Diseases of Skin
Common Terminologies
• Dermatosis / Dermatoses : Any cutaneous lesion or group
of lesions. Any Skin Disease
• Genodermatoses : Hereditary skin disorders, many of
which also accompanied by various systemic
manifestations of different altered enzyme functions.
• Genokeratoses : Hereditary skin diseases which are
characterized particularly by alterations in normal
keratinization process
• Dermatitis : Inflammation of skin. Not a final diagnosis
• Lesion : An area of altered skin. It can be solitary or multiple
• Rash: Widespread eruption of lesions
Distribution of Lesions
• Acral : Affecting the distal portions (extremities) of limbs
(hand & foot) and head (ears, nose, etc)
• Dermatomal: Corresponding with nerve root distribution
• Seborrheic : areas of skin which have a tendency to be oily.
Such as scalp, behined ears, eyebrows, nasolabial fold, etc
• Intertriginous : Area is where two skin areas may touch or
rub together. Examples of intertriginous areas are the axilla
of the arm, the anogenital region, between digits, etc
Shape of Lesions
• Annular: Lesions grouped in a circle
• Linear / Striate: Line like
• Reticular : Net-like
• Serpiginous : skin lesion having a wavy margin / Snake
like appearance
• Discoid / Nummular : Round or Coin shaped
• Herpetiform: Grouped or clustered vesicles or ulcers
• Morbilliform : A rash which looks like measles
• Target / Iris lesion: lesions having concentric rings like a
bulls-eye or archery target
Annular: Lesions grouped in a circle
Reticular : Net-like
Serpiginous : lesion having a wavy margin
Discoid / Nummular : Round or Coin shaped
Herpetiform: Grouped or clustered vesicles or ulcers
Morbilliform : A rash which looks like measles
Target /Iris lesion: lesions having concentric rings like a bulls-eye
Colour of Lesions
• Erythema : red skin due to increased blood supply and it
will blanch on pressure.
• Purpura : is bleeding into the skin
• Petechiae : Pin-point small red or purple spot caused by
bleeding into the skin.
• Ecchymoses : a subcutaneous spot of bleeding with
diameter larger than 1 centimeter
• Hyperpigmentation : may be caused by excess of melanin
or haemosiderin deposits that result in skin colour that is
darker than normal.
• Hypopigmentation : is loss of normal melanin and results
in skin colour that is paler than normal but not completely
white.
Erythema : red skin due to increased blood supply
Petechiae
Ecchymoses
Hyperpigmentation
Hypopigmentation
DiscreteLesions
• Macule : Circumscribed alterations in skin color less than
1 to 1.5 cm in diameter. The skin surface is neither
elevated or depressed in relation to the surrounding skin .
The surface is smooth.
• Patch : A large area of colour change (> 2cms) with a
smooth surface.
• Papule : A small raised or elevated palpable lesion less
than 0.5 cm in diameter.
• Plaque : is a raised or elevated palpable flat lesion greater
than 0.5 cm in diameter.
• Nodule : A swelling or enlargement of a papule in three
dimensions (height, width and length).
Macule
Papule
Plaque
Nodule
• Blister: Accumulation of fluid either within or below the
epidermis and mucous membrane
• Vesicle: Elevated fluid filled blister containing clear fluid
that is lesser than 0.5 cm in diameter
• Bulla: Elevated fluid filled blister containing clear fluid
that is greater than 0.5 cm in diameter
• Pustule : Circumscribed elevation of the skin that contains
a purulent exudate that may be white, yellow, or greenish-
yellow in color.
• Abscess : A localized collection of pus in a cavity formed by
disintegration or necrosis of tissue.
Vesicle
Bulla
Epidermal Changes
• Desquamation / Exfoliation: skin coming off in scales.
• Psoriasiform - large white or silver flakes, as in psoriasis.
• Pityriasiform - a branny powdery scale.
• Lichenoid - when scale is tightly adherent to the surface
of the skin.
• Keratotic - horny scale with plenty of keratin.
• Maceration - moist peeling skin.
• Verrucous - resembling a wart.
Desquamation
Psoriasiform
Pityriasiform
Verrucous
Secondary Changes
• Crusting: Crusts result when serum, blood, or purulent
exudate dries and it is a hallmark of pyogenic infection.
Crusts are yellow when they have arisen from dried
serum; green or yellow-green when formed from purulent
exudate; and brown or dark red when formed from blood.
• Ulcer : A discontinuity in skin or mucous membrane with
complete loss of epidermis and possible loss of dermis
• Erosion : a loss of epidermis above the basal layer, leaving
denuded surface.
• Fissure : Thin crack within the epithelium or linear
cleavages or gaps in the skin surface
Crusting
Ulcer
Erosion
Fissure
• Atrophy : Atrophy of the skin may involve the epidermis,
or the dermis, or both. It is the thinning process
associated with decreased number of cutaneous cells.
• Cicatrix (scar) : variety of dermal and epidermal changes
associated with wound healing and resulting in fibrous
tissue replacing normal tissue in the affected areas.
• Telangiectasis : localized group of superficial distended
blood capillary vessels. It appears as a red spot that may
look spidery and that blanches when pressure is applied
Cicatrix
Telangiectasis
Histological Changes
• Acantholysis: loss of intercellular connections
(desmosomes) between keratinocytes
• Acanthosis: thickening of prickle cell layer in epithelium.
• Basophilic degeneration: age and sunlight related changes
of collagen and elastic fibers
• Spongiosis: intraepidermal edema, causing splaying apart
of keratinocytes in stratum spinosum (resembling a
sponge), vesicles due to shearing of desmosomes
• Dyskeratosis : abnormal, premature keratinization of
keratinocytes below granular cell layer; often have
brightly eosinophilic cytoplasm
• Hyperkeratosis: thickened cornified layer
Acantholysis
Acanthosis
Basophilic degeneration
Spongiosis
Dyskeratosis
Hyperkeratosis

Skin terminologies.ppt

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  • 2.
    Common Terminologies • Dermatosis/ Dermatoses : Any cutaneous lesion or group of lesions. Any Skin Disease • Genodermatoses : Hereditary skin disorders, many of which also accompanied by various systemic manifestations of different altered enzyme functions. • Genokeratoses : Hereditary skin diseases which are characterized particularly by alterations in normal keratinization process
  • 3.
    • Dermatitis :Inflammation of skin. Not a final diagnosis • Lesion : An area of altered skin. It can be solitary or multiple • Rash: Widespread eruption of lesions
  • 5.
    Distribution of Lesions •Acral : Affecting the distal portions (extremities) of limbs (hand & foot) and head (ears, nose, etc) • Dermatomal: Corresponding with nerve root distribution • Seborrheic : areas of skin which have a tendency to be oily. Such as scalp, behined ears, eyebrows, nasolabial fold, etc • Intertriginous : Area is where two skin areas may touch or rub together. Examples of intertriginous areas are the axilla of the arm, the anogenital region, between digits, etc
  • 7.
    Shape of Lesions •Annular: Lesions grouped in a circle • Linear / Striate: Line like • Reticular : Net-like • Serpiginous : skin lesion having a wavy margin / Snake like appearance • Discoid / Nummular : Round or Coin shaped • Herpetiform: Grouped or clustered vesicles or ulcers • Morbilliform : A rash which looks like measles • Target / Iris lesion: lesions having concentric rings like a bulls-eye or archery target
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    Serpiginous : lesionhaving a wavy margin
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    Discoid / Nummular: Round or Coin shaped
  • 12.
    Herpetiform: Grouped orclustered vesicles or ulcers
  • 13.
    Morbilliform : Arash which looks like measles
  • 14.
    Target /Iris lesion:lesions having concentric rings like a bulls-eye
  • 15.
    Colour of Lesions •Erythema : red skin due to increased blood supply and it will blanch on pressure. • Purpura : is bleeding into the skin • Petechiae : Pin-point small red or purple spot caused by bleeding into the skin. • Ecchymoses : a subcutaneous spot of bleeding with diameter larger than 1 centimeter • Hyperpigmentation : may be caused by excess of melanin or haemosiderin deposits that result in skin colour that is darker than normal. • Hypopigmentation : is loss of normal melanin and results in skin colour that is paler than normal but not completely white.
  • 16.
    Erythema : redskin due to increased blood supply
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    DiscreteLesions • Macule :Circumscribed alterations in skin color less than 1 to 1.5 cm in diameter. The skin surface is neither elevated or depressed in relation to the surrounding skin . The surface is smooth. • Patch : A large area of colour change (> 2cms) with a smooth surface. • Papule : A small raised or elevated palpable lesion less than 0.5 cm in diameter. • Plaque : is a raised or elevated palpable flat lesion greater than 0.5 cm in diameter. • Nodule : A swelling or enlargement of a papule in three dimensions (height, width and length).
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    • Blister: Accumulationof fluid either within or below the epidermis and mucous membrane • Vesicle: Elevated fluid filled blister containing clear fluid that is lesser than 0.5 cm in diameter • Bulla: Elevated fluid filled blister containing clear fluid that is greater than 0.5 cm in diameter • Pustule : Circumscribed elevation of the skin that contains a purulent exudate that may be white, yellow, or greenish- yellow in color. • Abscess : A localized collection of pus in a cavity formed by disintegration or necrosis of tissue.
  • 28.
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    Epidermal Changes • Desquamation/ Exfoliation: skin coming off in scales. • Psoriasiform - large white or silver flakes, as in psoriasis. • Pityriasiform - a branny powdery scale. • Lichenoid - when scale is tightly adherent to the surface of the skin. • Keratotic - horny scale with plenty of keratin. • Maceration - moist peeling skin. • Verrucous - resembling a wart.
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    Secondary Changes • Crusting:Crusts result when serum, blood, or purulent exudate dries and it is a hallmark of pyogenic infection. Crusts are yellow when they have arisen from dried serum; green or yellow-green when formed from purulent exudate; and brown or dark red when formed from blood. • Ulcer : A discontinuity in skin or mucous membrane with complete loss of epidermis and possible loss of dermis • Erosion : a loss of epidermis above the basal layer, leaving denuded surface. • Fissure : Thin crack within the epithelium or linear cleavages or gaps in the skin surface
  • 37.
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    • Atrophy :Atrophy of the skin may involve the epidermis, or the dermis, or both. It is the thinning process associated with decreased number of cutaneous cells. • Cicatrix (scar) : variety of dermal and epidermal changes associated with wound healing and resulting in fibrous tissue replacing normal tissue in the affected areas. • Telangiectasis : localized group of superficial distended blood capillary vessels. It appears as a red spot that may look spidery and that blanches when pressure is applied
  • 42.
  • 43.
  • 44.
    Histological Changes • Acantholysis:loss of intercellular connections (desmosomes) between keratinocytes • Acanthosis: thickening of prickle cell layer in epithelium. • Basophilic degeneration: age and sunlight related changes of collagen and elastic fibers • Spongiosis: intraepidermal edema, causing splaying apart of keratinocytes in stratum spinosum (resembling a sponge), vesicles due to shearing of desmosomes • Dyskeratosis : abnormal, premature keratinization of keratinocytes below granular cell layer; often have brightly eosinophilic cytoplasm • Hyperkeratosis: thickened cornified layer
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