Physical Exam 1

Explanation: Primary lesions are the basis of a system of dermatologic nomenclature. These include macules, papules, plaques, vesicles, pustules, bullae, cysts, wheals (hives), nodules, and tumors, telangiectasia, and comedones. An erosion is considered a secondary lesion; that is described when the surface of the skin has been removed. Erosions are typically superficial involving the epidermis and a varying amount of dermis.

Explanation: Secondary lesions are changes that may occur to primary lesions. These include scale, crust, excoriation, erosion, color or pigmentation change, scarring, fissures, atrophy, lichenification, burrow, and erythema.

Explanation: The solitary papule in this image demonstrated a central dip or depression which is referred to as umbilicated. Annular refers to ring shaped. Serpiginous means snake like. Endophytic means a lesion is growing inward, deeper into the tissues

Explanation: Annular is a descriptive term that means ring like. The exam finding in this image shows a solitary plaque that is slightly erythematous (red) and annular (ring shaped). Serpiginous means snake like. Endophytic means a lesion is growing inward into deeper tissues. Herpetiform refers to a grouped appearance of lesions.

Explanation: A macule is a non-palpable lesion that measures less than 1cm. This is an example of a solar lentigo, acquired flat brown macule on sun exposed skin.

Explanation: A pustule is a fluid filled vesicle that contains pus.

Explanation: A plaque is a palpable lesion that is > 1cm. The plaque seen here is representative of psoriasis, classically described as a well demarcated erythematous plaque with silvery or micaceous scale.

Explanation: A bullae is fluid filled lesion (vesicle) that is > 0.5cm.in diameter.

Explanation: A vesicle is fluid filled lesion that is < 0.5cm. The exam findings in this photo demonstrate fluid filled vesicles in a grouped pattern on an erythematous base. These are consistent with a herpes zoster infection due to the varicella zoster virus.

Explanation: A nodule is a papule that measures between 0.5cm-2cm in diameter. This nodule is red (erythematous) and has what appears to have a focus of crust on the superior aspect.