Elementary skin lesions

Dr Bogdan Tarcau

https://dermnetnz.org

https://www.dermis.net/dermisroot/en/home/index.htm

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Dr Bogdan Tarcau

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Primary skin lesions - change of color

Macule < 1 cm
Patch > 1 cm

Hemodynamic macules
- change in vessel calibre
- blanch by digital/ glass slide pressure = diascopy
  - Active erythema: pink-red, hot
  - Passive erythema (cyanosis) venous congestion:
    red-violaceous, cold

Dr Bogdan Tarcau

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Primary skin lesions - change of color

Hemodynamic macules
- Erythema:
  - diffuse
- - circumscribed
  - generalised

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Vascular macules
- Telangiectasia
  (permanent change of vessel calibre)
- Hemangioma (benign vascular proliferation)

Primary skin lesions - change of color

Dr Bogdan Tarcau

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Purpuric macules (Purpura)

blood leaks in the dermis <-- injury/ coagulation defect
no blanching
change colour as haemoglobin degrades
appear fast and persist for 10-20 days

Primary skin lesions - change of color

Dr Bogdan Tarcau

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Purpuric macules (Purpura)

Petechiae (1-2 mm)
Purpura
Vibices (linear)
Hematomas (more profound)
Ecchymosis

Primary skin lesions - change of color

Dr Bogdan Tarcau

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Melanin-related macules:

hyperpigmented
- circumscribed: pigmented nevi
- diffuse: melasma
- congenital: nevi
- acquired: ephelides
- residual: lichen planus
hypopigmented/ acronymic
- congenital: albinism
- acquired/ primary: vitiligo
- secondary: pityriasis versicolor

Primary skin lesions - change of color

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Melanin-related macules: Hyperpigmented

Primary skin lesions - change of color

Pigmented nevus

Melasma

Ephelides

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Melanin-related macules: Hypopigmented

Primary skin lesions - change of color

Albinism + Vitiligo

Pityriasis versicolor

(hypopigmented version)

Dr Bogdan Tarcau

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Macules through substance deposits:

metabolism abnormalities: carotenemia
infectious disease: acute hepatitis
Jaundice
Tattoos

Primary skin lesions - change of color

Dr Bogdan Tarcau

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Primary skin lesions - solid

Dr Bogdan Tarcau

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Papule
- < 1 cm (some authors consider it under 0.5 cm)
- elevated
Plaque
- > 1 cm
- elevated
- broader than it is thick
Nodule
- > 1 cm
- elevated
- thicker than it is broad

Primary skin lesions - solid

Dr Bogdan Tarcau

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Papule
- < 1 cm (some authors consider it under 0.5 cm)
- oval - Syphilitic papules
- poligonal - Liche planus
- accuminate/ pointy: follicular keratosis
- plane: plane warts

Primary skin lesions - solid

Dr Bogdan Tarcau

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Papule

Primary skin lesions - solid

Dr Bogdan Tarcau

oval - Syphilitic papules (Syphilides)

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Papule

Primary skin lesions - solid

Dr Bogdan Tarcau

poligonal - Liche planus

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Papule

Primary skin lesions - solid

Dr Bogdan Tarcau

accuminate/ pointy: follicular keratosis

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Papule

Primary skin lesions - solid

Dr Bogdan Tarcau

plane: plane warts

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Wheal
- a special type of papule/ plaque
- appears in urticaria - hives
- oedema in the upper dermis (vs Angioedema - deeper dermis)
- pathognomic: easy come, easy go! (up to 24 h)
- do not associate any scale!
  (just dermal pathogenesis, no epidermal involvement)

Primary skin lesions - solid

Dr Bogdan Tarcau

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Wheal

Primary skin lesions - solid

Dr Bogdan Tarcau

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Papules: histopathological classification
- epidermal: vulgar wart (acanthosis)
- dermal: syphilides (infiltrate)
- dermo-epidermal: lichen planus (acanthosis + infiltrate)

Primary skin lesions - solid

Dr Bogdan Tarcau

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Nodule
- slightly elevated
- situated deep in the dermis and subcutaneous tissue
- acute: erythema nodosum
- subacute
- chronic: sarcoidosis

Primary skin lesions - solid

Dr Bogdan Tarcau

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Nodule
- Gumma
  - particular form of nodule with stage evolution:
    - raw
    - necrosis
    - ulceration
    - scar
  - tuberculosis
  - syphilis

Primary skin lesions - solid

Dr Bogdan Tarcau

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Primary skin lesions - solid

Dr Bogdan Tarcau

Vegetation
- papillomatous
- pedunculated
- irregular surface - cauliflower-like/warty

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Primary skin lesions - solid

Dr Bogdan Tarcau

Vegetation
- isolated: papilloma
- conflated: condyloma accuminata

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Primary skin lesions - solid

Dr Bogdan Tarcau

Lichenification
- indurated plaque
- accentuation of the skin creases - network like - pseudopapules
- primary: neurodermitis
- secondary: pruriginous dermatitis: chronic eczema

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Primary skin lesions - solid

Dr Bogdan Tarcau

Tumour
- nodular/ vegatative/ ulcerated
- benign: nevus, lipoma
- malignant: squamous cell carcinoma, basal cell carcinoma, malignant melanoma

Leziuni elementare

Elementary skin lesions

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - change of color

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Primary skin lesions - solid

Elementary skin lesions

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