Lesions PPT New

Brief Discussion On Lesions
By Debdip Mandal 1st year PG

On The Basis Of Types
A. Primary Lesions
B. Secondary Lesions
Primary Lesions : Associate with specific causes on

previously unaltered skin occur as initial reaction to
the internal and external environment.
Examples Vesicle, Bulla, Pustule, Nodule, Plaque,
Macule Etc
Secondary Lesions : Skin lesions that are results from
changes over time to primary lesions or from trauma to
primary lesions.
Examples Scars, Crusts, Erosions, Ulcers, Fissures.
Basis On article by JULIA BENDETTI, MD HAVARD MEDICAL

SCHOOL
Classification On The Basis Of Morphology
A.Raised lesions
B. Depressed lesions
C.Flat and Macular lesions
D.Surface Change
E. Fluid Filled lesions
F. Vascular lesions
Dermatologic lesions are classified according to their clinical
appearance and include the following frequently used terms
that are also applicable in oral mucosa
1. macule 6. bullae
2. papule 7. erosions
3. plaque 8. pustules
4. nodules 9. ulcers
5. vesicles 10. purpura
VESICLES
Vesicula meaning ‘little bladder’. It is a circumscribed,
elevated, superficial cavity containing fluid. Size <0.5cm. This
are dome shaped (dermatitis), umbilicated (herpes simplex),
flaccid (pemphigus).
The fluid in the cavity exerts equal pressure in all direction to
give rise a spherical shape. The roof of this kind of lesions is so
thin that its transparent and the serum or blood in the cavity is
seen.
These lesions are superficial and always well defined.
BULLAE
same as vesicle but size >0.5 cm. because of larger size bullae
are easily identifiable as tens or flaccid weepy blisters. Clinical
example of bulla is bullous phemphigoid.
HYPERKERATOSIS
Leider and Rosenblum define as “excessive cornification”.
Siemens said that “the stratum corneum may be thinned or
thickened”. Latter thickening may consist of normal
keratin(hyperkeratosis) or of an abnormal keratin in which
cellular neuclei retained and stainable.
CRUST
Crusts are hardened deposits that result when serum, blood or
purulent exudates dries on the surface of the skins.
The color of crust is yellow brown when formed from dried
serous secrection; turbid yellowish green when formed from
purulent secrection; and reddish black when hemorrahagic
secrection.
Removal of crust revel underlying erosion or ulcer
LICHENIFICATION
Repeated rubbing of the skin may induce a reactive thickening
of the epidermis, with changes in the collagen of the underlying
superficial dermis. These changes produce a thickened skin with
accentuated markings, which may resemble tree
bark.
A clinical example is lichen simplex chronicus.
PAPULES
In latin its meaning ‘pimple’
Superficial elevated solid lesions. Size <0.5cm. Elevated above,
rather than deep within the place of surrounding skins.
These are palpable. Sharply defined. Dome, Cone And flat
topped.
Elevation caused by metabolic or locally produced deposits by
localise cellular infiltrates.
PLAQUE
A solid plateu like elevation that occupies relatively large
surface area in comparison with its height above the normal skin
level.
Diameter >0.5cm. It is well defined and confluence of Papules
Clinical Example Is Psoriasis, Leukoplakia

NODULES
Larger than papules. These lesions are palpable, solid,round or
ellipsoidal. Involving epidermis, dermis or subcutaneous tissues.
Some additional features include temp, hard, soft, fluctuant,
painful etc. Diff surface of nodules like smooth, keratotic,
ulcerated or fungating also help in diagnosis
Example is irritation fibroma.
CYST
Encapsulated cavity or sac lined with a true epithelium that
contains fluid or semi solid material( cells and cell product). Its
spherical or 0val shaped as the tendency of the product to
spread equally in all directions.
May be hard, doughy or fluctuant.
EROSION
Moist circumscribed depressed lesions that results from loss of
aportion or all the viable epidermal or mucosal epithelium. May
result from trauma, rupture of vesicle bulla or epidermal
necrosis.
ULCER
A local defect, or excavation of the surface of an organ or
tissue, produced by sloughing of necrotic inflammatory tissue.
Loss of tissue from a surface leaving a uncovered wound.

Conditions are deeper than the basal layer of epithelium and
extend into dermis. Scarring may follow healing.
Borders are elevated, undermined.
In oral region following ulcerative lesions are seen

a. traumatic ulcer b. recurrent apthus ulcer. specific
granulomatous ulcer d. chemotherapeutic ulcer
ATROPHY
Refer to diminution in the size of cell tissue,organ,or part of the
body.
It is glossy,almost transparent,paper thin and wrinkled.
SINUS
Sinus is a tract connecting deep suppurative cavities to each
other or to the surface of the skin.
MACULE
Flat, even with the surface level of surrounding skin, and
perceptible only as an area of color different from surrounding
skin or mucous membrane.
It is ill defined or well defined. As no elevation or depression
present thus not palpable. May be of any size or colour.
Examples café-au-lait spot, port wine spot.

PATCHES
Its similar to macule.it is a flat area of skin or mucous
membrane with a different color from its surroundings. It is
larger than 0.5cm
example vitiligo
ERYTHEMA
It represents the blanchable pink to red color of skin or mucous
membrane due to dilation of arteries and vein in the dermis.
Clinical example is dusky erythema, erythematous candidiasis

PUSTULES
circumscribed superficial cavity of the skin that contains a
purulent exudate composed of leucocytes which may be white,
yellow,greenish yellow or hemorrhagic.
They are differ from vesicle as having turbid content.
PURPURA
reddish purple lesions caused by extravasation of red blood from
cutaneous vessels into skin or mucous membrane.
As red blood cells decompose over time, the color of purpuric
lesions changes from bluish red to yellowish brown or green.
INFARCT
An infarct is an area of cutaneous necrosis
resulting from a bland or inflammatory occlusion of
blood vessels in the skin.
A cutaneous infarct presents as a tender, irregularly shaped
dusky reddish-gray macule or firm plaque that is sometimes
depressed slightly below the plane of the skin. A clinical
example is cholesterol embolI.
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Lesions PPT New

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Brief Discussion On Lesions

By Debdip Mandal 1st year PG

Primary Lesions : Associate with specific causes on

Basis On article by JULIA BENDETTI, MD HAVARD MEDICAL

Clinical Example Is Psoriasis, Leukoplakia

Loss of tissue from a surface leaving a uncovered wound.

In oral region following ulcerative lesions are seen

Examples café-au-lait spot, port wine spot.

Clinical example is dusky erythema, erythematous candidiasis

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