EFFLORESCENCE IN THE SKIN

PRIMARY LESIONS
MORPHOLOGY
MACULE

NOTE
A macule is a change in surface color, without elevation or
depression and, therefore, no palpable, well or ill-defined,
variously sized, but generally considered less than either 5 or
10mm in diameter at the widest point.

EXTRA NOTE
flat circumscribed area of discoloration < 1 cm
Skin colour changes w.o elevation/depression

HYPERPIGMENTATION

PATCH

A patch is a large macule equal to or greater than either 5 or

10mm, depending on one's definition of a macule. Patches may
have some subtle surface change, such as a fine scale or
wrinkling, but although the consistency of the surface is changed,
the lesion itself is not palpable.

HIPOPIGMENTATION
A large macules 1 cm in diameter
DISEASE
Melasma
Hypopig post inflammation
Pityriasis versicolor
Pityriasis alba
Erythematous macule

HYPERPIGMENTION

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PAPULE

A papule is a circumscribed, solid elevation of skin with no visible

fluid, varying in size from a pinhead to either less than 5 or 10mm
in diameter at the widest point.
Circumscribed, solid elevation, no visible fluid Variously in size
from pinhead to 1 cm DISEASE Acne vulgaris - Roseacea

PLAQUE

A plaque has been described as a broad papule, or confluence of

papules equal to or greater than 1 cm, or alternatively as an
elevated, plateau-like lesion that is greater in its diameter than in
its depth.

NODULE

A nodule is morphologically similar to a papule, but is greater

than either 5 or 10mm in both width and depth, and most
frequently centered in the dermis or subcutaneous fat. The depth
of involvement is what differentiates a nodule from a papule.

PAPULES MILIER

PAPULES LENTIKULER
A broad papules (confluence of papule) 1 cm in
diameter

Morphologically similar papule > 1 cm in diameter

Circumscribed palpable mass

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VESICLE

A vesicle is a circumscribed, fluid-containing, epidermal elevation

generally considered less than either 5 or 10mm in diameter at
the widest point.

Vesikel milier
BULLA

Variously, circumscribed Fluid-filled lesion (blister), < 0,5

cm

Maybe pale or yellow serous exudate or Red from serum

mixed wirh blood

Vesikel lentikuler

A bulla is a large vesicle described as a rounded or irregularly

shaped blister containing serous or seropurulent fluid, equal to or
greater than either 5 or 10mm, depending on one's definition of a
vesicle.

Variously, circumscribed Fluid-filled lesion > 0.5 .

DIASEASE - varicella,herpes zoster

Flaccid bullae in pemphigus vulgaris

Tense bullae in pemphigoid bullous

PUSTULE

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A pustule is a small elevation of the skin containing cloudy or

purulent material usually consisting of necrotic inflammatory
cells. These can be either white or red.

Vesicel with pus inside.DIASEASE- Furuncle

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TUMOR

ALL THINGS WITH GROWTH : EPIDERMAL, DERMAL/SUBCUTAN &

MELANOSIT
Soft or firm & freely moveable/fixed mass of various size &
shape(>2 cm )
-

CYST
EROSION
ULCER
FISSURE
WHEAL
TELANGIECTASIA
BURROW

Veruca vulgaris

-Keratosis seboroik

ENLARGEMENT WITH ELEVATION IN THE SKIN SURFACE

A cyst is an epithelial-lined cavity containing liquid, semi-solid, or solid material.

Erosion is a discontinuity of the skin exhibiting incomplete loss of the epidermis a lesion that is moist, circumscribed, and
usually depressed.
An ulcer is a discontinuity of the skin exhibiting complete loss of the epidermis and often portions of the dermis and even
subcutaneous fat.
A fissure is a crack in the skin that is usually narrow but deep.
A wheal is a rounded or flat-topped, pale red papule or plaque that is characteristically evanescent, disappearing within 24 to
48 hour.
A telangiectasia represents an enlargement of superficial blood vessels to the point of being visible.
A burrow appears as a slightly elevated, grayish, tortuous line in the skin, and is caused by burrowing organisms.

SECONDARY LESION
MORPHOLOGY
SCALE

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NOTE
Dry or greasy laminated masses of keratin that represent
thickened stratum corneum.

EXTRA NOTE
Str corneum release from the skin
Pityriasiform (soft n small)
Psoriasiform (layers)
Ichtyiosiform (fish scale)
Culiculer (thin)
Lamelar (sheets)
-A dry, horny build-up of dead skin cells that often flakes
off the surface of the skin. Diseases that promote scale
include fungal infections, psoriasis, seborrheic
dermatitis, and iktiosis vulgaris.

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CRUST

FISSURA

Dried serum, pus, or blood usually mixed with epithelial and

sometimes bacterial debris.

Thin linear scracth in the dermis. Example diasease tinea pedis

LICHENIFICATION Epidermal thickening characterized by visible and palpable

thickening of the skin with accentuated skin markings.

EXCORIATION

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Collection of dried exudate consisting of serum, debris &

pus cells

A punctate or linear abrasion produced by mechanical means

(often scratching), usually involving only the epidermis but not
uncommonly reaching the papillary dermis.

Rough, thick epidermis with exaggerated skin

lines.

This is often a characteristic of scratch dermatitis

and atopic dermatitis.

The traumatic deeper until the point of papil

Shows serum and blood (bleedy)

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EROTION

ULCER

INDURATION
ATROPHY

SCAR

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Serum release from the skin, the process just in.The stratum
basal so not bleedy.

Loss of epidermis and part of dermis. Example diasease

Basalioma

Dermal thickening causing the cutaneous surface to feel thicker and firmer.
Refers to a loss of tissue, and can be epidermal, dermal, or
An area of skin that has become very thin and
subcutaneous. With epidermal atrophy, the skin appears thin,
wrinkled.
translucent, and wrinkled. Dermal or subcutaneous atrophy is
Normally seen in older individuals and people
represented by depression of the skin
who are using very strong topical corticosteroid
medication.

Collagenous tissues that permanently replace injured dermis

Scars appear over healed wounds and surgical incisions.

Typically irregular, they may be thick or thin and hypertrophic or atrophic. Red, blue, white, and silver are common
colors for scars

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Mechanisms of formation of rashes

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