Revision 2018

Skin Lesion
Skin LESION

• Primary skin lesion

• Flat
Macule (patch)

• Elevated
Papule, plaque, nodule, wheal (urtika), vesicle, bulae, tumor

• Depressed
Sinus, striae

• Secondary skin lesion

• Specific skin lesion

Primary skin lesion
FLAT lesion, PRIMARY
MACULE-PATCH (Latin: macula, “spot”)
Flat, even with the surface level of the surrounding skin,
without elevation or depression, and perceptible only as an
area color different from the sorrounding skin or mucous
membrane
 PURPURA
FLAT LESION, PRIMARY
ERYTHEMATOUS MACULE-PATCH, PURPURA
•Blanchable, Pink to red color of skin or mucous
membrane that due to dilatation of arteries and
veins in the papilary and reticular dermis.
•Pressure of a glass slide (diascopy) diferentiated
from extravasated red blood cell (purpura)

MACULE
RAISED LESION, PRIMARY
PAPULE (Latin: papula)
Superficial, solid, elevated lesion less than 0.5 cm in size in which a
significant portion projects above the plane of the surrounding skin.
RAISED LESION, PRIMARY
PLAQUE
Solid, plateu-like elevated lesion that occupies a relatively large
surface area in comparison with its height above normal skin level
and has a diameter larger than 0.5 cm.diameter larger than 0,5
cm.
RAISED LESION, PRIMARY
NODULE, NODULUS
•Solid, round or elipsoidal, palpable
lesion that has a diameter:
•Nodule: > 0,5 cm,
•Nodulus≤ 0,5cm
•Main consideration: depth of
involvement and substantive
palpability, rather than diameter
•Main type: epidermal, epidermal-
dermal, dermal, dermal-
subepidermal, subcutaneus
RAISED LESION, PRIMARY
WHEAL (Hives, Urtica)
•Swelling of the skin
•Characteristic: Evanescent,
disappearing within 24-48 hours.
•Result of edema produced by the
escape of plasma through vessel walls
in the upper portion of the dermis

Example :
Kaligata/biduran
Kena ulat bulu
RAISED LESION, PRIMARY
VESICLE-BULLA
•Vesicle (<0.5cm), bulla (>0.5cm)
•Circumsribed, elevated, superficial
cavity containing fluid.
•Transparent
•Filled with blood: Hemorhagic
bulae
RAISED LESION, PRIMARY
PUSTULE-BULAE HYPOPION
•Circumscribed, superficial cavity
of the skin that contains purulent
exudate
•Diameter ≤ 0,5cm: pustule
•Diameter > 0,5cm: bula
hypopion
RAISED LESION, PRIMARY
CYST
Sac containing liquid or
semisolid materials and
may be superficial or deep
SECONDARY skin lesion
LICHENIFICATION
•Thickened skin with
accentuated marking,
resemble tree bark.
•Induce by repeated
rubbing of the skin
SCALES (Latin: squama)
•Flakes of stratum
corneum
EROSION

•Moist, circumsribed, depressed

lesion that result from loss of a
portion or all of the viable
epidermal or mucosal
epithelium

•Red and ooze, but NO

BLEEDING
EXCORIATION

•Defect in which the

epidermis the upper dermis
have been destroyed

•Result PINPOINT BLEEDING

ULCERS
•Defect depper than
excoriation, heal with
scarring
•Characteristic including:
borders, base, and
sorounding skin
FISSURE
•Linear loss of continuity of
the skin’s surface or
mucosa that result from
excessive tension or
decreased elasticity of the
involved tissue
CRUST (Latin: crusta)
•Hardened deposits that result
when serum, blood, or purulent
exudate dries on the surface of the
skin
•Serous (serosa): yellow-brown,
•Purulent (pustulosa): turbid
yellowish-green
•Hemorrhagic (“sanguinolenta”): PUSTULAR CRUST
reddish-black HEMORHAGIC CRUST
•Medicamentosa: inapropriate
medication (ex: talc)

SEROUS CRUST
SCAR (sikatriks) ATROPHIC SCAR

•Proliferation of fibrous tissue that

replaces previously normal
collagen after a wound or
ulceration breaches the reticular
dermis.
•Characteristic: deeper pink, red
color hypo/hyperpigmented.
Wrinkled appearance at the
surface, absent of adnexal stucture
•Elevated: hypertrophic scar
•Depressed: atrophic scar
•Flat: eutrophic scar EUTROPHIC SCAR

HYPERTROPHIC SCAR
ATROPHY
•Diminution in the size of cell,
tissue, organ, or part of the
body
•Appear glossy, almost
transparent, paper thin, and
wrinkled, may not retain
normal skin line
Depressed lesion
SINUS
•Tract connecting deep
suppurative cavities
STRIAE
Linear deppresions of the
skin that usually measure
several centimeters in
length and result from
changes to the reticular
colagen that occur with
rapid streching of the skin.
SPECIFIC skin lesion
• Hair folicle infundibulum that
is dilated and plugged by
keratin and lipids.
• Open comedo “black head”:
pilocebaceous unit open to the
surface of the skin with visible
keratinaceous plug. OPEN COMEDO

• Closed comedo: infundibulum

closed, follicular opening
unapparent

COMEDO: CLOSED COMEDO

Specific for acne vulgaris

Persistent dilatation of the small capilaries in the superficial dermis
that are visible as fine, bright, nonpulsatile red lines ot net like
patterns on the skin

TELANGIEcTASIA: due to prolonged topical

corticosteroid therapy
 Wavy, threadlike tunnel through the outer portion of the
epidermis excavated by parasite

BURROW:
Specific for scabies and cutaneous larva
migrans
MILIA:
SPECIFIC FOR MILIA
Shape or configuration of skin
lesion
Anular
Ring-shaped; edge of
the lesion differs from
the center
ROUND/
NUMMULAR/
DISCOID

Coin-shaped; uniform
morphology from the
edge to center
Net-like or lacy in appearance, with somewhat regulary spaced rings or
partial rigs and sparing of intervening skin

RETICULAR
SERPIGINOUS
Serpentine or snake-like
Whorled
Like marble cake, with two
distinct colors interspersed in
a wavy pattern
Polycyclic
Coalescing circles, rings, or incompleted rings

ARCUATE
Arc-shaped, incomplete formation of annular lesion

LINEAR
Resembling a straight line

TARGETOID
Target-like, with at least three distinct zones
Arrangement of multiples skin
lesion
 SCATTERED
• Irregulary distributed

Lesions clustered together

Grouped/herpetiform
DISTRIBUTION of multiples
skin lesion
Dermatomal/zosteriform
•Unilateral and lying in the distribution of a single spinal
afferent root
Blaschkoid
•Following lines of skin cell migration during embriogenesis
Lymphangitic
•Lying along distribution of a lymp vessel
Sun exposed
•Occuring in areas usually not covered by clothing
Sun protected
•Occuring in areas usually covered by clothing
Acral
•Occuring in distal locations
Truncal
•Occuring on the trunk or central body
Extensor
•Occuring in the distal locations
Flexor
•Overlying the flexor muscles of the ectremities
Intertriginous
•Occuring in the skin fold