Skin terms

Descriptors
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
body

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
urticaria

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.