Terminology

Editor: Arcole Brandon, MD; Tyler Beck, MD, PhD
Faculty Editor: Eva Niklinska, MD

Primary Lesion

Secondary Lesion

Flat: Macule (<10mm) versus patch (>10mm)Excoriations: “Excavations” dug into skin secondary to scratching
Raised: Papule (<10mm) versus plaque (>10mm)Lichenification: Roughing of the skin with accentuation of skin markings
Fluid Filled: Vesicle (<10mm) versus Bullae (>10mm) versus Pustule (pus-filled)Scale: Flakes of stratum corneum
Nodule - firm, thicker, deeper, 1-3 cm in diameter.Crust: Rough surface, dried serum, blood, bacteria, and cellular debris
Mass - A solid growth much larger than a nodule, >3 cmUlceration: Loss of epidermis and dermis, Erosion: Loss of the epidermis
Fissure: A deep linear split through the epidermis into the dermis; a linear ulcer

Vascular Lesions

  • Telangiectasia: A blanching dilated capillary.
  • Petechiae: A nonblanching pinpoint or small blood red macule.
  • Ecchymosis or purpura: A nonblanching purple or discolored patch, a bruise.
  • Hematoma: A deep collection of blood in the deep dermis or subcutaneous tissue, often a nonblanching purplish mass.

Labeling of Skin Lesions, by Configuration and Distribution

1. Configuration: The arrangement or pattern of lesions in relation to other lesions

  • Annular: Ring-shaped usually with clear center.
  • Targetoid or Iris Lesions: Concentric rings; "Bulls eyes".
  • Gyrate: Ring-spiral shape.
  • Linear: In a line.
  • Discoid: Coin-like, circular.
  • Polymorphous: Occurring in several forms.
  • Punctate: Marked by points or dots.
  • Serpiginous: Snake-like.
  • Atrophy: Wasting of the epidermis in which the skin appears thin and transparent or in the dermis in which a focal area of depression is observed. 
  • Striae: Depressed bands of thin white shiny skin.

2. Distribution: The arrangement of lesions over an area of skin

  • Solitary: A single lesion.
  • Satellite: Single lesion in close proximity to a large grouping, patch, or plaque.
  • Grouped: Clustered, herpetiform.
  • Confluent: Merging together.
  • Diffuse: Disseminated over the whole body or one anatomic region, generalized. 
  • Discrete: Separate from other lesions.
  • Localized: Limited areas of involvement which are defined clearly.
  • Symmetrical or asymmetrical: Distributed bilaterally or unilaterally.
  • Zosteriform or dermatomal: Band-like distribution along a dermatome area.
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