PHYSICIANS MUST LEARN TO READ THE SKIN
►The basic skin lesions are the essential elements upon which clinical diagnosis rests.
►To read wards, one must recognize the basic letters; to read the skin, one must recognize the basic skin lesions.
►To understand a paragraph, one must know how the wards are put together; to arrive at a differential diagnosis, what the basic lesions represents, how the are arranged and distributed, when they occur together, and how they evolve.
International league of Dermatological society
►The lack standardization of basic terminology has been one of the principal barrier to successful communication among physicians in describing skin lesions.
►Example: the papule is variously described as not greater than 1 cm in size, less than 0.5 cm, smaller than a pea or ranging from the size of a pinhead to that of a split pea.
►The international league of Dermatological societies has published a glossary of basic skin lesions that provides a helpful step in this direction.
►The following visual glossary of current descriptive nomenclature is presented with some examples:
ILASTREATED GLOSSARY of basic skin lesions
PRIMARY LESIONS SECONDARY LESISONS
Macule Scale
Patch Crust
Papule Erosion
Plaque Excoriation
Nodule Ulcer
Cyst Fissure
Vesicle Scar
Bulla Atrophy
Pustule Striae
Abscess Sinus
Wheal, Burrow, Conmedo Telangieactasis, Petechiae, Purpura, Echimosis, Haematoma & Papiloma.
PRIMARY LESIONS
MACULE
ðSimply a change of color of the skin.
ðYou can not feel them and, if you close your eyes, they disappears.
ðThe most common color changes are white, brown and red (erytematous and purpuric)
PATCH
ðA large macule with or without overlying fine scale.
ðExample: melasma, vascular nevus (salmon), ptyriasis rosea.
PAPULE
ðA small elevated skin lesion, less than 0.5 cm in diameter.
ðExample: warts, nevi (mole) and molluscum contagiosum.
PLAQUE
ðAn elevated, flat-topped plateau-like lesion greater than 0.5 cm in diameter but without substantial depth.
ðExample: psoriasis, chronic eczematous dermatitis.
NODULE
ðAn elevated, marble-like lesion greater than 0.5 cm in both diameter and depth.
ðExample: erythema nodosum, BCC, Pyogenic granuloma and lipoma.
CYST
ðAn walled-off lesion filed with expressible materials that is either liquid or semisolid.
ðThey feel like an eyeball.
ðExample: pilar and epidermoid cysts.
VESICLE (small) and BULLA (L. blisters)
ðBlisters filled with clear fluid.
ðVesicles are less than, and bullae are greater than 0.5 cm in diameter.
ðExample ( vesicle): H. simplex, chickenpox and acute T. pedis
