Primary Lesions

and
Secondary Lesions

Dr. Gazi Asma Sultana

Associate Professor & Head of the Dept.
Department of Deramtology & Venereology
Tairunnessa Memorial Medical College and Hospital
SKIN Layers
Primary Lesions
 Primary Lesions

Primary lesions are of the following forms-

- Macules (or Patches)
- Papules (or Plaque)
- Nodules
- Tumors
- Wheals
- Vesicles
- Bullae
- Pustules
 Primary Leisons
(Cont.)
• Macules are
- Variously sized
- Circumscribed changes in skin color
- Without elevated or depression (non palpable)
(* If the lesions become slightly raised, they are then designated as papules)

• Patch
A patch is a large macule, 1 cm or greater in diameter
 Primary Lesions
(Cont.)
• Papules (Papulae) are
- Circumscribed
- Solid elevation with no visible fluid
- Varies in size ( From a pinhead to 1 cm)
• Plaque
- is a broad papule (or confluence of papules)1
- 1cm or more in diameter
- Generally flat
• Nodule
- Morphologically similar to papules
- More than 1 cm in diameter
Papule
 Primary Lesions
(Cont.)
• Tumors are
- Soft or firm
- Freely movable or fixed masses
- Are of various sizes and shapes
- But in general greater than 2cm in diameter
• Wheals are
- Evanescent, oedematous
- Plateau like elevations
- Are of various size and shape
- Usually oval or arcuate contours
- Pink to red colored
- Surrounded by a pink areola.
 Primary Lesions
(Cont.)
• Vesicles are
- Circumscribed, fluid containing
- Epidermal elevations (1 to 10 mm in size)
**When the contents are of a seropurulent in character, the lesions are known as Vesicopustules.
• Bullae are
- Round or irregular shaped blisters
- Contain serous or seropurulent fluid.
- Larger than 1 cm (10 mm).
• Pustules are
- Small elevations of the skin
- Contain purulent material.
Vesicles Bullae Pustules
Secondary Lesions
 Secondary Lesions

Secondary lesions are –

- Scales
- Crusts
- Erosions
- Ulcers
- Fissures
- Scars
 Secondary Lesions
(Cont.)
• Scales (Exfoliation)
- Dry or greasy laminated masses of keratin.
- Ordinarily, the body is constantly shedding imperceptible tiny, thin fragments of stratum
corneum.
- When the formation of epidermal cells are rapid or the process of normal keratinization is
interfered
with pathologic exfoliation results, producing scales.

• Crusts (Scabs)
- Dried serum, pus or blood mixed with epithelial and sometimes bacterial debris.
Scales Crust
 Secondary Lesions
(Cont.)
• Excoriations and Abrasions (Scratch Marks)
- An excoriation is a punctate or linear abrasion produced by mechanical means.
- Usually involve only the epidermis but not uncommonly reaching the papillary layer of the
dermis.
- Caused by scratching with the fingernails (in an effort to relive itching in a verity of
diseases ie eczema, scabis)
• Fissures (Cracks, Clefts)
- Is a linear cleft through the epidermis or into the dermis.
- Occurs most commonly when the skin is thickened and inelastic from inflammation and
dryness
- Most commonly in regions subjected to frequent movement
Fissures
 Secondary Lesions
(Cont.)
• Erosions
- Loss of all or potion of epidermis alone.
- May or may not become crusted
- Heals without a scar
• Ulcers
- Rounded or irregular shaped excavations
- Results from complete loss of epidermis and some portion of the dermis
- Heals with scaring
 Secondary Lesions
(Cont.)
Scars
- Composed of new connective tissue that replace lost substance in the dermis or
deeper parts.
- Occurs as a result of injury or disease as part of the normal reparative process.
Erosions Ulcers Scars
Thank you
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