Common Dermatology Terms Tanner Bartholow

Macule “A macule is a change in the color of the skin. It is flat, if you were to close your eyes and run your fingers over the surface of a purely macular lesion, you could not detect it. A macule greater than 1 cm. may be referred to as a patch” 1 erythema infectiosum

Papule “A papule is a solid raised lesion that has distinct borders and is less than 1 cm in diameter. Papules may have a variety of shapes in profile (domed, flat-topped, umbilicated) and may be associated with secondary features such as crusts or scales” 1 scabiesmolluscum contagiosum

Nodule “Nodule is a raised solid lesion more than 1 cm. and may be in the epidermis, dermis, or subcutaneous tissue” 1 Basal cell carcinoma

Plaque “A plaque is a solid, raised, flat-topped lesion greater than 1 cm. in diameter. It is analogous to the geological formation, the plateau” 1 psoriasis tuberous sclerosis

Vesicle “Vesicles are raised lesions less than 5mm. in diameter that are filled with clear fluid (blister)” 1

Bulla Bullous pemphigoid “Vesicles are raised lesions greater than 5mm. in diameter that are filled with clear fluid (blister)” 2

Pustule “Pustules are circumscribed elevated lesions that contain pus. They are most commonly infected (as in folliculitis) but may be sterile (as in pustular psoriasis)” 1 Group A Strep infection

Wheal (hive) “A wheal is an area of edema in the upper epidermis” 1 “Edematous, transient papule or plaque caused by infiltration of dermis by fluid” 2

Scales “Excessive number of dead keratinocytes produced by abnormal keratinization” 2 Seborrheic dermatitis

Petechiae, Purpura, Ecchymoses “The term "petechiae" refers to smaller lesions. "Purpura" and "ecchymoses" are terms that refer to larger lesions. In certain situations purpura may be palpable. In all situations, petechiae, ecchymoses, and purpura do not blanch when pressed.” 1 Thrombocytopenia Henoch-Schönlein Purpura

Quiz

1. Macule/patch (mongolian spot) 2. Plaque (psoriasis) 3. Macule/patch (tinea versicolor)

Treatment of purpura fulminans –Study from 7 burn centers over a 10 year period (70 total patients) 3 Neisseria meningitidis most common in infants through adolescents Streptococcus most often found in adults Treatments consisted of antibiotic treatment of the underlying infection Volume replenishment and ventilatory and inotropic support Corticosteroids used (38%) of time Protein C replaced in (9%) of patients Skin grafting and amputations required in (90%) 25% amputation of all extremities Early fasciotomoies reduced amputation in 6 of 14 patients

Resources 1. Williams, D., and M. Katcher. Nomenclature of Skin Lesions: Primary Care Dermatology Module. Wisconsin Area Health Education Center (AHEC) System Goljan, E Rapid Review Pathology. 2 nd Ed. Mosby Elsevier. Philadelphia. 3. Warner PM, Kagan RJ, Yakuboff KP, et al. Current management of purpura fulminans: a multicenter study. J Burn Care Rehabil 2003; 24: