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The Primary Lesions
Primary lesions are physical changes in the skin considered to be caused directlyby the disease process. Types of primary lesions are rarely specific to a singledisease entity.
1.MACULE
A macule is a change in the color of the skin (hypo or hyper). It is flat, if you wereto close your eyes and run your fingers over the surface of a purely macular lesion, you could not detect it. A macule greater than 0.5 cm. may be referred toas a
 patch
.
2.PAPULE
A papule is a solid raised lesion that has distinct borders and is less than 1 cm indiameter. 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.e.g acne vulgaris papules
3.NODULE
A nodule is a raised solid lesion more than 1 cm. Deeply seeded may be in theepidermis, dermis, or subcutaneous tissue.e.g leprosy nodules, nodular acne
4.PLAQUE
A plaque is a solid, raised, flat or rough lesion greater than 1 cm. in diameter withdefined edges.
5.VESICLE
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Vesicles are small raised lesions (blisters) less than 0.5 cm. in diameter that arefilled with clear fluid.e.g herpes simplex, dermaitis
6.BULLAE
Bullae are large circumscribed fluid-filled lesions (blisters) that are greater than 1cm. in diameter.
7.PUSTULE
Pustules are small circumscribed elevated lesions that contain pus. They aremost commonly infected (as in folliculitis) but may be sterile (as in pustular psoriasis). They may develop spontaneously or from a papule.e.g acne pustule
8.WHEAL
TRANSIENT solid swelling resembling an orange skine.g urticaria
9. ERYTHEMA
An area of redness or duskinesse.g cellulitis, drug reaction10.TUMORA tumor is a solid mass of the skin or subcutaneous tissue; it is larger than anodule. (Please bear in mind this definition does not at all mean that the lesion isa neoplasm.)11.BURROW Burrows are linear lesions produced by infestation of the skin and formation of tunnels (e.g., with infestation by the scabitic mite or by cutaneous larva migrans).
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12.TELANGIECTASIATelangiectasia are the permanent dilatation of superficial blood vessels in theskin and may occur as isolated phenomena or as part of a generalized disorder,such as ataxia telangiectasia.
The Secondary Lesions
Secondary lesions may evolve from primary lesions, or may be caused byexternal forces such as scratching, trauma, infection, or the healing process. Thedistinction between a primary and secondary lesion is not always clear.
1.EXUDATE
Fluid content of a broken papule, vesicle, bulla or pustule.e.g Impetigo, eczema, dermatitis
2. SCAB
A mass of an incomplete dried exudatee.g eczema or dermatitis,Impetigo
3. CRUST:
Friable mass of a completely dried exudate. If we remove the crust we will findthe erosion underneathe.g scabies, ImpetigoCrusting is the result of the drying of plasma or exudate on the skin. Pleaseremember that crusting is different from scaling. The two terms refer to differentphenomena and are not interchangeable. One can usually be distinguished fromthe other by appearance alone.EXUDATE
SCAB
CRUST
EROSION “result from removing the crust”
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