Skin terms

Macule – a flat, non-palpable, coloured lesion which is less than 1cm in size. It is usually red, brown
or depigmented. Examples include a freckle or a solar lentigo

Patch – as above but larger than 1cm in size. Examples include larger areas of vitiligo or the early
herald patch of pityriasis rosea

Papule – a palpably raised lesion which is less than 1cm in diameter. For example, the papules seen
in facial acne

Nodule – a palpably raised lesion which is more than 1cm in diameter. For example, a nodular BCC
or a dermatofibroma. If you can pinch the lesion between finger and thumb, it is a nodule rather
than a papule. In some cases, most of the nodule may lie beneath the skin surface as with a lipoma.

Plaque – flat-topped, slightly raised, or palpably different areas of skin. For example, the scaly, well-
defined red plaques of psoriasis

Vesicle – small fluid-filled blister less than 0.5cm in diameter. For example, the vesicles seen in
pompholyx eczema

Bulla – larger fluid-filled blister more than 0.5cm in diameter. For example, the bullae seen in
bullous pemphigoid or following a burn

Pustule – pustules result from accumulation of large numbers of leukocytes in the epidermis or
upper dermis. For example, the follicular pustules seen in facial acne or folliculitis elsewhere on the

Weal – the result of a rapid leak of fluid from blood vessels into the dermis causing a localised area
of dermal oedema; usually with erythema and typically last less than 24 hours. For example, in

Breaks in the skin surface

 Erosion – produced by surface loss chiefly involving only the epidermis
 Ulcer – tissue loss extends into the dermis. For example, leg ulcer
 Fissure – narrow, deep, cleft-shaped ulcer. For example, angular cheilitis or the deep
fissures that some patients develop in the heel skin
 Excoriation – scratch marks which can result in erosions or ulcers

Scale – flaking of the skin due to loss of damaged stratum corneum (as in fungal infection) or
abnormal stratum corneum (as in psoriasis). This indicates an abnormality of the epidermis

Crust – dried surface exudate of blood or serous fluid. For example, in impetigo

herpes simplex viral infection Disseminated – multiple small lesions at different sites without any specific pattern. guttate psoriasis Confluent – multiple lesions becoming merged together. For example. herpes zoster Photosensitive – Skin reactions caused by sun exposure affecting face. in vasculitis  Petechiae – pinpoint spots of purpura  Ecchymosis – extravasated blood in fat and muscle is an ecchymosis or bruise Shapes and patterns Discoid – circular or like a coin. For example. For example.multiple but separate lesions centred around on area. nape and V of the neck. usually truncal. pityriasis versicolor Exanthematous – multiple. with eczema or psoriasis . For example. For instance. red. For example. For example. For example. in granuloma annulare Target – concentric rings of different colours or shades. For example. Asymmetry suggests an exogenous cause such as a skin infection like tinea Flexural – affecting predominantly the flexures. For example. in pityriasis rosea Annular – ring shape. For example. in urticaria  Telangiectasia – presence of visible vessels close to the skin. psoriasis Dermatomal – following a dermatomal distribution.Results of changes in dermal blood vessels  Erythema . in erythema multiforme Serpiginous – wavy line. For example. parvovirus infection causing slapped cheek syndrome (Fifth disease) Symmetry and asymmetry – symmetry implies an endogenous cause such as psoriasis or atopic eczema. and dorsa of hands and arms Arrangements of multiple lesions Grouped . in rosacea  Purpura – caused by blood that has leaked from dermal blood vessels and therefore cannot be blanched by pressure. For example. scabies mites mites as they burrow through the skin Reticulate – lace-like pattern of a rash. atopic dermatitis in adults Extensor – affecting predominantly the extensor areas. For example. lesions. redness of the skin. drug eruptions or viral exanthems Erythroderma – total. or virtually total. in discoid eczema or psoriasis Oval – oval shaped. For example.diffuse redness due to increased blood flow in vessels deep in the skin and the individual vessels are not visible. For example. For example.