1. Terminology

2. Macule Patch

3. Macule
A circumscribed flat lesion <10mm in diameter with a change in the colour or textural change of the skin.

4. Patch – flat >10mm in diameter

5. Papule Nodule

6. Papule -A raised solid lesion <10mm in diameter felt on palpation
Papule -A raised solid lesion <10mm in diameter felt on palpation. They can be flat topped or dome shaped and can be of various colours.

7. Nodule A raised solid lesion >10mm in diameter
Nodule A raised solid lesion >10mm in diameter. It can involve any layer of the skin.

8. Plaque

9. Plaque – flat topped palpable lesion Diameter >> thickness

10. Vesicle Bulla Pustule Abscess

11. Vesicle - A small blister <10mm in diameter
Vesicle - A small blister <10mm in diameter. This is filled with clear fluid and lies in the epidermis or the dermo-epidermal junction. Bulla - A blister >10mm in diameter. Pustule - A blister filled with a visible collection of pus. Not all pustules are signs of infection. Abscess -A localized collection of pus >1cm in diameter.

13. Lesion due to a broken surface
Erosion - A superficial break in the skin, involving the epidermis but not the dermis therefore heals without scarring.
Ulcer - A circumscribed area of skin loss down to and involving the dermis. It will therefore heal with scarring.
Fissure - A linear split in the skin which can extend down into the dermis.
Excoriation – Localised damage due to scratching with linear erosions and crusts

15. Weal - A transient elevated lesion i. e
Weal - A transient elevated lesion i.e. papule or plaque which is compressible due to dermal oedema. It is usually red or white in colour. Cyst – A papule or nodule lined with an epithelial wall and filled with fluid, pus or keratin. Crust – dried exudate Scale - visible and palpable flakes of grouped epidermal cells

17. Lichenification – Thickening of epidermis with increased skin markings due to persistent rubbing Pedunculated – stalk–like lesion Papillomatous – surface has minute round or finger –like projections Filiform – rough finger–like projections

19. Summary History – similar to most medical conditions
Examination – Look and feel
Describe, describe, describe!

20. ACKNOWLEGEMENTS PCDS Prof Raimo Suhonen Dermnetnz Graham Chadwick