This document describes the key features to note when describing basic skin lesions, including size, shape, color, and distribution. It categorizes lesions as primary, secondary, or special and defines common types such as macules, papules, vesicles, bullae, and pustules. Secondary lesions include scales, crusts, erosions, and fissures. The document provides examples of different lesions and explores their characteristic arrangements, colors, and predilection for specific body sites.

1. PRESENTED BY:- DR. MARIA SAEED
DESCRIPTION OF BASIC
SKIN LESIONS

2. ● Size
● Types of Lesions
● Shape of lesions
● Pattern
● Color and pigmentation
● Distribution over the body surface
● Distribution of Lesions
WHEN DESCRIBING A SKIN
LESION,IT IS IMPORTANT TO NOTE
THE FOLLOWING FEATURES:-

3. TYPES OF LESION
Basic skin lesions are broadly categorized as :
1. Primary
2. Secondary
3. special

4. ● Primary lesions :- Basic reaction patterns of skin
with a definite morphology.
● Secondary lesion :- Develop during the evolutionary
process of skin disease or are created by scratching or
infection.
● Special skin lesion :- Specific for certain disease.

5. PRIMARY SKIN LESIONS
● Macule
● Patch
● Papule
● plaque
● nodule
● Vesicle
● Bulla
● Pustule
● Abscess
● Wheal
● Cyst

6. MACULE
● A Flat lesion with well
circumscribed change in skin
colour.Macules are non-
palpable.
● They are 0.5cm-1cm in size.
● Discoloration may be brown,
blue ,red and hypopigmented
or hyperpigmented

7. PATCH
● A macule is called a
patch usually larger than
1cm in size.
● Eg :- Vitiligo, melasma,
Congenital birth mark
etc.

8. PAPULE
● Elevated solid lesion less
than 1 cm.
● Papules may be of
various colors.
● E.g. Mole, Acne etc.

9. PLAQUE
● It is an indurated area of skin larger than 1 cm in
diameter which may be raised or depressed from
skin surface.

10. EXAMPLES OF PLAQUE
Tinea corporis
Lichen
Psoriasis planus

11. VESICLE
● A small, fluid containing
blisters less than a size of
1 cm.
● E.g.:- Chicken Pox,
Shingles (Zoster), Insect
bite etc.

12. Examples of Vesicle
Chicken pox Herpes zoster

13. BULLA
● A large fluid containing blister
more than 1 cm in size.

14. EXAMPLES OF BULLA
Bullous pemphigoid Fixed drug reaction

15. PUSTULE
● Pus containing vesicle.
● It is formed due to
collection of
inflammatory exudate
rich in leucocytes.

16. Acne Pustular Psoriasis
Folliculitis Scabies

17. NODULE
● A Nodule is a large ( 0.5 – 5.0 cm ) firm lesion
● Could be warm, soft,fluctuant,movable,fixed or
painful.
● Surface-smooth,keratotic,ulcerated or fungating.

18. EXAMPLES OF NODULE
Prurigo nodularis Neurofibromatosis
Hemangioma
Basal cell carcinoma

19. ABSCESS
● An Abscess is a collection of
pus usually caused by
bacterial infection.
● We usually find two types of
abscess (I) Skin Abscess (II)
Internal Abscess.

20. WHEAL
● It is a transient swelling
of skin disappearing
within 24 hrs.
● It is formed due to
sudden extravasation of
fluid in the dermis.
● Eg: Urticaria(hives)

21. CYST
● It is a spherical or oval
sac or an encapsulated
cavity containing fluid
or semi solid material.
● It is lined with true
epithelium.

22. SECONDARY SKIN LESIONS
● Scale
● Crust
● Erosion
● Fissure
● Scar
● Atrophy
● Lichenification

23. SCALE
● Excess dead epidermal
cells that are produced
by abnormal
keratinization and
shedding
● Eg: Psoriasis, Icthyosis

24. CRUST
● Dried exudate of body
fluids (blood / serous
fluid).
● Which might be either
yellow / red.
● E.g. :- Tinea Capitis,
Impetigo.

25. EROSION
● A focal loss of epidermis.
● Erosions do not
penetrate below the
dermoepidermal
junction and therefore
heal without scarring.
● Eg:- tinea pedis,
candidiasis, eczematous
disease, herpes simplex.

26. ULCER
● A focal loss of epidermis
and/or dermis
● Scarring depends on the
depth of the ulcer
● Eg-
Pyoderma
gangrenosum,decubitus
etc.

27. Pyoderma
gangrenosum
Decubitus ( Bed Sore)

28. FISSURE
● It is a linear loss of
continuity of skin due to
excessive tension.
● Eg:- eczema(fingertips),
intertrigo.

29. SCAR
● It is replacement of
normal skin by fibrous
tissue in the process of
healing of damaged skin.
● Scars are of two types-
hypertrophic and
atrophic.
● Eg:- acne, burns, herpes
zoster, keloid.

30. ● An area of overgrowth of
fibrous tissue that usually
develops after healing of skin
injury & extends beyond the
original defect.
Keloid Scar

31. ATROPHY
● Atrophy is reduction in size
and number of skin cells.
● It may be limited to epidermis,
dermis, or subcutaneous tissue.
● Eg:- leprosy,
atrophoderma,
lipoatrophy.

32. LICHENIFICATION
● Repeated rubbing of
skin results in
thickening and
hyperpigmentation of
skin.
● The skin markings
become prominent.
● Eg:- Lichen simplex
chronicus, Atopic
dermatitis.

33. ● Burrow
● Comedone
● Milia
● Telengiectasia
● Poikiloderma
Special lesions

34. BURROW
● It is a serpentine tunnel
made by scabies mite in
stratum corneum.
● The open end of the
tunnel has a papule.

35. COMEDONE
● It is a tiny plug present at
opening of hair follicle
formed by keratin and
sebum.
● It is of two types: Open
comedone (black head)
and Closed comedone
(white head).

36. MILIA
● It is a tiny superficial
cyst with epidermal
lining. Milia are seen on
face at periorbital region.

37. TELENGIECTASIA
● It is visible dilataion of
capillaries of skin which
blanch on pressure.
● Eg:- Dermatomyositis,
Systemic sclerosis.

38. POIKILODERMA
● It is a combination of
reticulate telengiectasia,
pigmentary change and
atrophy.
● Eg:- Dermatomyositis,
poikilo derma of civatte

39. VASCULOPATHY

40. ● Petechiae are pinpoint
brown spots.
● Less than 3 mm.
PETECHIAE

41. PURPURA
● Purpura are larger raised
lesions resulting from
bleeding within the skin.
● From 3 to 10mm

42. ECCHYMOSIS
● Discoloration of the skin
typically caused by
bruising.
● More than 10mm.

43. TARGET LESION
IRIS LIKE LESION
● Erythema multiforme
(commonly seen in
Herpes Simplex Virus.)

44. SHAPES OF LESIONS

45. CONFIGURATION OF LESIONS
Shapes Examples
Discoid Discoid Eczema, Psoriasis.
Arcuate Urticaria.
Annular Tinea corporis, Granuloma.
Polycyclic Psoriasis.
Linear Scabies, Psoriasis.
Reticular Oral Lichen Planus.
Serpiginous Cutaneous Larva Migrans.
Target Erthema Multiforme.
Digitate Chronic Superficial
Dermatosis.

46. Linear
Reticular
Discoid
Targetoid
Annular
Arcuate

47. ARRANGEMENT OF LESIONS WITH
EXAMPLES
● Grouped - herpetic vesicles.
● Scattered, Disseminated,
Exanthematous - Drug Eruptions. (chronic
bullous Disease of childhood.)
● Confluent –P. Versicolor.
● Satellite – Melanoma.
● Agminate – Acne Agminata.
● Erythroderma ( Generalized redness) –
Psoriasis, S.D.

48. COLOUR OF SKIN LESIONS
Colour Examples
Black Melanin e.g. melanoma.
Brown ( Dark, Pale
& Muddy)
Freckles, Beckers nevus.
Blue-Purple Angiomas ( Vascular Lesions), Blue nevus.
Red- Brown Secondary syphilis, Drug Eruptions.
Scarlet Red Pyogenic granuloma
Yellow- white Xanthomas, Molluscum contagiosum, Skin tags.
White-Pale Vitiligo, Tinea versicolor
Normal skin Colour is due to melanin, haemoglobin,
oxy-haemoglobin, carotenoid.

49. Brown colored papules
Melanoma Dermatofibroma

50. BLUE COLORED PAPULES
Blue nevus Lichen planus
violaceous papules

51. Drug Eruptions
Red- Brown coloured macules
Secondary syphilis

52. RED COLORED PAPULE
Acne
Folliculits
Insect bite

53. YELLOW-WHITE COLORED PAPULES.
Molluscum contagiosum Skin Tags

54. White
Tinea versicolor

55. DISTRIBUTION OF LESIONS
● Dermatomal/
zosteriform.
● Blaschkoid- following lines of
skin cell migration during
embryogenesis.
Longitudinal on limbs
Circumferential on trunk.

56. ● Symmetrical – Classical Psoriasis
(equally on extensor surfaces.)
● Asymmetrical – Cutaneous T-Cell
Lymphoma
● Photo Distributed – Dermatoses
caused by light – Chronic Actinic
Dermatitis.
● Airborne – It occurs due to allergens
on light spared areas.

57. DISORDERS HAVING PREDILECTION FOR
SPECIFIC BODY SITES
Body
Site
Type of Disorder Example
Scalp Hair Disorder, Dermatosis. Alopecia Areata,
Androgenic Areata.
Eye Lids Inflammatory Dermatosis,
Localized Lesion.
Contact Allergy, Atopic
Eczema.
Ears Inflammatory Dermatosis,
Localized Lesion.
Seborrhoeic Dermatitis,
Psoriasis.
Face Inflammatory Dermatosis,
Localized Lesion, Infection.
Acne, Seborrhoeic
Dermatitis, Lupus Rash.
Lips Inflammatory Dermatosis,
Localized Lesion, Infection.
Cheilitis, Viral warts
Cont…

58. Body
Site
Type of Disorder Example
Hands Inflammatory Dermatosis,
Localized Lesion, Infection,
Nail Disorder.
Erythema Multiform,
Photo-sensitivity,
Onychomycosis, Scabies
Limbs Inflammatory Dermatosis,
Localized Lesion, Infection.
Psoriasis, Contact
Dermatitis.
Feet Inflammatory Dermatosis,
Localized Lesion, Infection.
Psoriasis, Fungal
Infections, Corns and
Callus
Axillae Inflammatory Dermatosis,
Localized Lesion, Infection.
Psoriasis, Contact
Dermatitis.
Genitals Inflammatory Dermatosis,
Localized Lesion, Infection.
Genital Warts, STD.

59. THANK YOU