1. Skin lesions:
Defining the rash
Vicki Sweet, RN, MSN, CEN
MED 3015 C – Week 5

2. Rashes and lesions
 Usually temporary eruptions
 Difficult to diagnose
 No two look exactly alike
 Appearance may be altered by scratching
or self-treatment
 But… there are some common
characteristics

3. Describing the lesion
 Macules and patches
 Circumscribed, flat, nonpalpable changes in
skin color
 Examples: freckles, petechiae, vitiligo

4. Describing the lesion (cont.)
 Papules, nodules and wheals
 Palpable elevated solid masses
 Examples: nevi, mosquito bite, hive

5. Describing the lesion (cont.)
 Vesicles, bulla and pustules
 Circumscribed superficial elevations,
fluid-filled cavities within the skin layers
Typically, a vesicle bigger
than a pea is called a bulla

6. Lesions can be combination
 Examples:
 Maculopapular rashes
 Combination of flat and palpable lesions
 Maculovesicular rashes
 Combination of flat lesions, raised “blisters”
 Describe what you see – very hard to
“diagnose”

7. Dangerous rashes
 Petechial rash Petechial rash
 Meningococcal meningitis
 DIC
 Stevens-Johnson Syndrome
 Toxic shock syndrome
 Rash may look like a sunburn Stevens-Johnson rash
 Smallpox versus chicken pox
 Similar virus
 Progression of rash is more
diagnostic

8. Respecting what the skin
can tell us!
 The skin is the largest organ in the body
 It can reflect so much about our health
 Assess:
 Color
 Temperature
 Moisture
 Turgor
 Integrity