1. Common Dermatology Terms Tanner Bartholow

2. 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 http://www.pediatrics.wisc.edu/education/derm/tuta/macule.html erythema infectiosum

3. 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 http://www.pediatrics.wisc.edu/education/derm/tuta/papule.html

4. Nodule “Nodule is a raised solid lesion more than 1 cm. and may be in the epidermis, dermis, or subcutaneous tissue” 1 http://www.pediatrics.wisc.edu/education/derm/tuta/nodule.html Basal cell carcinoma http://www.pathguy.com/lectures/erf05_basal_cell_ca_arising.jpg

5. 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 http://www.pediatrics.wisc.edu/education/derm/tuta/plaque.html

6. Vesicle http://z.about.com/d/dermatology/1/0/M/5/three_lesions.jpg “Vesicles are raised lesions less than 5mm. in diameter that are filled with clear fluid (blister)” 1 http://dermatology.about.com/od/dermphotos/ig/Chicken-Pox-Pictures/chickenpox22.htm

7. Bulla http://www.aafp.org/afp/20020501/1861_f4.jpg Bullous pemphigoid “Vesicles are raised lesions greater than 5mm. in diameter that are filled with clear fluid (blister)” 2

8. 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 http://www.pediatrics.wisc.edu/education/derm/tuta/pustule.html Group A Strep infection

9. 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 http://www.pediatrics.wisc.edu/education/derm/tuta/wheal.html

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

11. 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

12. Quiz http://www.kidsgrowth.com/images/fp_images/mongolian_spot.jpg

13. http://www.mdconsult.com/das/pdxmd/media/1127/6112715/large.jpg

14. http://www.mycology.adelaide.edu.au/gallery/photos/malass1.gif

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

16. 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

17. Resources 1. Williams, D., and M. Katcher. Nomenclature of Skin Lesions: Primary Care Dermatology Module. Wisconsin Area Health Education Center (AHEC) System. 2003. 2. Goljan, E. 2007. 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: 119-126.