DERMATOLOGIC TERMINOLOGY

Rhett J. Drugge, MD Internet Dermatology Society Stamford, Connecticut The Descriptive Language of Dermatology, Rhett J. Drugge, M.D. Color - melanin, carotenoids, oxy Hgb, reduced Hgb Moisture - wetness or dryness of skin Turgor - tissue hydration Hair - distribution, texture and amount Nails - pitting, thickening, color changes, onychodystrophy, onychomaedesis, onychogryphosis, onychoschizia, subungual hyperkeratosis, pterygium, Mucous membranes - oral, ocular, genital

Lesion Types:

Macule : a circumscribed change in skin color without elevation or depression. Papule : a solid elevated lesion usually 0.5 cm or less in diameter. Plaque : a raised lesion that has a greater area as compared to its elevation above the skin surface. Wheal (hive) : a rounded or flat-topped elevated lesion formed by local dermal edema. Nodule: a palpable solid lesion of varying size, greater than 0.5 cm and less than 2 cm in diameter, which may be present in the epidermis, dermis or subcutis. Vesicle: a circumscribed elevated lesion which contains free fluid. Vesicles are 0.5 cm or less in diameter. Bulla, blister Pustule: (abscess) a circumscribed elevated lesion which contains pus. An abscess is usually in the dermis or subcutis. Purpura : a non-blanching erythema or violaceous color due to extravasation of blood into the tissue. Cyst: a sac containing liquid or semisolid material usually in the dermis. Scale : a heaping up of stratum corneum or keratin. Erosion : a loss of epidermis above the basal layer leaving denuded surface. Crust: an accumulation of serum, blood, or purulent exudate. Excoriations: linear crusts and erosions due to scratching. Ulcer: a loss of epidermis and part or all of dermis leaving depressed moist lesion.

Atrophy : a thinning of epidermis or dermis. Sclerosis : a hardening or induration of skin. Scar : fibrous tissue replacing normal skin in areas of healing. Lichenification: (1) an accentuation of skin markings commonly associated with thickening of epidermis usually caused by scratching or rubbing. (2) marked by the presence of fine papules. Scar: a variety of dermal and epidermal changes associated with wound healing, cf. hypertrophic scar, keloid, post-inflammatory dyspigmentation Poikiloderma: a combination of atrophy, hyper and hypopigmentation and telangiectasis. Telangiectasia: dilated superficial blood vessels, especially of the upper reticular dermal plexus. Nikolsky's Sign: a disadhesion of skin assessed by light pressure at the edge of a preexisting bulla.

Configuration:

linear - factitial, nevoid, Koebner phenomenon, autoinoculation. annular - ring-like-tinea, papulosquamous disorders and dermal processes. iris-target - erythema multiforme grouped - herpetiform. dermatomal - zosteriform (especially metastatic disease)

Distribution:

light exposed - L.E., drugs, seborrheic dermatitis , Acne rosacea , Acne vulgaris , Acute Contact Dermatitis, Arms generalized - drug, infection palms and soles - Secondary syphilis , Rocky Mt. Spotted Fever, erythema multiforme intertriginous - Candida, tinea, erythrasma.