border of lesion usually have a sharp margin
    • Tip of the hair not affected
    • Easily epilate hair shafts
    • Example: dermatophytosis, demodicosis, ischemic dermatopathy
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    Hint: self-induced
    • Self-Induced Alopecia: Border of lesion may have indistinct margin
    • Tip of hair usually broken
    • Hair not easily epilated
    • Exampled: any disease that could cause puritis and pain
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    Hint: sometimes called "flakes"
    • Scale: Accumulation of loose fragments of the stratum corneum
    • Due to disorder of maturation of epidermis or glandular secretions
    • Primary lesions: Primary seborrhea of Cocker spaniel, Sebaceous adenitis, Ichthyosis
    • Secondary lesions: Xerosis (dry skin), Flea allergy dermatitis, Canine atopic dermatitis, Pyoderma
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    Hint: accumulation of stuff....
    • Follicular Cast: Accumulation of keratin and sebaceous material that adheres to the hair  shaft
    • Example: primary seborrhea, dermatophytosis
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    Hint: Black heads
    • Comedo: Dilated hair follicles filled with cornified cells, and sebaceous  and sweat glands secretions
    • Example: feline chin acne, demodicosis
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    Hint: What is the color of skin lesion?
    • Erythema: redness of skin, caused by congestion of blood vessels in dermis
    • Blanches (disappears) on pressure- diascopy
    • Examples: Allergic dermatosis, cutaneous drug reaction
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    Hint: what color is the skin lesion?
    • Petechia: dark red to purple coloration, caused by extravasation of RBC into dermis (hemorrhage)
    • Does NOT blanch on pressure
    • Petechia < purpura < ecchymosis
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    Hint: less color
    • Hypopigmentation: lighter than normal skin color
    • Different than Depigmentation
    • Examples: Vitiligo, Cutaneous lymphoma, Albinism, Uveodermatologic syndrome
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    Hint: more color
    • Hyperpigmentation: darker than normal skin color
    • Example: Lentigo si
    • mplex, Hypothyroidism, Post-inflammatory
Card Set
Lesion Recognition
Recognition of skin lesions