It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues or to refer to various specialties including dermatology. Here is a refresher of the terminology to describe common skin lesions. For more detail, check our source.
- Inspect – Observe the overall appearance of the lesion i.e. site, number, pattern of distribution
- Describe – Inspect the individual lesions i.e. size, colour, morphology.
- Palpate – Feel the texture, temperature, tenderness, consistency and mobility.
- Expose – Thoroughly examine the other systems as appropriate i.e. nails, hair, mucous membranes and any other body system required.
- Acral (distal extremities)
- Dermatomal (confined to a single spinal nerve)
- Extensor or flexural
- Follicular (around the hair follicles)
- Generalised (not fitting any specific area)
- Pressure areas
- Seborrhoeic (around secretion of sebum)
- Specific body parts
Colour of individual lesion
- Hyper or hypopigmented
- Erythematous (blanching redness)
- Purpuric (non-blanching redness)
- Petechiae are spots (less than 2mm)
- Purpura are usually below 10mm
- Ecchymoses/bruises are usually above 10mm
Morphology of an individual lesion
- If it is flat (i.e. no palpable contour)
- Macule: less than 5mm
- Patch: more than 5mm
- If it is mildly raised
- Plaque: more than 1 cm of skin which is usually slightly elevated from the skin
- Wheal/weal: dermal oedema causing blanching erythema with central paleness usually a feature of urticaria
- If it is elevated
- Papule: solid lesion less than 5mm
- Pustule: pus filled papule
- Vesicle: fluid-filled papule
- Nodule: solid lesion more than 5mm
- Abscess: pus-filled nodule
- Bullae: fluid-filled nodule
- Scaling or hyperkeratosed
- Exfoliating means peeling
- Lichenoid are tight scales
- Psoriaform are large silver flakes
- Crusting: yellow or bloody dried discharge
- Excoriated (itched)
- Granular (fibrous healing tissue)
- Lichenification (thickened skin from rubbing)
Written by Dr Thujina Thillainathan & Dr Akash Doshi CT2
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