This document discusses assessing and classifying skin lesions. It begins by defining skin lesions and describing common symptoms. It then categorizes lesions as primary, secondary, or vascular. Primary lesions include macules, papules, plaques, nodules, vesicles, and pustules. Secondary lesions result from primary lesions, such as scales, crusts, erosions, and fissures. Vascular lesions involve changes to blood vessels. The document provides examples and characteristics of different lesion types and outlines how to assess lesions by visual inspection and palpation of characteristics like temperature, moisture, and texture.

1. Assessment of skin lesion
Presented by:
Abeer Alenzy, Amjad , Suaad , Smaher , Manar
omar
Supervisor:
Miss.mary

2. Objectives:
at the end of the presentation , students
will be able to:
-know the type of skin lesions.
-Differentiate between
primary, secondary, vascular lesions.
-Perform assessment of skin lesions.

3. Out line:
-definition of skin lesions.
-Types of skin lesions:
primary , secondary , vascular skin lesions.
-how to assess the lesions.
-determine The normal and abnormal findings

4. Introduction:
• What is a skin lesion?
• A skin lesion is any change in the normal character
of your skin and may occur on any part of your body
and cover a tiny or large area , can be singular or
multiple, confined to one specific area of your body
or distributed widely.
• Skin lesions include rash, cysts, pus-filled sacs,
blisters, swelling, discolorations, bumps, hardening,
or any other change in or on your skin.
• Skin lesions may result from a wide range of causes,
as harmless as a small scrape or as serious as skin
cancer.

5. Skin Lesion Symptoms
• A normal skin mole is tan, brown, or black.
• Moles are usually round and less than 1/4
inch (6 mm) in diameter.
• Symptoms of a skin lesion include a new
mole, and an old mole that has changed
shape, color, or size.
• Additional symptoms of a skin lesion
include skin lumps that increase in size,
bleed, ooze, contain blood vessels, or
become scaly or crusty.

7. Type of skin lesion:
• Primary
Skin
Lesions.
• Secondary
Skin
Lesions.
• Special Skin
Lesions.

8. Primary lesions

9. • Primary Lesions: Those lesions that
are the direct result of a pathologic
process
Definition:

10. • Macule : is a flat discolored lesion
that is less than 1 cm in diameter.
• Example: vitiligo

11. • Patch: is a flat discolored lesion
that is greater than 1 cm in
diameter.
• Example: “Cafe-au-lait” spot

12. • Papule: is a Small solid raised lesion
that is less than 0.5 cm in diameter.
• Example: Wart

13. • Plaque: is a solid raised lesion that
is greater than 0.5 cm in diameter.
• Example: Psoriasis

14. • Nodule: is a raised solid lesion more than
1 cm. and may be in the epidermis,
dermis, or subcutaneous tissue
• Example: Enlarged lymph node

15. • Tumor: is a solid mass of the skin or
subcutaneous tissue; it is larger
than a nodule.
• Example: Xanthoma

16. Vesicles: is raised lesions less
than 1 cm in diameter that are
filled with clear fluid.
• Example: Blister

17. • Bulla: is a large vesicle that is
more than 0.5 cm in diameter.
• Example: Blister

18. • Pustule: is circumscribed elevated
lesions that contain pus, They are
most commonly infected but may be
sterile.

19. • Wheal: is an area of edema in the
upper epidermis.

20. • Burrow: is linear lesions produced
by infestation of the skin and
formation of tunnels.

21. • Telangiectasia: is the permanent
dilatation of superficial blood vessels in
the skin and may occur as isolated
phenomena or as part of a generalized
disorder, such as ataxia telangiectasia.

22. Secondary Skin Lesions
Scale
Crust
Erosion
Fissure
Sinus
Scar
Atrophy
Lichenification

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

24. Types of scales
Fine to stratified
•Erythema
craquele(dense scale)
•Psoriasis(silvery scale)

25. • Ichthyosis vulgaris

26. • Tinea versicolor(fine)

27. Scaling in sheets(desquamation)
Scarlet fever(hands and feet)

28. • Staphylococcal scalded skin syndrome
• Kawasaki syndrome

29. Other types of scales
• Crack like - eczema
craquele.
• Exfoliative- drug rxn.
• Follicular- keratosis
pilaris.
• Gritty- actinic keratosis.
• Ichthyosiform- ichthyosis
vulgaris.
• Keratotic/
hyperkeratotic-
cutaneous horn.

30. Cont…
• Lamellar- lamellar
ichthyosis.
• Pityriasiform-
pityriasis rosea.
• Psoriasiform -
psoriasis vulgaris.
• Seborrheic-
seborrheic dermatitis.
• Wickham striae-
lichen planus

31. Crust
• Dried exudate of
body fluids (blood
/ serous fluid)
• Which might be
either yellow / red

32. Examples of crusting
Tinea capitis Impetigo

33. Erosion
• A focal loss of epidermis
• Erosions do not penetrate
below the
dermoepidermal junction
and therefore heal
without scarring
• Eg:- tinea
pedis,candidiasis,eczema
-tous disease, herpes
simplex
Tinea pedis candidiasis

34. ulcer
• A focal loss of
epidermis and/or
dermis
• Scarring depends on
the depth of the ulcer
• Eg-
chancroid,pyoderma
gangrenosum,decubit
us

35. • Pyoderma gangrenosum • decubitus

36. Fissure
•It is a linear loss of continuity of
skin due to excessive tension.
•Eg:- eczema(fingertips),intertrigo

37. • Finger fissure d/t eczema
• intertrigo

38. 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

39. • scar of herpes zoster • Burn scar

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

41. Lichenification
• Repeated rubbing of
skin results in
thickening and
hyperpigmentation of
skin
• The skin markings
become prominent.
• Eg:- Lichen simplex
chronicus, Atopic
dermatitis.

42. Vascular skin lesions
• Vascular lesions include acquired lesions (eg,
pyogenic granuloma) and those that are present
at birth or arise shortly after birth (vascular
birthmarks). Vascular birthmarks include
vascular tumors (eg, infantile hemangioma) and
vascular malformations. Vascular malformations
are congenital, life-long, localized defects in
vascular morphogenesis and include capillary
(eg, nevus flammeus), venous, arteriovenous (eg,
cirsoid aneurysm), and lymphatic
malformations.

43. definition of vascular lesion
• Vascular skin lesions are very common ,
occurring in about 40% all children 20% oh
hemangiomas are present at birth and most
begin in the first month of life

44. Type of vascular lesions
▫ Petechia
▫ Ecchymosis
▫ Hematoma
▫ Cherry Angioma
▫ Spider Angioma
▫ Telangiectasis

45. Petechia

46. Ecchymosis

47. Hematoma

48. Spider Angioma

49. Causes and Characteristics
• Causes are unclear but thought to include:
• family history
• environmental factors such as sun exposure
• gender (women are affected more than men)
• age (usually appear between the ages of 40-50)
• Usually symptomless, benign condition not
associated with any complications
• Most often occur on feet, ankles, and lower legs

50. ASSESSING LESION
The skin shouId be a continuous tissue and so note breaks
erosions and lesions
Document localized and pigmenteg variations including moles
freckles and vascular lesion and examine them closely
Lesion solid or fluid filled
Fluid filled lesions have a yellow or pink glow whereas solid
lesions do not
Vascular lesions are red topurple in color They may be causded of
extra vasationof blood into the skin tissue or by visible
superficial vascular irregularities
Example the axillae are usually more moist than other areas

51. PALPATION
• Is used to determine skins temperature
texture and turgor.

52. Temperature
• Compare side to side using the dorsal
aspect of your hand
• Temperature varies depending on area
being assessed for example exposed areas
may be cooler than unexposed areas

53. MOISTURE• Use light palpation to assess skin moisture
• Dependson environmental condition and
patients age Elderly people have drier skin
because 0f decrease sweat production
• Exposed areas are usully drier than unexposed
areas Also moisture varies varies according to
body area

54. TEXTURE
• USELIGHT PALPATION TO ASSESS texture
• Varies fromsoft and fine to coarse and thick
depending on area assessed and patients age
Exposed skin usually not as soft as unexposed
• Extensor surfaces such as elbows ha coarser skin
• Usually the younger the patient the sofer the skin

55. Summery
• ●Most benign skin lesions are diagnosed on the
basis of clinical appearance and history. If the
diagnosis of a lesion is uncertain, or if a lesion has
exhibited unexpected changes in appearance or
symptoms, a diagnostic procedure (eg, biopsy,
excision) is indicated to confirm the diagnosis.
• ●Benign lesions that are symptomatic or
cosmetically bothersome can often be managed
with simple procedures, such as cryotherapy,
electrosurgery, or excision.

56. Reference
• http://www.healthline.com/health/tinea-
versicolor#Treatment6
• Medical surgical nursing
• http://www.webmd.com/
• http://missinglink.ucsf.edu/lm/DermatologyGlo
ssary/secondarylesions1a.html
• https://ar.wikipedia.org/wiki/%D8%A5%D9%8
3%D8%B2%D9%8A%D9%85%D8%A7