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Journal of the Dermatology Nurses' Association:
doi: 10.1097/JDN.0b013e318211c6f0
DEPARTMENTS: Language of Dermatology

Essential Morphologic Terms and Definitions

Linton, Christina P.

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Christina P. Linton, PhD, FNP-BC, Department of Dermatology, Central Utah Clinic Provo, UT.

Correspondence concerning this article should be addressed to Christina P. Linton, PhD, FNP-BC, Department of Dermatology, Central Utah Clinic, 1055 North 500 West, Suite 111, Provo, UT 84604. E-mail: clinton@centralutahclinic.com

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MORPHOLOGY TERMINOLOGY

MORPHOLOGY - The form or structure of an individual skin lesion.

LESION - Any single area of altered skin. Lesions may be solitary or multiple.

PRIMARY LESION - A lesion directly associated with the disease process that is described with established dermatological terminology.

Example: Macule, papule, patch, plaque, vesicle, bulla, and others

SECONDARY LESION - Modification of a primary lesion that results from evolution of the primary lesion, traumatic injury, or other external factors.

Example: Erosion, fissure, ulceration, excoriation, and others

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FLAT LESIONS

MACULE - A circumscribed, flat area of discoloration that is less than 10 mm* in diameter.

Example: Freckle

PATCH - A circumscribed, flat area of discoloration that is greater than 10 mm* in diameter. Slight scale may or may not be present.

Example: Vitiligo

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RAISED LESIONS

PAPULE - A circumscribed, elevated, solid lesion that is less than 10 mm* in diameter.

Example: Wart

PLAQUE - A circumscribed, elevated, solid lesion that is greater than 10 mm* in diameter and is usually broader than it is thick.

Example: Psoriasis

NODULE - A palpable, solid lesion that is greater than 10 mm* in diameter. Nodules are usually found in the dermal or subcutaneous tissue, and the lesion may be above, level with, or below the skin surface.

Example: Dermatofibroma

TUMOR - A solid, firm lesion that is typically greater than 20 mm in diameter. Tumors can be above, level with, or beneath the skin surface. Also known as a mass.

Example: Metastatic carcinoma

WEAL - Transient, circumscribed, edematous papules or plaques caused by swelling in the dermis. Wheals may manifest with erythematous borders and pale centers and/or a narrow peripheral zone of pallor or vasoconstriction.

Example: Urticaria

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DEPRESSED LESIONS

BURROW - A thread-like linear or serpiginous (wavy, serpent-like) tunnel in the epidermis typically made by a parasite.

Example: Scabies

EROSION - A shallow, moist, or crusted lesion resulting from the loss of the superficial layers of the upper epidermis only, as from friction or pressure.

Example: Ruptured varicella vesicles

EXCORIATION - A skin abrasion that is usually superficial and due to scratching of the skin. Excoriations may be linear or focal.

Example: Neurotic excoriations from habitual picking

FISSURE - Sharply defined linear or wedge-shaped tears in the epidermis with abrupt walls.

Example: Interdigital tinea pedis

PITS - Small, sharply demarcated depressions in the skin or nail surface.

Example: Pitted keratolysis

ULCER - A circumscribed loss of the epidermis and at least upper dermis. Ulcers are further classified by their depth, border, shape, edge, and the tissue at its base.

Example: Venous stasis ulcer

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FLUID-FILLED LESIONS

ABSCESS - A localized accumulation of pus in the dermis or subcutaneous tissue that is frequently red, warm, and tender.

Example: Methicillin-resistant Staphylococcus aureus (MRSA) infection

BULLA (PLURAL = BULLAE) - A large, raised, circumscribed blister that is greater than 10 mm* in diameter and is fluid filled. The fluid can be clear, serous, hemorrhagic, or purulent.

Example: Pemphigus vulgaris

CARBUNCLE - An inflammatory nodule composed of two or more confluent furuncles with separate heads.

Example: Staphylococcus aureus infection

CYST - A closed cavity or sac containing fluid or semisolid material. A cyst may have an epithelial or endothelial lining.

Example: Epidermal inclusion cyst

FURUNCLE - An acute, round, firm, circumscribed, follicle-centered nodule caused by infection that is usually greater than 10 mm in diameter. Characterized by pain, redness, and potentially visible pus.

Example: Staphylococcus aureus infection

PUSTULE - A purulent (pus filled) vesicle. Pustules are filled with neutrophils and may be white or yellow. Not all pustules are infected.

Example: Bacterial folliculitis

VESICLE - A small, superficial, circumscribed blister that is less than 10 mm* in diameter and is fluid filled. The fluid may be clear, serous, hemorrhagic, or purulent.

Example: Herpes zoster

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VASCULAR LESIONS

ECCHYMOSIS (PLURAL = ECCHYMOSES) - Nonblanching, purpuric macules or patches greater than 3 mm in diameter due to extravasated blood in the skin. Color changes over time may go from blue-black to brown-yellow, or green before fading away.

Example: Bruise from blunt trauma

HEMATOMA - A collection of extravasated blood that is relatively or completely confined within a space. The blood is usually clotted (or partly clotted) and, depending on time, may manifest various degrees of organization and color.

Example: Postsurgical bleeding

PURPURA - Bleeding into the skin that results in violaceous (violet or purple) discoloration that varies according to its duration and does not blanch with pressure. Purpura includes petechiae and ecchymoses. When purpuric lesions are palpable, they represent vasculitis (vascular inflammation).

Example: Henoch-Schönlein purpura

PETECHIAE - Tiny, 1- to 2-mm (pinpoint to pinhead size) nonblanchable purpuric macules resulting from the rupture of small blood vessels. Color may be red, purple, or brown.

Example: Rocky Mountain spotted fever

TELANGIECTASIA - Small, superficial cutaneous blood vessels that become persistently visible because they are dilated.

Example: Erythrotelangiectatic rosacea

*Some authorities classify lesions using a 5-mm size designation.

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