This document summarizes the anatomy and functions of the skin and describes various primary and secondary skin lesions. It discusses the layers of the skin - epidermis, dermis, and hypodermis - and their components. It then defines and provides examples of different types of primary skin lesions including macules, papules, plaques, nodules, vesicles, bullae, pustules, and wheals. Secondary skin lesions like scales, crusts, and ulcers are also outlined. The functions of the skin in protection, sensation, temperature regulation, and vitamin D production are highlighted.

1. DEPARTMENTAL SAMINAR ON PRIMARY SKIN
LESIONS
BY
DR SAEEDA M MAKANDAR
1ST YEAR PG SCHOLAR DEPT OF PANCHAKARMA
GUIDED BY
DEPT OF PG STUDIES IN PANCHAKARMA
S V M AYURVEDIC MEDICAL COLLEGE AND
RESEARCH CENTER, ILKAL

2. SKIN AND PRIMARY SKIN
LESIONS

3. SKIN ANATOMY
• Largest organ ( Covers approx
area of 2m, wt 4 kg)
• Layers of the skin-
1. Epidermis
2. Dermis
3. Hypodermis (Subcutaneous
tissue)

4. EPIDERMIS
Epidermis has 2 types of cells
Keratinocytes
Dendritic cells
Layers of epidermis
1. Stratum Basale
2. Stratum Spinosum
3. Stratum Granulosum
4. Stratum Lucidum
5. Stratum Corneum

5. DERMIS
• Made up of fibrillar structural protein
known as collagen.
• It has connective tissue, blood vessels,
oil and sweat glands, nerves, hair
follicles and other structures.
• Dermis layers-
1. Papillary dermis
2. Reticular dermis
SUBCUTANEOUS
TISSUE

6. FUNCTIONS OF THE SKIN
• PROVIDES A PROTECTIVE BARRIER AGAINST MECHANICAL, THERMAL AND
PHYSICAL INJURY AND HAZARDOUS SUBSTANCES.
• PREVENTS LOSS OF MOISTURE..
• REDUCES HARMFUL EFFECTS OF UV RADIATION.
• ACTS AS A SENSORY ORGAN (TOUCH, DETECTS TEMPERATURE).
• HELPS REGULATE TEMPERATURE.
• AN IMMUNE ORGAN TO DETECT INFECTIONS ETC.
• PRODUCTION OF VITAMIN D.
• ELIMINATION OF WASTE PRODUCTS THROUGH THE PERSPIRATION.

7. EXAMINATION OF SKIN LESIONS
• History taking asking symptoms of which patient
complains.
• Distribution of rashes.
• Site of the rashes.
• Pattern of the lesions like,
1. Diffused
2. Linear
3. Scattered
4. Groups
• Related scars of previously dameged skin.
• Colour of the skin.
• Shape and size of the lesions.
• Border.

8. Types of skin lesions, are
1. Primary skin lesions
2. Secondary skin lesions

9. PRIMARY SKIN LESIONS
1. Macule
2. Papule
3. Plaque
4. Nodule
5. Papilloma
6. Vesicle
7. Bulla
8. Pustule
9. Wheal
10. Talengiectasia
11. Patechia
12. Purpura
13. Ecchymosis
14. Haematoma
15. Paikiloderma
16. Erythema
17. Burrow
18. Comedo

10. 1. Scale
2. Crust
3. Excoriation
4. Lichenification
5. Fissure
6. Errosion
7. Ulcer
8. Sinus
9. Scar
10. Keloid
scar
11. Atrophy
12. Stria
SECONDARY SKIN LESIONS

11. MACULE
• It is Non palpable area
of altered colour.
• It doesn’t involve any
change in thickness or
texture of the skin.
• Ex- vitilogo, freckle,
tinea versicolor.

12. PAPULE
LICHEN PLANUS
Secondary syphilis
• It is an elevated Palpable
lesion,
arbitrarily <0.5cm in
diameter.
• Can have distinct/indistinct
borders.
• Ex: papular eczema,
syphilis,
lichen planus.

13. PLAQUE
PLAQUE PSORIASIS
• It is palpable flat
topped discoid lesion
and is >2cm.
• Ex : Plaque psoriasis.

14. NODULE
• It is a solid palpable lesion
within
the skin i.e > 0.5cm.
• They project more deeply
into the corium and
hypoderm than Papules.
• Ex: Nodular syphilide,
nodular leprosy
Nodular scabies
NODULAR HISTOID
LEPROSY

15. PAPILLOMA
• Pedunculated lesion
projecting from the skin.
• Caused by Human
papilloma virus
( HPV)

16. VESICLE
• It is a small fluid filled
blister.
• < 0.5 cm In diameter.
• Here fluid becomes trapped
under the epidermis
• Ex: In Allergic reactions,
Dermatitis, poison ivy, cold
sore
( herpis simplex)
DERMATITIS
HERPIS SIMPLEX

17. BULLA
• A large fluid filled blister.
• Diameter is > 0.5 cm.
• Contents usually serous
may be hemorrhagic.
• Ex: Pemphigus, dermatitis
Herpetiformis.
PEMPHIGUS VULGARIS
DERMATITIS
HERPETIFORMIS

18. PUSTULE
• It is a papular lesion
containing turbid
purulent material ( pus).
• They usually apear white
bumps surrounded by
red skin.
• Ex : Impetigo
contagiosa, sycosis
vulgaris, pustular
eczema, Furunculosis etc
PUSTULES IN ACNE VULGARIS
FURUNCULOSIS

19. WHEAL
• Also called as pomphi.
• These are irregular, variously
sized,itchy, transient (<24hrs).
• Elevated lesions are white in
center and have red margin.
• Caused by Circumscribed
oedema of the corium.
• Ex : Urticaria
URTICARIA
WHEAL

20. TELANGIECTASIA
• Dialation of superficial blood
vessels on skin or mucous
membrane.
• Ex : Habitual corticosteroid use,
Scleroderma, SLE
In SCLERODERMA
TELANGIECTASIA

21. PETECHIAE
PETECHIAE
• Pin head sized macules
of blood.
• May be small area due to
trauma.
• Ex: In drug reactions,
Endocarditis.

22. PURPURA
• Larger petechiae which do
not blanch on pressure.
• Reddish or purplish spots of
various sizes and shapes.
• Ex : Vasciculitis, in clotting
defects.
VASCICULITIS

23. ECCHYMOSIS
TRAUMA
• These are larger petechiae
which do not blanch on
pressure.
• Reddish or purplish spots
of various size and shape.
• Ex : Trauma,
Thrombocytopnia.

24. HAEMATOMA
• Swelling due to gross
bleeding out side the blood
vessels.
• In case of injury.

25. POIKILODERMA
• It is the combination of atrophy,
Hyperpigmentation and
telangiectasia.
• Has cappilary haemorhages
accompanied by general pruritus.
• Site- All over body Including
scalp.
• Ex: Mycosis fungoides,
Epitheliomatosis
MYCOSIS
FUNGOIDES

26. ERYTHEMA
• Redness of skin that
blanches on pressure.
• It may localized or
widespread.

27. BURROW
• Linear or carved track left by the
burrowing scabies mite.
• Intense itching.
• Ex: Scabies

28. COMEDO
• Commonly known as blackheads.
• Dark horny keratin and
sebaceous plugs within
Pilosebaceous opening.
• Ex : Acne vulgaris