MORPHOLOGY

OF
SKIN LESIONS
Dr. Riaz Uddin Ahmed
MBBS, DDV, MCPS, FCPS
Associate Professor of
Dermatology
Bangladesh Medical College

A. Primary lesions- The original lesions

are known as primary lesion which are
as follows:

Macule, patch
Papule, plaque, nodule, tumor
Wheals
Vesicle
Bullae
Pustule

B. Secondary Lesions: the primary lesions

continue to full development or may be
modified by regression, trauma of other
extraneous factors, producing secondary
Scales
lesion
which are as follows:
Crusts
Excoriations and abrasions
Fissures
Erosions
Ulcers
Scar-hypertrophic scars
Keloid
Atrophy
Cyst

C. Special Lesion: lesions that are

produced special circumstances of
body system which are as follows:
Erythema-Erythema multiforme, erythema
nodosum
Telangiectasia
Purpura
Petechiae
Ecchymoses
Vibices
Haematoma
Erythroderma (exfoliative dermatitis)

A. Primary Lesions

Mucule- Latin:
macula, spot
Macules are
variously
sized,
circumscribed
changes in
skin color,
without
elevation or
depression and
less than 1 cm
in diameter

Macule

Papule

Patch: A patch is a circumscribed

changes in skin color without
elevation or depression and 1 cm or
greater in diameter
Papule- (Latin Paula, Pimple)
Papules are circumscribed, solid
elevations of skin having diameter
less than 1 cm

Plaques: (FrenchPlaque- Plate)

A plaque is a broad
papule (or
confluences of
papules), 1 cm or
more in diameter.

Plaque

Nodule

Crust

Wheal

Vesicle

Scale

Pustule
Erosion

Hypertrophic Scar
Erythroderma

Keloid

Purpura

Nodules (Latins: nodulus- small

knot)- Nodules are form of papules
but largest (>1 cm) and invade
deeply.

Tumors
Tumors are soft or firm and freely movable or fixed
masses of various sizes and shape. A tumor is an
abnormal mass of tissue, the growth of which
exceeds and un-coordinated with normal tissue and
persists in the same excessive manner after cessation
of stimulus which evoked the change.
Wheals (Hives) wheals are evanescent, oedematous,
flat elevations of various sizes.
Vesicles (Latin Little bladder) vesicles are
circumscribed epidermal elevations 1-10 mm in size
and usually containing clear fluid.
Bulloe (Latin-Bubble)- Bulloe are circumscribed or
irregularly shaped cavity more than 10 mm in
diameter containing serous or seropurulent fluid.
Pusteules (Latin- Pustula-Pus)- pustules are small

Secondary Lesions
Scales: (Latin Squama-scales)- scales are dry or greasy laminated
masses of keratin.
Excoriations (Latin Abrasio)- an excoriation is a punctate or linear
abrasion produced by mechanical means usually involving only the
epidermis and rarely reaching the papillary layer of the dermis.
Fissures (Latin- Cracks)- a fissure is a linear cleft through the
epidermis or rarely into the dermis caused by disease or injury
Erosions loss of all or portion of epidermis alone
Ulcers (Latin- Ulcus- Sore)- ulcers are rounded or irregularly shaped
excavations that result from loss of epidermis and dermis.
Crusts (Latin- crusta-bark)- crusts are dried serum, pus or blood,
usually mixed with epithalial and bacterial debris.
Scars ( )- scars are new formations in the dermis or deeper parts as a
result of injury or disease, as a part of the normal reparative and
healing process scar may be hypertrophic.
Keloid (Latin- Cheloid-clawlike)- a keloid is a firm, irregularly shaped,
thickened, hypertrophic, fibrous, pink or red excrescence.

Hypertropic Scar

Keloid

Claw-like prejections There is claw-like

absent
projections present
in Keloid
Hypertrophic scar
Keloid extend and
does not extend
spread beyond the
beyond the original
limits of the original
wound
injury
In hypertrophic scar,
there is sponteneous
improvement within
first six months

Sponteneous
improvement does
not occur in Keloid

Ulcer

Scar

Atrophy

Atrophy: this refers to

a diminuation of
some or all layers of
kin
Cyst: a cyst is a cavity
containing liquid or
solid or semi-solid
material may be
superficial or deep.

Cyst

SPECIAL LESIONS
Erythema: erythema may be defined as
redness of skin due to dilatation of blood
vassals which may be localised or wide spread
near the surface of the skin.
Erythema multiforme: erythema multiforme is
a mucocuteneous in which various types of
skin reaction may occur from the same
causative agents and conversely many

Erythroderma: erythroderma isa terminal

condition of any inflammatory disorder which
affects either universally or more than 90%
body surface area characterised by erythema,
oedema, scaling, thickening and itching
chilliness caused by idiopathic, drug or
secondary to some reactional process to an
underlying systemic or cutaneous dermatosis.
Telengiactasia: permanent dilatation of blood

Ecchymoses: siguify a deeper and extensive

inter stitial haemorrhage, which forms a flat
irregularly shaped, bluists-purplish patch.
Vibices (singuler-vibex) are linear purpuric
lesions.
Haematoma: designates a pool-like collection
of extravasated blood in a dead space in
tissue that, if of sufficient size, produces
swelling that fluctuates on palpation.