Dermatologic Disorders

GENERAL OVERVIEW
DESCRIPTION OF SKIN LESIONS
Dermatologic conditions are usually described by the types of lesions that appear on the skin,
their shape, and configuration. See Figure 33-1, page 1094, for types of skin lesions.
FIGURE 33-1 Types of skin lesions.
Primary Lesions

Maculaflat, circumscribed discoloration of skin; may have any size or shape.

Papulesolid, elevated lesion less than 1 cm wide.

Noduleraised, solid lesion larger than 1 cm wide.

Vesiclecircumscribed elevated lesion less than 1 cm, containing fluid.

Bullaa vesicle or blister larger than 1 cm wide.

Pustulecircumscribed raised lesion that contains pus; may form as a result of purulent
changes in a vesicle.

Whealelevation of the skin that lasts less than 24 hours, caused by edema of the
dermis; may be surrounded by erythema or blanching.

Plaquesolid, elevated lesion on the skin or mucous membrane, larger than 1 cm in

diameter; psoriasis is commonly manifested as plaques on the skin; leukoplakia is an
example of plaques on mucous membranes.

Cystsoft or firm mass in the skin, filled with semisolid or with liquid material
contained in a sac.

Secondary Lesions
Secondary lesions involve changes that take place in primary lesions that modify them.

Scaleheaped-up, horny layer of dead epidermis; may develop as a result of

inflammatory changes.

Crustcovering formed by the drying of serum, blood, or pus on the skin.

Excoriationlinear scratch marks or traumatized areas of skin.

Fissurecracks in the skin, usually from marked drying and long-standing

inflammation.

Ulcerlesion formed by local destruction of the epidermis and by part or all of the
underlying dermis.

Lichenificationthickening of skin accompanied by accentuation of skin markings.

Scarnew formation of connective tissue that replaces the loss of substance in the
dermis as a result of injury or disease.

Atrophydiminution in size or in loss of skin cells that causes thinning of the skin.

Shape and Configuration

After the type of lesion is identified, the shape, configuration or arrangement (in relation to each
other), and pattern of distribution
P.1094
are noted (see Figure 33-2). The following are descriptions commonly used:
FIGURE 33-2 Shape and arrangement of skin lesions: (A) annular, (B) grouped, (C) iris, (D)
confluent, (E) herpetiform, (F) linear, (G) zosteriform.

Annularring-shaped

Circinatecircular

Confluentlesions run together or join

Discoiddisk-shaped

Discretelesions remain separate

Generalizedwidespread eruption

Groupedclustering of lesions

Guttatedroplike

Herpetiformgrouped vesicles

Irisring or a series of concentric circles

Linearin lines

Multiformmore than one kind of skin lesion

Nummularcoin-shaped

Polymorphousoccurring in several or many forms

Reticulatedlacelike network

Serpiginoussnakelike or creeping eruption

Telangiectasiatiny, superficial, dilated cutaneous vessel; can be seen as a red thread or

line

Zosteriform or dermatomalbandlike distribution, limited to one or more dermatomes

of skin