Image Gallery: Secondary Skin

Lesions
Alexander Werner Resnick, VMD, DACVD, Animal Dermatology Center

DERMATOLOGY | JUNE 2019 | PEER REVIEWED | WEB-EXCLUSIVE

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In dermatologic diseases, abnormalities are visually apparent; thus, accurate recognition of

skin lesions is key to diagnosis and management. Dermatologic diseases are often chronic,
requiring clear documentation in patient medical records. Accurate recognition of skin
lesions, as well as concise documentation, permits the formulation of a relevant di erential
list and appropriate record of disease progression and/or patient response to treatment.

Whereas primary lesions (Part 1) involve changes in the skin caused directly by the disease
process, secondary skin lesions most often develop from primary skin lesions as a result of
patient or environmental factors. Several skin lesions (eg, scale, crust, stria, pigmentation
change) may be considered either primary or secondary, depending on the cause. For
example, hereditary abnormalities of keratinization (eg, congenital ichthyosis in golden /
retrievers) produce, as a primary lesion, excessive scale due to the lack of proper
desquamation, with resultant accumulation of rafts of keratinocytes being shed together
rather than imperceptibly as individual cells. Conversely, in ammatory dermatoses produce
scale as a secondary lesion by increasing epidermal turnover, resulting in excessive
production of keratinocytes that ultimately require shedding. e following images exhibit
secondary dermatologic lesions.

FIGURE 1 Alopecia. Alopecia is a visible decrease in or loss of the

hair coat. Secondary alopecia may result from manual removal of
the hair by scratching.

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FIGURE 2 Scale. Scale is an increased accumulation of
keratinocytes producing a visible thin fragment. Scaling is o en
caused by chronic inflammation, resulting in increased
epidermopoiesis.

FIGURE 3 Crust. Crust is a thick accumulation of cells within dried

exudate (eg, serum, blood, cellular debris, or medications).

FIGURE 4 Epidermal collarette. Epidermal collarette is an o en

circular lesion with a margin of crust and/or erythema. This lesion is
most commonly associated with superficial pyoderma.
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FIGURE 5 Stria/striae. Striae are lines or stripes associated with
abnormal stretching of the skin as a result of thinning. Striae are
most o en associated with an excess of corticosteroids (iatrogenic
or natural).

FIGURE 6 Excoriation. Excoriation represents injury to the skin,

typically from scratching, and is o en linear in appearance.

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FIGURE 7 Lichenification. Associated with chronic irritation of and
friction applied to the skin by scratching, lichenification is a
thickening of the skin, o en with accentuation of normal skin lines.

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FIGURE 8 Erosion. Erosion is an incomplete loss of epidermis;
erosions do not penetrate the epidermal–dermal junction.

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FIGURE 9 Ulceration. Ulceration is a defect in the skin that
penetrates completely through and with resultant loss of the
epidermis.

FIGURE 10 Fissure. A fissure is a linear cle or tear that extends

through the epidermis.

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FIGURE 11 Scar. A scar develops as a result of trauma or damage
through to the dermis or subcutaneous tissue. It is a visible defect
that may be palpably depressed and composed of fibrous tissue
that has replaced normal skin.

FIGURE 12 Pigmentation change. Pigmentation change refers to

an alteration in the normal color of the skin and/or hair coat.
Endocrinopathy and chronic inflammation are common causes of
pigmentation change.

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 SUGGESTED READING
Mueller RS. Dermatology for the Small Animal Practitioner. Jackson WY: Teton
NewMedia; 2000.

Rhodes KH, Werner AH, eds. Blackwell’s Five-Minute Veterinary Consult Clinical
Companion: Small Animal Dermatology. 3rd ed. West Sussex, UK: John Wiley &
Sons; 2018.

AUTHOR
Alexander Werner Resnick
VMD, DACVD
Animal Dermatology Center

Alexander Werner Resnick, VMD, DACVD, is the editor of the dermatology section of
the 5-Minute Veterinary Consult textbook and coauthor of the second and third
editions of Small Animal Dermatology Clinical Companion. He practices at the Animal
Dermatology Center in Studio City and Westlake Village, California, and Reno, Nevada.

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