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Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
Skin lesions
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Skin lesions

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  • 1. Skin lesions Types
  • 2. • Primary lesions — Primary lesions are either the first visible lesion or involve the initial skin changes. The terms used to describe primary skin lesions include the following: • Macules are nonpalpable lesions that vary in pigmentation from the surrounding skin • There are no elevations or depressions
  • 3. macules • macules
  • 4. Differential diagnosis of macules Erythematous macules Drug eruption Viral exanthem Secondary syphilis Rheumatic fever Photodistributed macules Drugs Dermatomyositis Lupus erythematosus Porphyria cutanea tarda Polymorphous light eruption Hypopigmented macules Postinflammatory Tinea versicolor Vitiligo Halo nevus Sarcoidosis Tuberous sclerosis Cutaneous T cell lymphoma Leprosy Hyperpigmented macules Nevi Fixed drug eruption Postinflammatory Ephelis (freckle) Lentigo Schamberg's purpura Nevus Mongolian spot Purpura Stasis dermatitis Melasma Melanoma Ochronosis Mastocytosis Café au lait spot
  • 5. papules • Papules are palpable, discrete lesions measuring ≤5 mm diameter • They may be isolated or grouped
  • 6. papule • ,
  • 7. Differential diagnosis of papules Isolated papules Acrochordon Actinic keratosis Angiofibroma Appendageal tumors (benign or malignant) Bacillary angiomatosis Basal cell carcinoma Chondrodermatitis nodularis helicis Dermatofibroma Fungal infections (early) Hemangioma Keratoacanthoma Melanoma Milia Molluscum contagiosum Neurofibroma Nevus Pyogenic granuloma Sebaceous hyperplasia Seborrheic keratosis Squamous cell carcinoma Venous lake Wart
  • 8. Papular eruptions Papular eruptions Acne rosacea Acne vulgaris Appendageal tumors (usually benign) Arthropod bite Bacillary angiomatosis Dermatomyositis Drug eruption Eczematous dermatitis Flat warts Folliculitis Granuloma annulare Keratosis pilaris Lichen nitidus Lichen planus Lichen sclerosus Lupus erythematosus Lymphoma Miliaria Molluscum contagiosum Neurofibromatosis Pediculosis corporis Perioral dermatitis Pityriasis rosea
  • 9. Polymorphous light eruption Psoriasis Sarcoidosis Sarcoma Scabies Syphilis Urticaria Vasculitis Viral exanthem Xanthoma
  • 10. plaques • Plaques are large (≥5 mm) superficial flat lesions, often formed by a confluence of papules
  • 11. Differential diagnosis of plaques Acanthosis nigricans Candidiasis Cellulitis Deep fungal infections Dermatomyositis Diaper dermatitis Eczematous dermatitis Erythrasma Tinea infections Granuloma annulare Ichthyosis Lichen planus Lymphoma (cutaneous T cell) Morphea Myxedema Necrobiosis lipoidica diabeticorum Paget's disease Pityriasis rosea Lichen sclerosus Lupus erythematosus Lyme disease Psoriasis Sarcoidosis Seborrheic dermatitis Sweet's syndrome Syphilis Tinea versicolor Vasculitis Xanthelasma
  • 12. nodules • Nodules are palpable, discrete lesions measuring ≥6 mm diameter • They may be isolated or grouped. Tumors are large nodules
  • 13. The differential diagnosis of tumors and nodules is shown in a table Acrochordon Angioma Appendageal tumors Basal cell carcinoma Callus/clavus Chondrodermatitis nodularis helicis Dermatofibroma Dermatofibrosarcoma Erythema nodosum Hidradenitis suppurativa Histiocytosis Inclusion cyst Kaposi's sarcoma Keloid Lipoma Lymphoma (cutaneous) Melanoma Metastatic carcinoma Neurofibroma Nevus Prurigo nodularis Pyogenic granuloma Seborrheic keratosis Squamous cell carcinoma Syphilis Tuberous sclerosis Venous lake Wart Xanthoma
  • 14. nodules
  • 15. Cysts • Cysts are enclosed cavities with a lining that can contain a liquid or semisolid material • see pilar cyst
  • 16. Telangiectasia is a dilated superficial blood vessel
  • 17. pustules • Pustules are small, circumscribed skin papules containing purulent materia
  • 18. Differential diagnosis of pustules Acne rosacea/perioral dermatitis Acne vulgaris Arthropod bite (fire ants) Drug eruption Eosinophilic folliculitis Erythema toxicum neonatorum Folliculitis Fungal or yeast infections (especially tinea capitis and Majocchi's granuloma) Gonorrhea (disseminated) Herpes simplex/zoster Impetigo Keratosis pilaris Neonatal pustulosis Pseudofolliculitis barbae Pustular psoriasis Pyoderma gangrenosum Syphilis Varicella
  • 19. vesicles • Vesicles are small (<5 mm diameter), circumscribed skin papules containing serous material • Bullae are large (≥6 mm) vesicles.
  • 20. Vesicles • Multiple vesicles are present in this patient with herpes zoster
  • 21. Urticaria • Wheals are irregularly elevated edematous skin areas that are often erythematous • The borders of a wheal are sharp but not stable; they may move to adjacent uninvolved areas over periods of hours
  • 22. Urticaria
  • 23. Secondary lesions • Secondary lesions — Secondary lesions of the skin represent evolved changes from the skin disorder, due to secondary manipulation or as a result of infection. Examples include: • Excoriation describes superficial, often linear, skin erosion caused by scratching (picture 10). • Lichenification is increased skin markings and thickening with induration secondary to chronic inflammation caused by scratching or other irritation (picture 11). • Edema is swelling due to accumulation of water in tissue (picture 12). • Scale describes superficial epidermal cells that are dead and cast off from the skin (picture 13). • Crust is dried exudate, a "scab." • Fissure is a deep skin split extending into the dermis. • Erosion is a superficial, focal loss of part of the epidermis. Lesions usually heal without scarring (picture 14). Ulceration is focal loss of the epidermis extending into the dermis. Lesions may heal with scarring (picture 15). The differential diagnosis of erosions and ulcers is shown in a table (table 8). • Atrophy is decreased skin thickness due to skin thinning. • Scar is abnormal fibrous tissue that replaces normal tissue after skin injury. • Hypopigmentation (picture 16) is decreased skin pigment; hyperpigmentation (picture 17) is increased skin pigment; and depigmentation (picture 18) is total loss of skin pigment.

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