Q: What terminology should be used to describe skin rashes?
A: Skin rashes are described using the terminology of primary and secondary lesions. Primary lesions are physical changes in the skin considered to be caused directly by the disease process. Secondary lesions may result from primary lesions, or may be caused by external forces such as scratching, trauma, infection and the healing process.
Primary lesions:
Vesicle — circular, free fluid-filled,
up to 1 cm
Bulla — circular, free fluid-filled, greater
than 1 cm
Macule — a change in the color of the skin, circular, flat discoloration, brown, blue, red or hypo-pigmented, less than 1 cm
Patch — same as a macule but larger than 1 cm
Papule — superficial, solid, less than
1 cm; color varies
Nodule — circular, elevated, solid, greater than 1 cm; may be seen in the epidermis, dermis or subcutaneous tissue
Pustule — circular, collection of leukocytes, free fluid-filled; varies in size
Wheal — firm, edematous plaque, infiltration of dermis; may last few hours
Plaque — superficial, elevated, solid, flat-topped lesion
Secondary lesions:
Scale — consists of flakes or plates
Crust — the result of the drying of plasma or exudate on the skin
Fissure — crack or split in the skin
Erosion — loss of epidermis
Ulcer — loss of epidermis and dermis and sometimes underlying tissue
Lichenification — refers to a thickening of epidermis seen with exaggeration of normal skin lines
Atrophy — loss of substance, thinning
Scar — thickening
Excoriation — linear erosion
Please send your wound treatment-related questions to Donna Sardina at [email protected].
From the January 01, 2011 Issue of McKnight's Long-Term Care News
