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Dermatology

  1. Dermatology overview and skin structure
  2. Skin related disorders

There are many conditions affecting the skin's structure and functions. Most of these conditions are usually characterized by changes of skin structure in the form of lesions that have more or less distinct characteristics. Appropriate diagnosis is based on analysis of clinical picture, historical information and laboratory tests. Examination of morphology, configuration and distribution of the lesion also help to determine the cause and possible treatment of the particular disease. The initial lesion that characterizes a particular conditions is known under the term primary lesion. Identification of such lesions is one of the most significant aspect in diagnosis establishing.

Over time, while the skin disease is progressing or regressing primary lesions may develop in secondary lesions. There are some common terms that describe macroscopic morphology of the skin lesions are listed below:

  • Macule is small localized change in the color of skin neither depressed not elevated. They are usually presented in the form of nonpalpable spots ranging is size from 5-10mm in diameter.
  • Patch is a large change in the color of the skin. It usually looks like nonpalpable spot. Sometimes they have wrinkling or subtle surface.
  • Papule is a circumscribed small solid bump elevated on skin and is less than one centimeter in diameter. Papule is opposite vesicle which contains fluid or a macule flat surface.
  • Plaque is a big circumscribed raised solid bump or confluence of papules. It is usually greater in its diameter than in its depth.
  • Nodule is morphologically close to papules, it is raised small solid collection of tissue. It is palpable and ranges in size from 1 to 2 centimeters. Nodule are presented in the epidermis, dermis and hypodermis.
  • Vesicle is a small circumscribed elevated blister containing fluid. It is usually 5-10mm in diameter.
  • Bulla is a blister filled with water and is more than 5 mm in diameter. Bulls has thin wall.
  • Pustule is a small elevation of the skin containing pus (mixture of inflammatory cell and liquid). Pustules are frequently formed in oil glands and hair follicles.
  • Cyst is a raised cavity that contains fluid, gas, or semisolid material. The outer wall of a cyst is called the capsule. Cysts are usually palpable.
  • Erosion is moist, circumscribed and depressed lesion characterized by incomplete loss of epidermis.
  • Ulcer is an tissue erosion of the dermis and hypodermis. It is always depressed below the level of the surrounding tissue.
  • Fissure is the narrow and deep crack in the skin.
  • Wheal is a red pale plaque or papule that is usually rounded or flat-topped. Wheal usually causes itching, can be red or pale.
  • Telangiectasia are small dilated blood vessels exserted on the surface of the skin
  • Burrow represents a slightly raised tortuos line on the skin caused by burrowing organisms

As it was pointed above primary skin lesion may develop into secondary lesions. Secondary lesions include:

  • Scale greasy or dry masses of keratin. It is usually associated with excessive dryness
  • Crust dried mixture of blood, pus and serum. Crust can be mixed with bacterial debris and epithelial cells.
  • Lichenification palpable thickening of epedermis. Lichenification usually develops as a result of constant rubbing or starching that hypertrophy of the outer skin layer.
  • Excoriation is an abrasion induced by applied friction force. Excoriation usually involves only epidermis.
  • Induration localized hardening of soft tissues
  • Atropthy mean loss of tissues caused by external or internal triggers. Atrophy may affect epidermis, demis and subcutaneous tissues


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