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The major types of primary lesions are:

• Macule. A small, circular, flat spot less than a quarter of an inch wide. The color of a macule is different from nearby
skin, and are usually brown, white, or red. Freckles and flat moles are considered macules. Macules bigger than an
inch are called patches.
• Vesicle. A raised lesion less than a a quarter of an inch across filled with clear fluid; vesicles bigger than this are
called blisters. Vesicles may be caused by sunburn, insect bites, chemical irritation, or some viral infections, such as
cold sores.
• Pustule. A raised lesion filled with pus usually caused by an infection, such as impetigo or boils.
• Papule. A solid, raised, rough lesion that may be red, pink or brown. A patch of closely-grouped papules is called a
plaque. Papules are associated with conditions such as warts, syphilis, psoriasis, or skin cancer.
• Nodule. A solidlesion with distinct edges that is usually more deeply rooted than a papule.A nodule feels like a hard
mass, distinct from the skin around it. A large nodule is called a tumor.
• Wheal. A raised skin lesion that can be itchy and usually disappears soon after it appears. Wheals are generally part
ofan allergic reaction.
• Bulla (plural bullae) is a rounded or irregularly shaped blister containing serous or seropurulent fluid, greater than 1
cm in diameter
• Cyst is a closed sac having a distinct membrane and division on the nearby tissue. It may contain air, fluids, or semi-
solid material
• Petechia is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood
• Purpura is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They
are caused by bleeding underneath the skin.

The major types of secondary skin lesions are:

• Ulcer. Lesion that erodes the upper portion of the skin and part of the lower portion beneath. Ulcers can be caused by
conditions such as bacterial infection or injury, or frommore long-lasting problems such as scleroderma. An ulcer that
looks like a deep crack in the skin is called a fissure.
• Scale. A dry build-up of dead skin cells that often flakes off the surface of the skin. Diseases that cause scale include
fungal infections and psoriasis.
• Crust. A dried collection of blood, serum, or pus. Also called a scab, a crust is often part ofthe normal healing process
of many infectious lesions.
• Excoriation. A hollow, crusted area caused by scratching or picking at a skin sore.
• Scar. Discolored, fibrous tissue that permanently replaces normal skin after the tissue has been destroyed. A very
thick and raised scar is called a keloid.
• Comedo
-blackhead (medically known as an open comedo) is a yellow or blackish bump or plug on the skin
-whitehead (medically known as an close comedo) non inflamed pore blocked with sebum, a symptom of acne
• Epidermal collarette. A feature of a skin lesion, consisting of an encircling rim of epidermal scale with the free edge
toward the central area. May represent the margins of an earlier bulla, vesicle or pustule. Characteristic of bullous
• Induration hardening of an area of the body as a reaction to inflammation, hyperemia, or neoplastic infiltration
• Erosion is caused by loss of the surface of a skin lesion; it is a shallow moist or crusted lesion.
• Fissure is a thin crack within epidermis or epithelium, and is due to excessive dryness.
• Lichenification is caused by chronic rubbing, which results in palpably thickened skin with increased skin markings
and lichenoid scale. It occurs in chronic atopic eczema and lichen simplex.
• Sclerosis. Hardened scar-like tissue.
• Hyperpigmentation may be due to hypermelanosis or haemosiderin deposits that result in skin colour that is darker
than normal.