Fissure: linear, often painful breaks within the skin surface, as a result of excessive xerosis (dryness of skin). HA Integumentary Physical Exam 67 Terms. Examples include freckles, flat moles, tattoos, and port-wine stains, and the rashes of rickettsial infections, rubella, measles (can also have papules and plaques), and some allergic drug eruptions. Dermatographism is the appearance of an urticarial wheal after focal pressure (eg, stroking or scratching the skin) in the distribution of the pressure. Close inspection Size of the lesion(s) Assess the size of the lesion(s): measure their width and height (if raised). (See also Evaluation of the Dermatologic Patient andDiagnostic Tests for Skin Disorders.). Darier sign refers to rapid swelling of a lesion when stroked. Traumatically induced lesions, including excoriations caused by the patient's fingernails, are typically linear. Linear lesions take on the shape of a straight line and are suggestive of some forms of contact dermatitis, linear epidermal nevi, and lichen striatus. Examples include nevi, warts, lichen planus, insect bites, seborrheic keratoses, actinic keratoses, some lesions of acne, and skin cancers. Black skin lesions may be melanocytic, including nevi and melanoma. Please confirm that you are a health care professional. Other examples of vesicle Impetigo Insect bite Herpes simplex Dermatitis herpetiformis 26. Often pathology develops in the process of chronic diseases, for example, such as liver failure. A macule is a distinct discoloration of the skin that is flat and smaller than 1 centimeter in … There are many risk factors for PUs, which include age > 65 years, decreased mobility, and impaired sensation, among others. Merck and Co., Inc., Kenilworth, NJ, USA (known as MSD outside the US and Canada) is a global healthcare leader working to help the world be well. Obviously, before we discuss them, we need to know what a skin lesion is! These may be caused by burns, bites, irritant contact dermatitis or allergic contact dermatitis, and drug reactions. Pustules are vesicles that contain pus. Although few patterns are pathognomonic, some are consistent with certain diseases. Scale is heaped-up accumulations of horny epithelium that occur in disorders such as psoriasis, seborrheic dermatitis, and fungal infections. Wheals are pruritic and red. A patch is a large macule. herpes simplex. Click for word document: Approach to Skin Lesions Background. Green fingernails suggest Pseudomonas aeruginosa infection. Petechiae are nonblanchable punctate foci of hemorrhage. The pattern of multiple lesions or the shape of an individual lesion can be useful in narrowing the differential diagnosis. Cutaneous tumors are often pink or red. Define and give an example of these secondary lesions: crust, scale, fissure, erosion, ulcer crust--thickened dried out exudate left when vesicles/postules burst or dry up. Lesions of psoriasis and granuloma annulare commonly form plaques. Erosions can be subtle, shallow lesions with loss of only the upper layers of cells and may be difficult to identify. Depressed Elevated Crust/Scab (dried serum, blood, or pus overlying the lesion) Scale (dry, thin or thick flakes of skin overlying the lesion) Lichenification (thickened skin with accentuation of normal skin lines) Hypertrophic Scar (within boundary of injury) Keloid Scar (extend beyond boundary of injury) Atrophic Scar (fibrotic replacement of tissue at site of injury) Ulcer (complete loss of epidermis extending into dermis or deeper; heals with scar) Erosion (partial loss of epidermis only; heals without scar) Fissure (linear slit-like cleavage of skin) Excoriation/Scratch (linear erosion induced by scratching). Crusting can occur in inflammatory or infectious skin diseases (eg, impetigo). In addition, the skin can serve as a window for the evaluation of internal health and disease. hsalqahtani. Examples include granuloma annulare, some drug eruptions, some dermatophyte infections (eg, tinea [ringworm]), and secondary syphilis. Learn more about our commitment to Global Medical Knowledge. Nikolsky sign is epidermal shearing that occurs with gentle lateral pressure on seemingly uninvolved skin in patients with toxic epidermal necrolysis and some autoimmune bullous diseases. Excoriations may be linear or focal. Violet skin may result from cutaneous hemorrhage or vasculitis. Target (bull’s-eye or iris) lesions appear as rings with central duskiness and are classic for erythema multiforme. Examples include some fungal and parasitic infections (eg, cutaneous larva migrans). Hidradenitis suppurativa involves skin containing a high density of apocrine glands, including the axillae, groin, and under the breasts. Psoriasis frequently exhibits this phenomenon, as may lichen planus, often resulting in linear lesions. Deep dermal nevi appear blue. Induration, or deep thickening of the skin, can result from edema, inflammation, or infiltration, including by cancer. Wheals are a common manifestation of hypersensitivity to drugs, stings or bites, autoimmunity, and, less commonly, physical stimuli including temperature, pressure, and sunlight. of skin lesion images obtained with standard cameras are presented. An enanthema is a lesion of the mucous membranes, such as the oral mucosa, conjunctiva and external genitalia. The major types and characteristics of skin lesions are given in . Reticulated lesions have a lacy or networked pattern. An excoriation is a linear erosion caused by scratching, rubbing, or picking. Erosion. Unless they are peracute, these lesions are typically accompanied by inflammation in the superficial dermis and may be accompanied by epidermal hyperplasia, particularly at … Stria (plural striae) are linear, atrophic, pink, purple, or white lesions of the skin and are sometimes called “stretch marks”. Macule. Lesions are on sun-exposed or protected skin. Some skin diseases are very prone to break down into sores. Circumscribed and elevated. Some scars become hypertrophic or thickened and raised. Erosion: Partial thickness loss of epidermis (may be a primary lesion or secondary feature of another lesion such as an eroded papule) Ulcer: Loss of at least the full thickness of epidermis (may be a primary lesion or secondary feature) Petechia: Small (< 0.5 mm) nonblanching macule caused by bleeding of small blood vessels Yellow skin is typical of jaundice, xanthelasmas and xanthomas, and pseudoxanthoma elasticum. Configuration is the shape of single lesions and the arrangement of clusters of lesions. Examples include warts and seborrheic keratoses. Disease or impairment of the skin’s normal function can lead to significant morbidity and mortality 1.. Auspitz sign is the appearance of pinpoint bleeding after scale is removed from plaques in psoriasis. But nevertheless, we note that erosive lesions are mainly localized on the epithelium of the face, genitals, hands, mucous membrane of the oral cavity, and also in the area of natural folds. Erosion is an eating away of a surface. Now on sale in the Medical Bookstore. Causes include venous stasis dermatitis, physical trauma with or without vascular compromise (eg, caused by decubitus ulcers or peripheral arterial disease), infections, and vasculitis. Scars are areas of fibrosis that replace normal skin after injury. WikiMatrix Their age is also shown by the rather mild nature of the reliefs, with a few peaks over 1000 m of altitude, presenting what remains of the superficial erosion which has partly left untouched the magmatic intrusions and the metamorphic rocks originated before the Variscan orogeny. [21] [33] Excoriation : a punctate or linear abrasion produced by mechanical means (often scratching), usually involving only the epidermis, but commonly reaching the papillary dermis . 11. Examples include cutis marmorata and livedo reticularis. Partial loss of epidermis. Definition (NCI) A circumscribed and often suppurating skin crater which usually includes loss of skin integrity of the superficial skin or the mucous membranes. Serpiginous lesions have linear, branched, and curving elements. Crusts (scabs) consist of dried serum, blood, or pus. Purpura is a larger area of hemorrhage that may be palpable. 4.25). Secondary lesions, on the other … Plaques are palpable lesions > 10 mm in diameter that are elevated or depressed compared to the skin surface. Configuration of the lesion(s) Assess the configuration of the lesion(s).. Configuration refers to the shape or outline of skin lesions. (NICHD) The diagnosis of any skin lesion starts with an accurate description of it. It is usually produced by induration of the dermis and/or subcutaneous tissue. Erosion: intraepithelial loss of epidermis, usually heals without scarring, moist, circumscribed, usually depressed lesion due to loss of all or part of the epidermis e.g. In this lesson, we are going to discuss secondary lesions found on the skin. The term maculopapular is often loosely and improperly used to describe many red rashes; because this term is nonspecific and easily misused, it should be avoided. Example: Ruptured varicella vesicles. A lesionis any abnormal growth or area of skin that differs from the skin around it. Lichenification is thickening of the skin with accentuation of normal skin markings; it results from repeated scratching or rubbing. MORPHOLOGY OF SKIN LESIONS: Secondary Skin Lesions Skin Lesion Secondary Skin Lesion Lesion that develops from trauma, manipulation (rubbing, scratching), complication (infection) of initial lesion, or develops naturally over time Primary Skin Lesion Initial lesion not altered by trauma, manipulation (rubbing, scratching), complication (infection), or natural regression over time. Classic autoimmune bullous diseases include pemphigus vulgaris and bullous pemphigoid. Rash is a general term for a temporary skin eruption. The skin lesions may be associated with purpura and superficial erosions of the oral mucosa. Examples include nevi, warts, lichen planus, insect bites, seborrheic keratoses, actinic keratoses, some lesions of acne, and skin cancers. Indurated skin has a hard, resistant feeling. Furthermore, skin lesions can be broken down into two major groups: primary and secondary. This language, reviewed here, can be used to describe any skin finding. Plate 6 shows the definition and appearance of common primary lesions. ... Ch 23: Skin Lesions 58 Terms. Bullae are clear fluid-filled blisters > 10 mm in diameter. Koebner phenomenon describes the development of lesions within areas of trauma (eg, caused by scratching, rubbing, or injury). Park YS, Kang JH, Kim HY, Kang DW, Chang WS, Kim JP, Chang JW Stereotact Funct Neurosurg 2011;89(3):178-84. The link you have selected will take you to a third-party website. Examples include molluscum contagiosum and herpes simplex. About the signs and symptoms of skin erosion, its causes of appearance and methods of treatment in … Atrophy is thinning of the skin, which may appear dry and wrinkled, resembling cigarette paper. Nodules are firm papules or lesions that extend into the dermis or subcutaneous tissue. Vesicles are small, clear, fluid-filled blisters < 10 mm in diameter. Induration is characteristic of panniculitis, some skin infections, and cutaneous metastatic cancers. Superficial vascular lesions such as port-wine stains may appear red. Shades of blue, silver, and gray can result from deposition of drugs or metals in the skin, including minocycline, amiodarone, and silver (argyria). Thousands of new, high … Reserve your copy today. An aphtha is a painful, sharply circumscribed, round erosion with a diameter of 1 cm or less in the mucous membrane (Fig. Examples include nevi, warts, lichen planus, insect bites, seborrheic keratoses, actinic keratoses, some lesions of acne, and skin cancers. Macules are flat, nonpalpable lesions usually < 10 mm in diameter. Each type of injury creates a complex set of skin responses, such as erythema, macules, papules, pustules, vesicles/bullae, erosion, and ulcers. Some skin lesions have visible or palpable texture that suggests a diagnosis. The key features of skin lesions are (1) the type of lesion, (2) secondary changes to the surface of the lesion, (3) the color of the lesion, (4) the shape of the lesion, and (5) the arrangement and distribution of the lesions. Vesicle A small, fluid filled lesion, <0.5 cm in diameter, raised above the plane of surrounding skin. Example: Scabies. It is accompanied by peripheral inflammatory flush. An extensive language has been developed to standardize the description of skin lesions, including, Lesion type (sometimes called primary morphology), Lesion configuration (sometimes called secondary morphology). Surface sores are called erosions; these may start off as blisters or pustules. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual in the remainder of the world. To do that, you need to know how to describe a lesion with the associated language. Nummular lesions are circular or coin-shaped; an example is nummular eczema. Secondary lesions of herpes zoster. A lilac color of the eyelids or heliotrope eruption is characteristic of dermatomyositis. Purpura may indicate a coagulopathy. Vesicles are characteristic of herpes infections, acute allergic contact dermatitis, and some autoimmune blistering disorders (eg, dermatitis herpetiformis). Ulcers result from loss of the epidermis and at least part of the dermis. Full thickness sores are ulcers. cjmeshia PLUS. Insect … Sclerosis: Sclerosis refers to a circumscribed, diffuse hardening or induration in the skin. Fluid is often visible and the lesions are translucent 24. Vitiligo may be patchy and isolated or may group around the distal extremities and face, particularly around the eyes and mouth. Distribution is random or patterned, symmetric or asymmetric. Examples include cysts, lipomas, and fibromas. Epub 2011 Apr 20 doi: 10.1159/000324903. The effort to use precise descriptive terms also encourages a clinician to look with more care and more closely at a patient’s skin lesions. Ischemic skin appears purple to gray in color. The term maculopapular is often loosely and improperly used to describe many red rashes; because this term is nonspecific and easily misused, it should be avoided. Last full review/revision Feb 2019| Content last modified Feb 2019, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Cross-section of the skin and skin structures, Musculoskeletal and Connective Tissue Disorders. The trusted provider of medical information since 1899, Lesion Configuration (Secondary Morphology). Plaques may be flat topped or rounded. Pressure ulcers (PUs) are defined as areas of necrosis and ulceration where tissues are compressed between bone and hard surfaces, such as a bed or chair. The Manual was first published in 1899 as a service to the community. A combination procedure with double C-shaped skin incision and dual-floor burr hole method to prevent skin erosion on the scalp and reduce postoperative skin complications in deep brain stimulation. Atrophy may be caused by chronic sun exposure, aging, and some inflammatory and neoplastic skin diseases, including cutaneous T-cell lymphoma and lupus erythematosus. Erosion of the stomach is a lesion of the walls of the stomach, accompanied by one or more ulcers, or placed on the bottom surfaces of the body, as shown in the photo. Pityriasis rosea and chronic dermatitis of any type may be scaly. Primary lesions are abnormalities that result as a direct effect of a disease. Herpetiform describes grouped papules or vesicles arranged like those of a herpes simplex infection. Red skin (erythema) can result from many different inflammatory or infectious diseases. Translations in context of "skin erosion" in English-French from Reverso Context: Heat, moisture and sweat retention coupled with friction cause maceration, inflammation with erythema, burning and exsudation, and sometimes skin erosion. Umbilicated lesions have a central indentation and are usually viral. Annular lesions are rings with central clearing. The following are examples of skin lesions: Freckles are collections of brown pigment that typically occur in children, morphing into age-spots in adults. Up to 5% of normal patients may exhibit this sign, which is a form of physical urticaria. Papules are elevated lesions usually < 10 mm in diameter that can be felt or palpated. Telangiectases are foci of small, permanently dilated blood vessels that may occur in areas of sun damage, rosacea, systemic diseases (especially systemic sclerosis), or inherited diseases (eg, ataxia-telangiectasia, hereditary hemorrhagic telangiectasia) or after long-term therapy with topical fluorinated corticosteroids. The word "erosion" comes from the Latin "erodere" meaning to eat out. MORPHOLOGY OF SKIN LESIONS: Secondary Skin Lesions Skin Lesion Secondary Skin Lesion Lesion that develops from trauma, manipulation (rubbing, scratching), complication (infection) of initial lesion, or develops naturally over time Primary Skin Lesion Initial lesion not altered by trauma, manipulation (rubbing, scratching), complication (infection), or natural regression over time. Such a lesion of the skin as erosion, often bothers men, women. The typical wheal lasts < 24 hours. A disorder characterized by circumscribed, inflammatory and necrotic erosive lesion on the skin. Zosteriform describes lesions clustered in a dermatomal distribution similar to those of herpes zoster. Particular body parts are affected (eg, palms or soles, scalp, mucosal membranes). Discoid lupus erythematosus has characteristic lesions on sun-exposed skin of the face, especially the forehead, nose, and the conchal bowl of the ear. Macules represent a change in color and are not raised or depressed compared to the skin surface. To determine the cause of erosion is possible only if a full diagnostic study. Erosion: An erosion is a discontinuity of the skin exhibiting incomplete loss of the epidermis, a lesion that is moist, circumscribed, and usually depressed. Are ulcers primary or secondary. This site complies with the HONcode standard for trustworthy health information: verify here. Your skin is not only your largest organ but is also an integral component of the body’s defence system. Verrucous lesions have an irregular, pebbly, or rough surface. 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