Skin Lesion Report: 1) Location 2) Type 3) Color 4) Shape: circular, annular, serpiginous, umbilicated 5) Size 6) Margin/ border 7) Consistency:

soft, hard, dry, mobile, tender 8) Polar: single or multiple 9) Distribution: isolated, scattered, group, herpetiformis, annular, arciform, linear, reticular, polycylic Flat lesion Macule Infarct Sclerosis Teleangictasis Elevated lesion Papule Plaque Nodule Wheal Vesicle and bulla Pustule Abscess Cyst Exudate Scales Scar Lichenification Depressed lesion Atrophy Sclerosis Erosion Excoriation Ulcer Sinus Gangrene

Primary Lesions 1. Macule and Patch Macule: circumscribed, flat lesion that differs from surrounding skin because of its color. Macule < 1cm; Patch> 1cm Examples: Hypopigmentated macule and patch (Ptyriasis versicolor) Depigmentated macule and patch (Vitiligo) Hypopigmentated macule and patch (Ptyriasis alba) Hyperpigmentated macule (Linear whorled neviod hypermelanosis) Hyperpigmentated macule and patch (Freckles) Hyperpigmentated patch (Melasma) Erythematous patch (malar rash with SLE)

2. Papule Papule: small, solid, elevation lesions, which smaller than 0.5cm Examples: Keratosis pilaris (flat top papule) Moluscum contagiosum (dome shape papule) 3. Plaques Elevation that occupies a relatively large surface area compare to its height, confluence of few papules Examples: Psoriasis Tinea Cruris Morbus Hansen Verrucous plaque (Veruca Vulgaris) Verrucous plaque (Giant condyloma acuminata) 4. Nodules Palpable, solid, round, or ellipsoidal lesion Examples: Hemangioma Prurigo nodularis Erythema Nodusum Leprosum Granuloma pyogenicum 5. Pustule Circumscribed raised lesion hat contains a purulent exudate Examples: Acne Vulgaris Psoriasis Pustulosa Foliculitis 6. Vesicle and bullae Circumscribed, elevated lesion contain fluid. <1cm= vesicle; >1cm= bullae Examples: Herpes zooster Friction bullae 7. Urticaria/Wheals Rounded or flat-topped elevated papule / plaque that evanescent, dissapearing within hours

Secondary skin abnormalities 1. Scale Abnormal sheeding or accumulation of stratum corneum in perceptible flakes. Examples: Exfoliative dermatitis Staphylococcus scalded skin syndrom Psoriasis Psoriasis pustulosa (keratotic scale) Pityriasis Rosea (collarete) Keratoderma palmaris 2. Crusts Hardened deposits that result when serum, blood, or purulent exudate dries on skin surface, characteristic of pyogenic infections. Examples: Varicella zooster Bullous Pemphigoid Crusted Impetigo Honey coloured crust (Crusted impetigo) 3. Erosion Defect that affects part or whole epidermis but not basal membrane. Healing not leave cicatrix. Examples: Impetigo crustosa Chancroid Scabies with secunder infection Lichen Simplex Chronicus Herpes Genital 4. Ulcer Defect that affects whole epidermis as well as basal membrane Examples: Pyoderma gangrenosum Pedis ulcer Pyogenic ulcer

5. Fissure Linear defect that start from surface till dermal layer Examples: Keratosis plantaris 6. Atrophy Diminution in size of cell, tissue, organ, or part of body Examples: Systematic Scleroderma Limited Scleroderma 7. Scar Elevation of skin result of accumulation of fibrotic fibres in place of normal collagen fibres Examples: Scar atrophy (acne/ Pasca zooster) Keloid Scar hypertrophy (Hidradenitis supurativa) 8. Excoriation Erosion due to scratching, appearance of continuous erosion 9. Comedo Elevation of skin due to widening of infundibulum of hair follicles that are filled with keratin masses, sebum and certain microorganisms. Examples: White head comedo Black head comedo 10. Millia Small pearly firm noninflammatory elevation of skin due to retention of keratin in an oil gland duct blocked by a thin layer of epithelium- also called white head 11. Cuniculus Canal found on stratum corneum or stratum spinosum due to larva infestation of certain parasited Examples: Scabies Cutaneus larva migrans

12. Lichenification Thickening of skin that is marked by bold appearance of lines on the skin, whether transversal or longitudinal in nature. Examples: Lichen simplex chronicus 13. Teleangiectasis Widening of capillaries, venules, or arterioles that are visible on the skin surface. 14. Purpura (petechie or ecchymosis) Change in skin color to a reddish color due to bleeding under the skin. When pressed with an object glass (diascopy test) redness will not disappear compare macule and patch which will turn pale Petechiae < 1cm; Ecchymosis >1cm 15. Striae Irregular areas of skin that look like bands, stripes or lines. Grows rapidly