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.

Systematic Examination

1. Inspect – Observe the overall appearance of the lesion i.e. site, number, pattern of distribution
2. Describe – Inspect the individual lesions i.e. size, colour, morphology.
3. Palpate – Feel the texture, temperature, tenderness, consistency and mobility.
4. Expose – Thoroughly examine the other systems as appropriate i.e. nails, hair, mucous membranes and any other body system required.

Distribution

• Acral (distal extremities)
• Dermatomal (confined to a single spinal nerve)
• Extensor or flexural
• Follicular (around the hair follicles)
• Generalised (not fitting any specific area)
• Photosensitive 
• 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

Surface