Reuben Notes
Skin Layers
Epidermis
Dermal-Epideramal Junction (Basement Membrane)
Dermis
Skin Structures
Hair Follicle
Eccrine Glands
Apocrine Glands
Sebaceous Glands
Arrectores Pilorum
Primary LesionsMacule:Circumscirbed, Flat (without elevation or depression), Nonpalpable change in skin color. <1 cm in diameter.e.g., freckle, petechiaePatch:Similar to macule but > 1 cm Papule:Palpable, circumscribed, solid elevation,Less than 1 cm in diametere.g., elevated nevusWheal:Irregularly shapedElevated area or superficial localized edemavaries in sizeEdematous papulee.g., hive, mosquito biteNodule:Elevated solid massDeeper and firmer than papule1-2 cme.g., wartTumor:Solid mass that extends deep through subcutaneous tissuesimilar to Nodulelarger than 2 cme.g., epitheliomaPlaque:an elevation above the skin with a plateau-like surface. Vesicle:Circumscribed elevation of skinfilled with serous fluidless than 1cm.e.g., herpes simplex, chickenpoxBulla:Similar to vesicle but > 1 cm. Pustule:Circumscribed elevation of skinSimilar to vesicle but filled with neutrophils and dead bacteria.Fluid is white or yellow (pus)Varies in sizee.g., acne, staphylococcal infection Secondary LesionsScale:an excess of horny material on the skinCrust:scab consisting of dried blood, serum, or pusErosion:Scooped out and shallow break. No damage to the dermisFissure:linear form of an erosionUlcer:Deep lesion involving the dermisEschar:Dark colored, hard to remove crust on ulcer Shapes and Arrangements of LesionsAnnular:round lesion, ring-like.The rim is different from the centerLinear:long, thin lesion or smaller lesions in a long, thin line.Target or Iris:Concentric rings like an arches target.Imbricated:Target lesions with near form of an erosionSerpiginous:Snake-like.Partially circular and undulatingGeographic:Outline of a continent on a mapVegetating:Lesion has a surface that grows outward in uneven, fleshy tufts that feel soft.Verrucous:Wart-LikeTufts of protruding lesion are hyperkeratotic, not soft.Zosteriform:Conforming to the distribution of a nerve root.Polycyclic or Circinate:Annular lesions grow together, Parts of their cirlces form larger lesion.Grouped:Several similar lesions located in close proximity surrounded by a large area of normal skin Morphology of LesionsThe following aspects should be included in every description:SizeColorConsistency: Soft, Medium, FirmConfiguration: Shape or outline of lesionMargination: sharp or diffuseSurface Characteristics: Smooth or rough