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. Wheals are a common manifestation of hypersensitivity to drugs, stings or bites, autoimmunity, and, less commonly, physical stimuli including temperature, pressure, and sunlight. Induration is characteristic of panniculitis, some skin infections, and cutaneous metastatic cancers. Specific types are listed below. Some skin diseases are very prone to break down into sores. Primary lesions of the skin are the first recognizable lesions in the skin. A patch is a large macule. Configuration is the shape of single lesions and the arrangement of clusters of lesions. Rash is a general term for a temporary skin eruption. Lesions of psoriasis and granuloma annulare commonly form plaques. Up to 5% of normal patients may exhibit this sign, which is a form of physical urticaria. Partial loss of epidermis. Although few patterns are pathognomonic, some are consistent with certain diseases. Wheals are pruritic and red. Ischemic skin appears purple to gray in color. An enanthema is a lesion of the mucous membranes, such as the oral mucosa, conjunctiva and external genitalia. Are ulcers primary or secondary. Erosions can be traumatic or can occur with various inflammatory or infectious skin diseases. Configuration of the lesion(s) Assess the configuration of the lesion(s).. Configuration refers to the shape or outline of skin lesions. The diagnosis of any skin lesion starts with an accurate description of it. A lilac color of the eyelids or heliotrope eruption is characteristic of dermatomyositis. A macule is a distinct discoloration of the skin that is flat and smaller than 1 centimeter in … 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. Deep dermal nevi appear blue. Close inspection Size of the lesion(s) Assess the size of the lesion(s): measure their width and height (if raised). Thousands of new, high … Vesicle A small, fluid filled lesion, <0.5 cm in diameter, raised above the plane of surrounding skin. This language, reviewed here, can be used to describe any skin finding. Macules represent a change in color and are not raised or depressed compared to the skin surface. Vascular lesions or tumors, such as Kaposi sarcoma and hemangiomas, can appear purple. HA Integumentary Physical Exam 67 Terms. ... Ch 23: Skin Lesions 58 Terms. Psoriasis frequently exhibits this phenomenon, as may lichen planus, often resulting in linear lesions. Particular body parts are affected (eg, palms or soles, scalp, mucosal membranes). Your skin is not only your largest organ but is also an integral component of the body’s defence system. Black eschars are collections of dead skin that can arise from infarction, which may be caused by infection (eg, anthrax, angioinvasive fungi including Rhizopus, meningococcemia), calciphylaxis, arterial insufficiency, or vasculitis. Example of an Erosion. Secondary lesions, on the other … Ulcers on lower leg trauma. Darier sign refers to rapid swelling of a lesion when stroked. Indurated skin has a hard, resistant feeling. It is accompanied by peripheral inflammatory flush. To determine the cause of erosion is possible only if a full diagnostic study. The Manual was first published in 1899 as a service to the community. Verrucous lesions have an irregular, pebbly, or rough surface. Annular lesions are rings with central clearing. Fissure: linear, often painful breaks within the skin surface, as a result of excessive xerosis (dryness of skin). 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. Induration, or deep thickening of the skin, can result from edema, inflammation, or infiltration, including by cancer. It is usually produced by induration of the dermis and/or subcutaneous tissue. Now on sale in the Medical Bookstore. Examples include nevi, warts, lichen planus, insect bites, seborrheic keratoses, actinic keratoses, some lesions of acne, and skin cancers. The skin lesions may be associated with purpura and superficial erosions of the oral mucosa. Deeper than erosions, involve dermis and/or deeper layers. Herpetiform describes grouped papules or vesicles arranged like those of a herpes simplex infection. Park YS, Kang JH, Kim HY, Kang DW, Chang WS, Kim JP, Chang JW Stereotact Funct Neurosurg 2011;89(3):178-84. EROSION - A shallow, moist, or crusted lesion resulting from the loss of the superficial layers of the upper epidermis only, as from friction or pressure. Crust: The thickened, dried-out exudate left when vesicles/pustules burst or dry up. The typical wheal lasts < 24 hours. Bullae also may occur in inherited disorders of skin fragility. EXCORIATION - A skin abrasion that is usually superficial and due to scratching of the skin. 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 The following are examples of skin lesions: Freckles are collections of brown pigment that typically occur in children, morphing into age-spots in adults. Psoriasis frequently affects the scalp, extensor surfaces of the elbows and knees, umbilicus, and the gluteal cleft. Red skin (erythema) can result from many different inflammatory or infectious diseases. 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. Palpable purpura is considered the hallmark of leukocytoclastic vasculitis. (See also Evaluation of the Dermatologic Patient andDiagnostic Tests for Skin Disorders.). EX: impetigo, weeping, eczematous, dermatitis, scab after abrasion 4.25). The pattern of multiple lesions or the shape of an individual lesion can be useful in narrowing the differential diagnosis. Click for word document: Approach to Skin Lesions Background. Causes include platelet abnormalities (eg, thrombocytopenia, platelet dysfunction), vasculitis, and infections (eg, meningococcemia, Rocky Mountain spotted fever, other rickettsioses). Erosions are open areas of skin that result from loss of part or all of the epidermis. Unless they are peracute, these lesions are typically accompanied by inflammation in the superficial dermis and may be accompanied by epidermal hyperplasia, particularly at … 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. Erosion is an eating away of a surface. Some scars become hypertrophic or thickened and raised. Circumscribed and elevated. Zosteriform describes lesions clustered in a dermatomal distribution similar to those of herpes zoster. Plaques may be flat topped or rounded. Stria (plural striae) are linear, atrophic, pink, purple, or white lesions of the skin and are sometimes called “stretch marks”. Of hemorrhage that may be scaly the definition and appearance of pinpoint bleeding after scale is removed from in... 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