Descript about the various Primary lesions in Dermatology!

1. PRIMARY SKIN LESIONS
Dr Aseem Sharma
Dermatology Resident

2. MACULE (L: Spot)
Flat
Non-palpable
Alteration in Color
No Change in Texture

3. MACULE
Hypopigmented VITILIGO
TUBEROUS SCLEROSIS
Hyperpigmented NEUROFIBROMATOSIS
EPHELIDS
MONGOLIAN SPOTS
Erythematous VIRAL / DRUG RASH
Pupurae THROMBOCYTOPENIC
PURPURA

4. MACULE

5. MACULE

6. MACULE

7. PAPULE (L. pimple)
• Small
• Solid
• Elevated lesions
• < 01 cm dia

8. PAPULE
• Epidermal hyperplasia/ Extraenous infiltrates
• SHAPE
ACUMINATE (Follicular LP)
DOME-SHAPED (M. contagiosum)
FLAT TOPPED (Lichen Planus)
PAPULO-SQUAMOUS (Guttate Psoriasis)

9. PAPULE
• COLOUR
WHITE (M. contagiosum)
VIOLACEOUS (L. Planus)
YELLOWISH (Xanthomatosis)
FLESH COLOURED (A. sebaceum)
BLUISH-BLACK (Malignant Melanoma)

10. PAPULE

11. PAPULE

12. PAPULE

13. PAPULE

14. PLAQUE
• Solid
• Plateau-like elevation
• Large Surface Area
• Coalescence/ Enlargmenent

15. PLAQUE
• Psoriasis Vulgaris
• Lichen Simplex Chronicus
• Borderline Tuberculoid Leprosy

16. PLAQUE

17. PLAQUE

18. PATCH
• Large Macule OR Plaque ??
• Rarely used

19. NODULE (L: small knot)
• Solid
• Raised
• Round
• 3D growth of Papule
• Diff from papule in Depth
• Tumour

20. NODULE
• Epidermal (Nodular BCC/ Keratoacanthoma)
• Dermal (Dermatofibroma)
• Subcutaneous (Lipoma/ Eythema Nodosum)

21. NODULE

22. NODULE

23. NODULE

24. TUMOUR

25. WHEAL
• ‘Urticaria / Hives’
• Evanescent
• Elevated Lesion
• With Erythema and Edema
• Blanching
• Dermographism (25%)
• Angioedema

26. WHEAL
Transient Vascular Reaction in Dermis

Vasodilation / Increased Capillary permeability

Extravasation of fluid from Capillaries

Edema

27. WHEAL

28. DERMOGRAPHISM

29. ANGIOEDEMA

30. VESICLE (L: bladder)/ BULLA (L: bubble)
• Elevated lesion
• Contains Clear Fluid
• < 0.5 cm dia = VESICLE
• > 0.5 cm dia = BULLA

31. VESICLE/ BULLA
• Levels
Stratum Corneum - Impetigo Contagiosum
- Pemphigus Foliaceus
Stratum Spongiosum - Contact Dermatitis
- Pompholyx
Stratum basale - Pemphigus Vulgaris
Dermo-Epidermal Junction - Bullos Pemphigid
- Dermatitis Herpetiformis

32. VESICLE/ BULLA

33. VESICLE/ BULLA

34. VESICLE/ BULLA

35. VESICLE/ BULLA

36. PUSTULE
• Raised lesion
• Elevated
• Fluid-filled lesions
• WBCs + Debris +/- Bacteria

37. PUSTULE
• Pyoderma
• Halogenoderma
• 2° to Vesicular lesions (Herpes Zoster/
Varicella)
• Acne Vulgaris
• Pustular Psoriasis

38. PUSTULE

39. PUSTULE

40. PUSTULE

41. CYST
• Sac containing liquid/ semisolid material
• ‘Resilient feel’
TYPES
- KERATINOUS Squamous ep Epidermis
- PILAR Multilayered ep Hair Follicle

42. CYST

43. CYST

44. ABSCESS
• Elevated lesion
• Collection of pus under skin
• Lack well-defined lining
• Surrounding skin changes

45. ABSCESS

46. THANK YOU