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SEPTEMBER 04,2021
INTRODUCTION TO DERMATOLOGY
DR. KAREL HELDEN M. CLORES-DATOR
3. PAPULE
Elevated lesions <1 cm in diameter that can be felt
or palpated
e.g Molluscum contagiosum
8. VESICLE
• Circumscribed, small, clear, fluid-filled blister <1 cm
in diameter
• e.g. Herpes simplex or varicella
4. PLAQUE
Palpable lesions >1 cm in diameter that are
elevated or depressed compared to the skin surface
[Equivalent of patch but it is elevated]
9. BULLAE [Bigger version of vesicle]
• Circumscribed, small, clear, fluid-filled blister >1 cm
in diameter [Sometimes it can be hemorrhagic]
• When you touch it, it can be tense, fluctuant or
flaccid
6. TUMOR
Firm and freely movable or fixed masses of various
size and shape, generally are 2 cm in diameter
[Merkel cell carcinoma: rare carcinoma of the
skin] A.2. SECONDARY LESIONS
1. SCALES
Dry or greasy laminated masses of keratin
Fine, delicate, branny, coarse [Stratum corneum
that became thick is the one that is sloughing off]
Hypopigmentation
o Skin with lesion is lighter than the normal skin
Can Happen when treated with topical
steroid
o Hypo/hyperpigmentation not permanent, go
back to normal within 6 months.
Dermatomal seen in herpes zoster, sometimes in
incontinentia pigmenti (rare congenital condition),
epidermal nevus.
Following lines of cleavage [Lines produce when
stand against gravity, and the skin sags]
Scar
Hypertrophic or keloidal
Pityriais rosea follows line of cleavage, triangular acne on the chest in keloid former
Christmas tree pattern individual.
Individual acne marks merge forming a
Lines of Blaschko [Embryonic in origin, not visible; large keloid.
Left by epidermal migration of the cells of the skin]
Resembles line
Resembles water drops
Striae distensae / stretch marks
Guttate psoriasis
Description: erythematous to hyperpigmented
linear plaques Nummular
Annular
Dark
Pigmented Nevus
Hypopigmented Lesions [lesion that is lighter than
Tool used to assess sensation of the skin. The pins are
the color of the skin]
of different sharpness (pointed/dull) and thickness.
This is usually done if the patient is suspected of
having Leprosy or Hansen’s Disease
In lieu of this specific tool, tip of ballpen or pencil
can be used instead and assess the patient by
asking whether they can feel the sensation as blunt
(eraser part) or sharp (tip of the pencil/pen)
If the patient reported negative sensation, or even
diminished sensation (hyposthetic) it is a
Document as: Multiple, hypopigmented macules
characteristic of an anesthetic lesion (Hansen’s
and patches at the back
Disease or Leprosy)
Diagnosis: Pityriasis versicolor (an-an
Depigmented Lesions (devoid of pigment/no C. DOCUMENTING A DERMATOLOGIC EXAMINATION
melanin)
[combination of classifying the lesion]
1. Number (solitary or multiple)
2. Distribution (Generalized or Localized)
3. Configuration
4. Color
5. Primary lesion
6. Secondary lesion
7. Location (usually, when the lesion is generalized,
Document as: Multiple, depigmented patches on the localization can be omitted)
face SAMPLE DERMATOLOGIC DIAGNOSIS
Diagnosis: Vitiligo Diagnosis: Psoriasis
7. Consistency [Touching the lesion is not usually advised, Document as:
especially if the lesion is suspected to be infectious] Multiple, generalized, guttate,
Soft erythematous papules and
Firm or indurated plaques with whitish scaling
REFERENCES
1. Dator, K., Introduction to Dermatology. [powerpoint slides]
2. Sidenotes