SKIN INTEGRITY

Intact skin refers to the presence of normal skin and skin layers
uninterrupted by wounds. The appearance of the skin and skin integrity are influenced by
internal factors such as genetics, age, and underlying health of the individual as well as
external factors as activity

PRIMARY SKIN LESIONS

1. Macule, Patch - Flat, unelevated change in color. Macules are 1m to 1 cm in size and
circumscribed. Examples: freackles, measles, petechiae, flat moles.

2. Papule - Circumscribed, solid elevation of skin. Papules are less than 1 cm. Examples :
warts ,acne, pimples, elevated moles

3.Plaques - are larger than 1cm. Examples: psoriasis, rubeola.

4. Nodule, Tumor - Elevated, solid, hard mass that extends deeper into the dermis that a
papule. Nodules have a circumscribed border and are 0.5 to 2cm. Examples: squamous
cell carcinoma, fibroma. Tumors are larger than 2cm and may have an irregular border.
Examples: malignant melanoma, hemangioma.

5. Pustule - Vesicles or bulla fiiled with pus. Examples: acne vulgaris, impetigo.

6. Vesicle, Bulla - A circumscribed, round or ova, thin translucent mass filled with serous
fluid or blood. Vesicles are less than 0.5cm. Examples: herpes simplex, early chicken
pox, small burn blister. Bullae are larger than 0.5 cm. Examples: large blister, second-
degree burn, herpes simplex.

7. Cyst - 1 cm or larger elevated, encapsulated, fluid-filled or semi solid mass arising

from the subcutaneous tissue or dermis. Examples: sebaceous and epidermoid cysts,
chalazion of the eyelid.

8. Wheal - reddened, localized collection of edema fluid; irregular in shape. Size varies.
Examples: hives, mosquito bites.

SECONDARY SKIN LESIONS

1. Atrophy - A translucent, dry, paper like, sometimes wriked skin surface

resulting from thinning or wasting of the skin due to loss of collagen and elastin.
Examples: Striae, aged skin

2. Erosion - Wearing away of the superficial epidermis causing a moist, shallow

depression. Examples Scratch marks, ruptured vesicles.
3. Lichenification- rough thickened, hardened area of epidermis resulting from chronic
irritation such as scratching or rubbing. E.g. Chronic dermatitis

4. Scales - shedding flakes of greasy, keratinized skin tissue. Color may be white, gray or
silver. Examples Dry skin, dandruff, psoriasis and eczema

5. Crust - dry blood, serum, or pus left on the skin surface when vesicles or pustules
burst. Can be red-brown, orange or yellow. Examples: Eczema, impetigo, herpes, or
scabs following abrasion

6. Ulcer - deep, irregularly shaped area of skin loss extending into the dermis or
subcutaneous tissue. May bleed. May leave scar. Examples: Decubitus ulcers (pressure
sores), stasis ulcers, chancres.

7. Fissure - linear crack with sharp edges, extending into the dermis. Examples Cracks at
the corners of the mouth or in the hands, athlete's foot.

8. Scar - flat irregular area of connective tissue left after a lesion or wound has healed.
New scars may be red or purple; older scars may be silvery or white. Examples healed
surgical wound or injury, healed once.

9.Keloid - Elevated, irregular ,darkened area or excess scar tissue caused by excessive
collagen formation during healing. Extends beyond the site if the original injury. Higher
incidence in people of African descent. Examples : Keloid from ear piercing or surgery.

10. Excoriation - Linear erosion. Examples: scratches, some chemical burns