Primary Skin Lesions: Macules, Papules, Nodules

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Questions and Answers

What distinguishes primary lesions from secondary lesions in dermatology?

  • Secondary lesions always require more aggressive treatment than primary lesions.
  • Primary lesions are the initial manifestations of a skin disease, while secondary lesions result from changes in primary lesions. (correct)
  • Primary lesions are always larger than secondary lesions.
  • Secondary lesions are more likely to be infectious than primary lesions.

A dermatologist observes a small, circumscribed skin discoloration of 0.7 cm in diameter. According to the classification of skin lesions, what term would MOST accurately describe this?

  • Nodule
  • Plaque
  • Macule (correct)
  • Patch

A patient presents with several flat, depigmented areas on their skin, each approximately 2 cm in diameter. Considering the size and appearance of these lesions, how should they be classified?

  • Patches (correct)
  • Vesicles
  • Macules
  • Papules

A raised, solid lesion on the skin is measured to be 0.4 cm in diameter. Which term BEST describes this type of primary lesion?

<p>Papule (C)</p> Signup and view all the answers

A physician identifies a solid, raised skin lesion that is 0.8 cm in diameter and extends deeper into the dermis. Which of the following BEST describes this lesion?

<p>Nodule (A)</p> Signup and view all the answers

Which characteristic of a plaque distinguishes it from other types of skin lesions?

<p>It has a large surface area compared to its height. (C)</p> Signup and view all the answers

How does a vesicle differ from a bulla?

<p>A vesicle is smaller than a bulla. (B)</p> Signup and view all the answers

A dermatology patient has a fluid-filled lesion with a diameter of 0.7 cm. The MOST appropriate term to describe this lesion would be:

<p>Bulla (A)</p> Signup and view all the answers

What is one key characteristic that differentiates a cyst from a vesicle or bulla?

<p>A cyst has a wall. (A)</p> Signup and view all the answers

A patient presents with transient, edematous, and itchy skin elevations. Which primary lesion is MOST consistent with these symptoms?

<p>Wheal (D)</p> Signup and view all the answers

A dermatologist identifies a 'black head' during a skin examination. How should this lesion be classified?

<p>Open comedo (B)</p> Signup and view all the answers

A linear skin lesion is observed, caused by a mite tunneling within the epidermis. What specific type of primary lesion is this?

<p>Burrow (D)</p> Signup and view all the answers

Which process leads to the formation of secondary skin lesions?

<p>Modification of primary lesions. (C)</p> Signup and view all the answers

What distinguishes a furrow from a burrow in dermatology?

<p>A furrow is a de-roofed burrow caused by scratching. (D)</p> Signup and view all the answers

Which of the following BEST describes a pustule?

<p>A small elevation of the skin containing purulent material. (A)</p> Signup and view all the answers

What is the composition of a scale, as it relates to skin lesions?

<p>Laminated masses of keratin (C)</p> Signup and view all the answers

What primary substance forms a crust on the skin?

<p>Dried serum, pus, or blood (A)</p> Signup and view all the answers

How does an erosion differ from an ulcer in terms of skin layer involvement?

<p>An erosion involves the epidermis, while an ulcer extends into the dermis. (A)</p> Signup and view all the answers

Which layer(s) of the skin are affected in an ulcer?

<p>The epidermis and at least a portion of the dermis (A)</p> Signup and view all the answers

What differentiates an excoriation from an abrasion?

<p>Excoriations are caused by scratching, while abrasions are due to mechanical trauma. (D)</p> Signup and view all the answers

Which skin layer(s) are affected by a fissure?

<p>Epidermis extending into the dermis (D)</p> Signup and view all the answers

A patient presents with a cluster of small, raised lesions, each filled with clear fluid and less than 0.5 cm in diameter. Which term BEST describes these lesions?

<p>Vesicles (D)</p> Signup and view all the answers

A chronic skin condition presents with large, raised areas that are distinctly different in texture and consistency from the surrounding skin. These elevated areas do not appear particularly deep. What type of primary lesion would BEST describe this presentation?

<p>Plaque (D)</p> Signup and view all the answers

A dermatologist notes a lesion described as 'circumscribed'. What does this term indicate about the lesion?

<p>It has clearly defined borders. (D)</p> Signup and view all the answers

In distinguishing between a papule and a nodule, what is the MOST critical factor to consider?

<p>The size of the lesion. (B)</p> Signup and view all the answers

A patient reports intensely itchy skin with several small, raised, linear lesions visible between the fingers. What primary lesion is MOST likely present?

<p>Burrows (D)</p> Signup and view all the answers

A patient has a localized loss of the epidermis after a mild burn, but the dermis remains intact. This would BEST be described as:

<p>An erosion (B)</p> Signup and view all the answers

A patient presents with several areas of dry, flaky skin resembling scales. What is the primary component of these skin lesions?

<p>Keratin (D)</p> Signup and view all the answers

After a minor cut, a dried, hardened area forms on the skin. What is the MOST accurate term to describe this?

<p>Crust (C)</p> Signup and view all the answers

A deep scratch caused by a fingernail results in damage to the epidermis, but not as deep as a fissure. This is best described as which type of secondary lesion?

<p>Excoriation (B)</p> Signup and view all the answers

Which of the following skin lesions is MOST likely to result in scarring?

<p>Ulcer (A)</p> Signup and view all the answers

A hiker develops a small, linear crack on the heel of their foot. The crack extends through the epidermis and slightly into the dermis, causing some discomfort. The MOST likely diagnosis is:

<p>Fissure (C)</p> Signup and view all the answers

A patient presents with urticaria. What type of primary lesion is characteristic of this condition?

<p>Wheal (A)</p> Signup and view all the answers

A patient exhibits multiple small, yellowish papules on their forehead. These are identified as 'white heads'. What is the correct classification for these lesions?

<p>Closed comedo (A)</p> Signup and view all the answers

A patient with scabies presents with intense itching and small, linear lesions in the web spaces between their fingers. The lesions are MOST likely:

<p>Burrows (A)</p> Signup and view all the answers

A patient presents with a de-roofed burrow secondary to scratching. The MOST accurate term for this secondary lesion is:

<p>Furrow (C)</p> Signup and view all the answers

A patient has small elevations on their skin containing pus. These are BEST described as:

<p>Pustules (C)</p> Signup and view all the answers

A patient with psoriasis is MOST likely to present with which type of skin lesion?

<p>Scales (B)</p> Signup and view all the answers

A patient presents with dried serum and blood on the surface of a scratched insect bite. This is BEST described as:

<p>Crust (B)</p> Signup and view all the answers

A patient presents with several solid, raised lesions on their skin. Some are 0.3 cm in diameter, while others are 0.7 cm. According to diagnostic criteria, which of the following is the MOST accurate way to classify these lesions?

<p>The smaller lesions are papules, and the larger ones are nodules. (A)</p> Signup and view all the answers

A patient exhibits signs of urticaria. Which primary lesion is MOST typically associated with this condition?

<p>Wheal (C)</p> Signup and view all the answers

A dermatologist is examining a patient with acne and observes both 'black heads' and 'white heads'. How should these lesions be classified in terms of primary lesions?

<p>Black heads are open comedones, while white heads are closed comedones. (A)</p> Signup and view all the answers

In a case of scabies, the primary lesion is described as a tunnel within the epidermis caused by a mite. This lesion is BEST described as which of the following?

<p>A burrow (B)</p> Signup and view all the answers

A patient presents with a cluster of small, purulent elevations on the skin. These lesions could be MOST accurately described as:

<p>Pustules (A)</p> Signup and view all the answers

Flashcards

Primary Lesions

The initial lesions of skin diseases.

Macule

A circumscribed area of skin discoloration less than 1 cm in diameter.

Patch

A macule more than 1 cm in diameter.

Papule

A circumscribed solid elevation of skin less than 0.5 cm in diameter.

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Nodule

A circumscribed solid elevation of skin more than 0.5 cm in diameter.

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Plaque (skin)

An area of change of texture or consistency of the skin that occupies a large surface area in comparison with its height.

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Vesicle

An elevation of the skin containing fluid less than 0.5 cm in diameter.

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Bulla

An elevation of the skin containing fluid more than 0.5 cm in diameter.

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Cyst

A cyst differs from a vesicle or a bulla by having a wall.

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Wheal

The primary lesion of urticaria characterized by transient edematous elevations of the skin.

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Comedo

The primary lesion of acne, may be open or closed.

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Burrow (skin)

A linear elevation of the epidermis tunneled by the female sarcoptes scabiei mite.

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Secondary Lesions

Lesions that occur as a result of modification of primary lesions.

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Furrow

A de-roofed burrow caused by scratching of a burrow.

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Pustule

A small elevation of the skin containing purulent material.

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Scale (skin)

Dry or greasy laminated masses of keratin.

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Crust (skin)

Dried material on the skin as serum, pus or blood.

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Erosion (skin)

A partial or total loss of the epidermis, not reaching the dermis, that heals without a scar.

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Ulcer (skin)

A rounded or irregularly shaped excavations that result from total loss of the epidermis plus some portion of the dermis.

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Excoriations & Abrasions

Superficial discontinuation of the skin: only epidermal.

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Fissure

A linear cleft through the epidermis extending into the dermis.

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Study Notes

  • Cutaneous signs pertain to lesions affecting the skin's appearance and/or integrity.

Primary Lesions

  • These are the first skin lesions to appear.

Macule

  • Skin discoloration in a circumscribed area, less than 1 cm in diameter is known as a macule.
  • Macules can be hypopigmented, hyperpigmented, or erythematous.
  • These occur in conditions such as pityriasis versicolor (brown macule) and vitiligo (white macule).
  • A macule that is larger than 1 cm in diameter is classified as a patch.

Papule

  • A papule is a circumscribed, solid elevation of skin, less than 0.5 cm in diameter.
  • These occur in psoriasis and lichen planus.

Nodule

  • A raised solid skin elevation that is more than 0.5 cm in diameter.
  • Nodules are deep lesions indicative of dermal or subcutaneous pathology, for example, lepromatous leprosy.

Plaque

  • This is defined as a change in skin texture or its consistency.
  • Plaques can be elevated or depressed relative to the skin surface.
  • Elevated plaques can arise on their own or from the merging of multiple papules.
  • They have a large surface area relative to their height, unlike nodules.

Vesicle

  • An elevation of the skin containing fluid, measuring less than 0.5 cm in diameter

Bulla

  • An elevation of the skin containing fluid, measuring greater than 0.5 cm in diameter.

Cyst

  • A cyst differs from a vesicle or bulla due to its presence of a wall.

Wheal

  • A wheal is the primary lesion seen in urticaria:
  • It appears as a transient, edematous elevation of the skin of variable size, often accompanied by itching.

Comedo

  • The primary lesion of acne.
  • The two types are: open comedo (blackhead), which is a slightly elevated papule with dilated central opening filled with blackened keratin; and closed comedo (whitehead), which is a yellowish papule.

Burrow

  • The primary lesion of scabies.
  • A linear elevation in the epidermis is caused by tunneling from the female sarcoptes scabiei mite.

Secondary Lesions

  • Secondary lesions appear as a result of changes or modifications to primary lesions.

Furrow

  • A furrow is effectively a de-roofed burrow that arises from scratching a burrow.

Pustule

  • A pustule is a small skin elevation containing purulent material.
  • It can appear as a primary lesion or develop secondary to a papule or vesicle.

Scale

  • Scale presents as dry or greasy laminated masses of keratin.

Crust

  • A crust is identified as dried material like serum, pus, or blood on the skin.

Erosion

  • This involves a partial or total loss of the epidermis without reaching the dermis.
  • Erosions heal without scarring because the dermis remains unaffected.

Ulcer

  • Ulcers are rounded or irregularly shaped excavations resulting from a total loss of the epidermis and a portion of the dermis.
  • Shape, size, and depth are variable depending on the disease process.

Excoriations and Abrasions

  • Involve superficial breaks in the skin.
  • Excoriations result from scratching with fingernails.
  • Abrasions are due to mechanical trauma or constant friction.

Fissure (Crack)

  • A fissure is a linear cleft that extends through the epidermis into the dermis.

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