1. Histology of Skin Terminology of Skin Lesions

2. SUBCUTANEOUS FATTY TISSUE (hypodermis)
EPIDERMIS
● keratinocytes (5 layers) ● melanocytes ● Langerhans cells ● Merkel cells
(basement membrane)
DERMIS
● fibroblasts
● collagen, elastic fibres ground substance
● sebaceous glands
● sweat glands
● hair follicles + m.arrector
● nerve fibres special nerve corpuscle
● blood and lymph vessels
SUBCUTANEOUS FATTY TISSUE (hypodermis)
● lobes of fatty tissue
● blood vessels
● lymph vessels

3. Description of Skin Lesions
Primary and secondary lesions (eflorescence)
single or multiple
grouped (multiple lesions grouped in one area)
disseminated (exanthema – widespread discrete lesions)
arranged (in line, in ring, snake-like…)

4. Primary Lesion MACULE (spot)
any flat lesion, circumscribed discoloration, size < 1cm PATCH = larger macule with some surface changes

5. Primary Lesion
PAPULE any elevated lesion, size < 1cm, various color, papules may become confluent and form plaques

6. Primary Lesion
NODUL
any elevated, circumcribed lesion, size > 1cm in both diameter and depth

7. URTICARIA (weal, hives, nettle-rash)
Primary Lesion
URTICARIA (weal, hives, nettle-rash)
a firm plaque resulting from dermal oedema, it is transient - may last only a few hours

8. Primary Lesion
VESICLE (blister) a fluid-filled lesion, size < 1cm, BULLA - size > 1 cm in diameter

9. Primary Lesion
PUSTULE a circumscribed collection of leukocytes and fluid, size < 1cm

10. Secondary Lesions scale erosion ulcus excoriation fissure crust
eschar (necrosis)
erosion
ulcus
excoriation
fissure

11. a collection of dried serum, blood or pus, and cellular debris
Secondary Lesion
CRUST
a collection of dried serum, blood or pus, and cellular debris

12. Secondary Lesion SCALE (squama)
an excess dead keratinocytes that are produced by abnormal keratinization and shedding, scale are dry and usually whitish or yellowish

13. Secondary Lesion
ESCHAR (necrosis)
(e.g. bedsore, burn…)

14. Secondary Lesion
FISSURE a linear split in epidermis or dermis, with sharply defined vertical walls, over a joint or along a skin crease (skin isn´t flexible due to mycosis, eczema, psoriasis…)

15. Secondary Lesions
EXCORIATION a localized damage to the skin due to scratching
EROSION a partial loss of epidermis, heals without scarring

16. Secondary Lesion
ULCER a full thickness loss of epidermis end dermis, which will heal with scarring

17. Lesions can be: single or multiple
grouped (multiple lesions grouped in one area… …are confluent in one area)
disseminated (exanthema = widespread discrete lesions)
arranged (lesions form some configuration – e.g. in line, in ring, snake-like…)

18. Arrangements of Lesions
linear configuration
serpiginous configuration
moniliform configuration

19. Arrangements of Lesions
zosteriform configuration
herpetiform conf.
geografical configuration

20. Arrangements of Lesions
circinate, semicircinate configuration
iris form (concentric circles)
annular conf.

21. …erythroderma, erythema atrophy, lichenification
Other Changes
…erythroderma, erythema
atrophy, lichenification
papilomatosis, pachydermatosis
hyperpigmentation, depigmentation
scars….

22. Describing of Lesions:
sites involved and distribution (a-symmetrical, predilection sites; arrangement, single or multiple)
size (mm, cm)
shape (round, oval, irregular, pedunculated…)
surface features (smooth, rough, shiny, dull, squamous, uneven…)
demarcation - border of lesion (well defined or circumscribed, poorly defined…)
color (pink, red, purple, white, brown, yellowish…)
consistency (soft, firm, normal, hard, elastic…)
surroundings (with inflammation, normal…)

23. Blisters, pustules:
blister roof – thin, thick, flaccid…
content – clear, turbid, haemorrhagic…
Ulcers:
base – deep x shallow, uneven, clear, coated, with granulation tissue…
edge – undermined, collowed, flat, adjacent, with epitelization…