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Glossary of dermatology

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Macules are circumscribed alterations in skin color.  The skin surface is neither elevated or depressed in relation to the surrounding skin.  Macules may be of any size or color.  A macule greater than 2 cm. in diameter is called a patch. Ex:  café-au-lait:  Mongolian spot; freckle

Papule is a solid, elevated lesion with no visible fluid which may be up to ½ cm. in diameter.  The elevation may be accounted for by metabolic deposits, infiltrates, or hyperplasia of cellular elements, etc.

A papulosquamous lesion is a papule with desquamation (scaling).

Nodules are forms of papules, but are larger and deeper.  They may be located in the dermis or subcutaneous tissue, or in the epidermis.  Nodules are usually ½ cm. or more in diameter. Ex:  Metastatic neoplasm; xanthoma

An elevated area of skin 2 cm. or more in diameter.  It may be formed by a coalescence of papules or nodules.  The surface area is greater than its height.  It is a plate-like lesion.

A wheal is an evanescent rounded or flat-topped elevation in the skin that is edematous, and often erythematous.  They may vary in size from a few mm. to many cm.  The shape may change and these lesions are usually pruritic (itchy).  These are really variations of papules, nodules or plaques that are evanescent.

Vesicles are circumscribed epidermal elevations in the skin containing clear fluid and less than ½ cm. in diameter.  If the lesion has a diameter of greater than ½ cm, it is called a bulla.  Vesicles and bullae arise from a cleavage at various levels of the skin.  The more superficial the location, the more flaccid the bullous lesion.  Vesicles and bullae are commonly called blisters.  It is the diameter, not the cleavage plane that differentiates vesicles and bullae.

A pustule is a circumscribed elevation of the skin that contains a purulent exudate that may be white, yellow, or greenish-yellow in color.

A localized  collection of pus in a cavity formed by disintegration or necrosis of tissue.

A cyst is a closed sac that contains liquid or semisolid material.  On palpation a cyst is usually resilient.

Atrophy of the skin may involve the epidermis, or the dermis, or both.  It is the thinning process associated with decreased number of cutaneous cells.  Sometimes the normal skin markings may be lost.  Dermal atrophy may give rise to a depression in the skin.

  • Stria: (plural striae) are linear, atrophic, pink, purple, or white lesions of the skin and are sometimes called “stretch marks”.

Sclerosis refers to a circumscribed, diffuse hardening or induration in the skin.  It is usually produced by induration of the dermis and/or subcutaneous tissue.  Palpation is often necessary in diagnosing sclerosis.

A loss of epidermis.

A loss of epidermis and dermis (and sometimes deeper tissue). If erosions and/or ulcers are produced by scratching, the term excoriation is used.

Fissures are linear cleavages or gaps in the skin surface. (a variation really of an erosion or ulcer)

Shedding of epidermal cells.

Scars occur whenever ulceration has taken place and they reflect the pattern of healing.  They may be hypertrophic, atrophic, or cribriform (perforated with multiple small pits).

Crusts result when serum, blood, or purulent exudate dries and it is a hallmark of pyogenic infection.  Crusts are yellow when they have arisen from dried serum; green or yellow-green when formed from purulent exudate; and brown or dark red when formed from blood.

A chronic thickening of the epidermis with exaggeration of its normal markings, often as a result of scratching or rubbing.

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