Dermal pathology

1. Terminology
a. Primary lesions
i. Definition of what a primary lesion is
ii. Macule
iii. Papule
iv. Nodules
v. Plaque
vi. Wheal
vii. Vesicles and bullae
viii. Pusules
ix. Abscess
x. Cyst
xi. Atrophy
xii. Sclerosis
xiii. Erosion
xiv. Ulcer
b. Secondary skin lesions
2. What features would indicate to you that a lesion is benign or
malignant
TOPIC Describing skin lesions
1. Skin
a. Function
b. Layers
2. Types of skin lesions
a. Primary
i. An area of tissue with impaired function due to
damage by trauma or disease
1. Macule
2. Patch
3. Papule
4. Nodule
5. Plaque
6. Vesicle
7. Bulla
8. Pustule
9. Abscess
b. Secondary
i. A lesion arising as a consequence of any primary
lesion
1. Scale
2. Crust
3. Ulcer
4. Fissure
5. Atrophy
6. Lichenification

3. Considerations (What features would indicate to you that a

lesion is benign or malignant?)
a. Features to note
i. Size
ii. Type
iii. Shape and symmetry
iv. Colour and pigmentation
v. Surface features (smooth; rough)
vi. Distribution over the body (extensor; flexor
surfaces)

Power point presentation: Understanding and describing lesions

Slide 1 - Purpose
It is important to understand and be able to systematically describe
the different features and observable patterns of skin lesions. This
aids in the communication of observable features between health
professionals (for example when making a referral), documentation
and record keeping purposes, and is the first step in making a full
assessment, differential diagnosis, and identification of a presenting
cutaneous condition.
Slide 2 : What is skin?
Normal skin
- Form
- Function
What is a lesion?
A lesion is any single area of altered skin. It may be solitary or
multiple.
Slide 3: Describing a typical lesion
How to describe a lesion Following the clinical examination, a typical lesion can be described
in terms of its:
- Type
- Surface features
- Colour (including erythematous or non-erythematous)
- Border (well/poorly defined, or accentuated)
- Size, shape, and symmetry (includes round, irregular,
serpiginous)
- Location
Slide 4: Types of skin lesions
Skin lesions can be subdivided into primary lesions and secondary
lesions.
Primary lesions
- Primary lesions are directly caused by the disease process
Types of primary lesions
- Macule
o
o Freckles, moles, rubella, measles
- Papule
o Naevi, warts, lichen planus, some forms of acne
- Nodules

o Cysts, lipomas, and fibromas

Plaque
o Pso
Vesicles
Bullae
Pustule
Urticaria (wheals)
Abscess
Cyst
Atrophy
Ulcer

Secondary lesions
- Secondary lesions are a result of the disease process
Types of secondary lesions
- Scar
- Crusts
- Lichenification

Use the descriptors from the following website

http://www2.kumc.edu/internalmedicine/students/ambulatory/dermk
estenhandout61003.pdf
Slide 4: Surface features of lesions
- Normal/smooth (i.e. same as the surrounding skin)
- Scaly
o Excess dead epidermal scales produced by shedding
from stratum corneum or abnormal keratinisation
- Hyperkeratotic
o Increased keratinisation (cornifica
- Warty
- Crust
- Exudate
- Excoriated
https://books.google.com.au/books?id=zpsb9e63AcC&pg=PA32&lpg=PA32&dq=description+of+surface+fe
atures+of+skin+lesions&source=bl&ots=Ddmx_zW2uI&sig=6uJq7Q
X5wV9nKntAuU6UFpNTigc&hl=en&sa=X&ved=0CDwQ6AEwBWoVCh
MI0J3wi4XHyAIVRd-mCh2LBgta#v=onepage&q=description%20of
%20surface%20features%20of%20skin%20lesions&f=true
Use page 33
Slide 5: Colour of the lesion

Including erythematous or non-erythematous

Red skin
Orange skin
Yellow Skin
Green fingernails
Violet skin
Shades of blue, silver, and gray
Black skin

Slide 6: Borders
- Well/poorly defined
Slide
-

7: Size and shape of individual lesion

Linear lesions
Annular lesions
Nummular lesions
Target (bulls eye or iris) lesions
Serpiginous lesions
Reticulated lesions
Herpetiform
Zosteriform

http://www.msdmanuals.com/en-au/professional/dermatologicdisorders/approach-to-the-dermatologic-patient/description-of-skinlesions