Skin Lesions Types

Name/Feature
Macule

Size
Less than 10
mm

Color
Brown, white,
red

Description
Flat,
discolored

Nodule

0.5 - 2 cms

None

Pustule

Varies

White, yellow,
greenishyellow

Distinct
borders,
hard and
deep into the
skin
Pus filled,
elevated

Papule

Less than 10
mm

Red, pink,
brown

Raised,
rough, solid

Plaque

Less than 10
mm

Same as
Papule

Bulla

Greater than
1 cm

Clear

Solid,
elevated, flat
or circular
topped
Fluid filled

Wheal

3 - 4 mm

Pale red

Vesicle

Less than 1
cm

Clear

Tumor

Greater than
2 cm
None

None

Telangiectasia

None

Raised,
rounded, flat
topped
Filled with
fluid,
elevated
A large
nodule
Dilated blood
vessels close
to skin's
surface

Caused By
Hives, leprosy,
measles,
rashes
Inflammation,
tuberculosis,
roundworms

Bacterial
infections
Like in boils
Warts,
syphilis,
psoriasis
Psoriasis

Burns, bites,
drug
reactions
Allergic
reactions
Herpes,
allergies,
sunburn
No certain
causes
Rosacea,
scleroderma

Secondary Skin Lesions

1.Scale - Dry or greasy in texture; Present on the skin in a flaky or scale-like
form; Caused by fungal infections
2.Crust (Scab)- Serum, pus or blood which has dried and pooled on the skin

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3.Keloids- Exaggerated formation of scar tissue or swollen scar tissue, that

extends beyond the edges of the original wound
4.Lichenification- Thickening of the skin, so that the area becomes elevated
5.Erosion- Small areas of the skin, in which the upper skin layer is lost
6.Fissure- A narrow, deep crack on the skin, extending to the flesh; Caused due
to excessive drying of the skin; Occurs at corners of the mouth and on
hands and feet
7.Atrophy- decrease In cell size; A very wrinkled and thin area of the skin;
Example of atrophied skin is stretch marks
8.Ulcers- A discontinuous loss of the skin, sometimes reaching the fat layer
9.Scars- Discolored tissue, that permanently replaces the skin in that area; Some
scars are thick and raised, others depressed

Melanin: It is brown in color and present in the the epidermis. Responsible for
Melasma/ chloasma, linea nigra and darkened areola in pregnancy
There are 5 basic types of wound;
Incision
The skin is cut by a sharp object, usually a knife or razor with smooth and defined edges.
This type of wound may be deep, but will usually heal quickly.
An incision wound is a cut in the skin caused by a sharp object such as a knife, broken glass,
scissors or surgeons scalpel. Incision wounds are neat and the edges of the skin are
usually smooth.
Laceration
This type of wound is caused by a jagged edge, the skin has been torn, rather than cut. A
lacerated wound will take longer than an incised to heal and leave a scar.
A laceration is injury to the skin that results in the skin being cut or torn open. Lacerations can
be shallow, only injuring the surface skin, or deep, causing injury to the muscles, tendons,
ligaments, blood vessels or nerves. Lacerations are most commonly made by some sort of blunt
trauma such as being hit with a fist or baseball bat. Unlike an incision wound, a laceration is
generally jagged because the skin is torn instead of cut.
Abrasion
An abrasion is a type of wound in which the skin is scraped or rubbed off. When skin is
dragged on carpet, the resulting wound, often called a carpet burn, is an abrasion. Abrasions
are usually superficial wounds, meaning that only the outer layers of skin are affected. A
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deep abrasion, one that penetrates to the inner layers of skin, can leave a scar. Parts of the
body with thin layers of skin, such as the knees and elbows, are most prone to abrasions.
Abrasions are caused by contact with a rough surface, the skin has been ground away.
The wound is shallow, but the area damaged can be extensive. These wounds have the highest
risk of contamination by foreign material and objects. Thus requiring extensive cleaning before
dressing.
Contusion
Also commonly referred to as bruising, although the outer layer of skin may appear
undamaged, there may have been extensive damage to underlying structures. Blood
accumulates under the skin causing localised swelling.
A contusion is a kind of closed wound, meaning that the skin is not broken. Contusions are
caused by blunt force trauma to the skin that results in tissue damage. When the blood vessels
under the skin are broken, blood pools under the skin causing a bruise.
Puncture
Caused by sharp pointed objects. These wounds appear very small, however they are deep.
Frequently structures that lie deep beneath the surface have been damaged.
A puncture wound is created when a sharp object enters the skin. These wounds are usually
small and do not bleed a lot. Although these wounds tend to close over quickly, they still need
treatment as infection is a possibility. Puncture wounds are prone to a tetanus infection, so
it is important to seek medical advice for any puncture wound. Common types of
puncture wounds include stepping on a nail or bites from animals.

Burns
There are three levels of burns:
First-degree burns affect only the outer layer (EPIDERMIS ONLY) of the skin. They
cause pain, redness, and swelling. There are many causes of first degree burns including hot

water from the sink and sunburn.

Most first degree burns can be treated at home. First, run the burned area under cold water.
Then apply a soothing cream, such as aloe, to the burn and cover with a loose gauze
bandage.

Second-degree burns affect both the outer and underlying layer of skin (EPIDERMIS &
DERMIS). They cause MOST PAINFUL, redness, swelling, and blistering. They are also
called partial thickness burns. Second degree burns can be caused by flames, chemicals,
hot liquids and other catalysts.

Third-degree burns affect the deep layers of skin (SQ & MUSCLES). They are also
called full thickness burns. They cause white or blackened (CHARRED MEAT
APPEARANCE), burned skin. The skin may be numb (INSENSITIVE/ PAINLESS)
due to the damage of nerves.

Degree of perineal lacerations

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first-degree lacerations - superficial tears involve the skin of the perineum and
the tissue around the opening of the vagina or the outermost layer of the
vagina itself, but no muscles; few or no stitches are required. They usually
heal quickly and cause little or no discomfort.
Second-degree lacerations - go deeper, into the muscles underneath.
These tears need to be stitched closed, layer by layer. They'll cause you some
discomfort and usually take a few weeks to heal. The stitches dissolve on their
own during the healing period.
These severe tears are called third- or fourth-degree lacerations.
Third-degree laceration is a tear in the vaginal tissue, perineal skin, and
perineal muscles that extends into the anal sphincter (the muscle that
surrounds your anus).
Fourth-degree tear goes through the RECTAL sphincter and the tissue
underneath it.Some women tear at the top of the vagina, near the urethra. (This
is known as a periurethral laceration.)
Complicated tears:

- sulcus tear -a woman may tear her cervix or her labia (the folds of skin just
outside the vagina) or tear deeply into the tissue of her vagina
rectovaginal fistula - is a medical condition where there is a fistula or abnormal connection
between the rectum and the vagina.
-

If the opening between the rectum and vagina is wide it will allow
both flatulence and feces to escape through the vagina, leading to fecal incontinence.

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Suturing the Vagina

- The apex of the incision is identified in the posterior wall of the
vagina. The first stitch must be inserted posterior wall of the
vagina
-

Alternatively the skin layer can be closed using interrupted

stitches.

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