a flat & generally less than 0.5 cm area of skin or mucous membranes with different color from surrounding tissue. Macules may have nonpalpable & fine scale
patch
a flat & generally greater than 0.5 cm area of skin or mucous membranes with different color from surrounding tissue. Patches may have nonpalpable & fine scale
cyst
raised & smooth; a closed cavity or sac containing fluid or semisolid material. A cyst may have an epithelial or endothelial or membranous lining
nodule
raised & smooth; a dermal or subcutaneous & firm & well-defined lesion that is usually greater than 0.5 cm in diameter
papule
raised & smooth; a papule is a discrete & solid & elevated body that is usually less than 0.5 cm in diameter. Papules are further classified by shape & size & color & surface change
plaque
raised & smooth; a plaque is a discrete & solid & elevated body that is usually broader than it is thick & measuring more than 0.5 cm in diameter. Plaques may be further classified by shape & size & color & surface change
crust
surface change; a hardened layer that results when serum (yellow-brown) or blood(red-black) or purulent (yellow-green) exudate dries on the skin surface. Crusts may be thin or thick & can have varying color.
scale
surface change; results from excess stratum corneum that accumulates in flakes or plates. Scale usually has a white or gray color.
bulla
fluid-filled; greater than 0.5 cm in diameter; can be clear or serous or hemorrhagic or pus-filled; a large vesicle
pustule
fluid-filled; a circumscribed elevation that contains pus; usually less than 0.5 cm in diameter
vesicle
fluid-filled; less than 0.5 cm in diameter; fluid may be clear or serous or hemorrhagic or pus-filled
erythema
localied & blanchable redness of the skin or mucous membranes; no leakage of blood flow (allows blanching to occur)
erythroderma
generalized & blanchable redness of the skin that may be associated with desquamation; no leakage of blood flow (allowing blanching to occur)
telangiectasia
a visible & persistent dilation of small superficial cutaneous blood vessels; will blanch
ecchymosis
a purpuric lesion; an extravasation of blood into the skin or mucous membranes; may progress over time from blue-black to brown-yellow or green; do not blanch because blood has leaked outside the vessels into the surrounding skin
petechiae
(initlally) purpuric lesions; non-blanchable macules resulting from tiny hemmorhages; can be differentiated from pigmented lesions by color; do not blanch
palpable purpura
a purpuric lesion; raised & palpable discoloration of skin or mucous membranes due to vascular inflammation in the skin & extravasation of blood; do not blanch
atrohpy
sunken lesion; a thinning of tissue defined by its location (epidermal vs. dermal vs. subcutaneous atrophy)
erosion
sunken lesion; a localized loss of the epidermal or mucosal epithelium
ulcer
sunken lesion; a circumscribed loss of the epidermis and at least upper dermis
gangrene
necrotic & usually black tissue due to obstruction or diminution or loss of blood supply; may be wet (often follows a crushing injury & has an offensive odor & spreads rapidly) or dry (affected area becomes cold & dry & shriveled)
eschar
a scab or dry crust that results from trauma or infection or excoriating skin disease
tumor
raised & smooth; a large nodule
milia (s. milium)
raised & smooth; superfcial cysts
wheal
also called a hive; a firm & edementous plaque resulting from inflitration of the dermis with fluid; are transient & may last only a few hours
target lesion
a dusky red & round maculopapule with a classic 'iris' appearance. Results from centrifugal spread of the red maculopapule to a circumference of 1 - 3 cm as the center becomes cyanotic or purpuric or vesicular. Consists of two distinct zones: an inner zone of acute epidermal injury with necrosis or blisters & an outer zone of erythema.
burrow
a narrow & elevated & tortuous channel produced by a parasite
comedones (s. comedo)
open = blackhead; closed = whitehead
desquamation
a normal process in which the cornified layer of the epidermis is sloughed off in fine scales or sheets
excoriation
an erosion caused by scratching; often linear
fissure
a linear loss of epidermis & dermis with sharply defined & nearly vertical walls
lichenification
an area of thickened epidermis induced by scratching; skin lines are accentuated so the surface looks like a washboard
induration
thickening of the skin caused by a process below the epidermis
agminted lesions
clustered lesions
serpiginous lesions
snakelike or serpentine in shape
annular lesions
ring-shaped
acral
a pattern of skin lesions involving the distal aspects of the head & the extremities
dermatomal
a pattern of skin lesion distribution in which the lesions follow the sensory skin innervation of a particular nerve root; do not cross the midline of the body
intertriginous
a pattern of skin lesions inovolving creases & folds
lyphangitic
a pattern of skin lesions appearing along the path of the lymph channels of the leg or arm
photodistributed
a pattern of skin lesions that follows the sun-exposed skin
arcuate lesions
arc-shaped
polycyclic lesions
formed from coalescing circles or rings or incomplete rings
reticulate lesions
netlike
dermatitis
inflammation of the skin
atopic dermatitis
common chronic & itchy dermatitis that waxes & wanes; occurs in up to 20% of children & 1% of adults; exact etiology unknown; associated with asthma & allergy
contact dermatitis
caused by contact; may be irritant (could irritate anyone's skin with enough exposure) or allergic (type IV delayed hypersensitivity reaction - exposure causes sensitization)
stasis dermatitis
occurs in patients with chronic swelling of the lower legs frpm venous insufficiency; compromised circulation to the skin leads to dryness & inflammation; most often involves medial ankle
lichen simplex chronicus
may or may not be an underlying dermatitis; itching leads to scratching which leads to lichenification (thickening) of the skin; results in cycle
white dermatographism
occurs in patients with atopic dermatitis; normal red blanching turns white as a result of over-correction (over-vasodilation); indicates hypersensitivity
spongiotic
edematous skin; appears 'sponge-like' due to increased fluid-filled intercellular spaces
acanthosis
thickening of the epidermis; typical of chronic dermatitis (emerges due to constant scratching)
acute dermatitis
characterized by edema; edema fluid may emerge from the surface as an ooze or crust; fluid may pool under surface if stratum corneum is thick
pediatric vs. adult atopic dermatitis
pediatric - tends to be itchy & on extremities/cheeks & affect extensor surfaces; adult - tends to affect flexor surfaces & spare head/face
chronic stasis dermatitis
characterized by erythema & red-brown discoloration due to deep deposits of hemosiderin (product of degraded RBCs)
pathophysiology of stasis dermatitis
once thought to be related to hypoxia (now shown to be untrue); related to increased hydrostatic pressure -> leakage of fibrinogen -> fibrin cuffs
Rhus dermatitis
contact dermatitis response to plants from the genus Rhus (contain oleoresins); Rhus includes poison ivy & mango skin; generally erupts within 2 days; tends to present with linear lesions where plant stroked skin - papules then vesicles; can be treated by washing within 10 minutes; later treatment with calomine but NOT topical Benadryl (can sensitize) or with topical corticosteroids if severe
neomycin
topical antibiotic; highly sensitizing; often produces allergic contact dermatitis