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D4 Dermatology
Morphology
Toronto Notes 2019
Macule
Nodule
Scale
Lichenification
Patch
Tumour
Fissure
Annular
Papule
Erosion
Vesicle
Reticular
Plaque
Ulcer
Bulla
Figure 2. Examples of primary and secondary morphology
Targetoid
Satellite
Other Morphological Terms
• cyst:aninternallyepithelial-linedstructurecontainingsemi-solidmaterialorfluid
• pustule:anelevatedlesioncontainingacollectionofneutrophils(infectiousorinflammatoryinnature)
• scar:replacementfibrosisofdermisandsubcutaneoustissue(hypertrophicoratrophic)
• wheal:aspecialformofpapuleorplaquethatistransient(<24h)andblanchable,oftenwithahaloand
central clearing, formed by edema in the dermis (e.g. urticaria)
• comedone:aspecialcollectionofsebumandkeratin
■ open comedo (blackhead)
■ closed comedo (whitehead)
• petechiae:pinpointextravasationofbloodintodermisresultinginhemorrhagiclesions;non-
blanchable, <3 mm in size
• purpura:largerthanpetechia,3mm-1cminsize
• ecchymosis:largerthanpurpura,>1cminsize(i.e.a“bruise”)
• telangiectasia:dilatedsuperficialbloodvessels;blanchable,reticulated,andofsmallcalibre,canbe
associated with benign or malignant entities
Patterns and Distribution
• acral:relatingtothehandsandfeet(e.g.perniosis,secondarysyphilis)
• annular:ring-shaped(e.g.granulomaannulare)
• follicular:involvinghairfollicles(e.g.folliculitis)
• guttate:lesionsfollowinga“drop-like”pattern(e.g.guttatepsoriasis)
• Koebnerphenomenon:i.e.isomorphicresponse,appearanceoflesionsataninjurysite(e.g.lichen planus, psoriasis, vitiligo)
• morbilliform:literallymeans“measles-like”,aneruptioncomposedofmaculesandpapuleswith truncal predominance
• reticular:lesionsfollowinganet-likepattern(e.g.livedoreticularis)
• satellite:smalllesionsscatteredaroundtheperipheryofalargerlesion(e.g.candidadiaperdermatitis)
• serpiginous:lesionsfollowingasnake-likepattern(e.g.cutaneouslarvamigrans)
• target/targetoid:concentricringlesions,likeadartboard(e.g.EM)
• otherdescriptiveterms:discrete,clustered,linear,confluent,dermatitic,indurated(i.e.hardorfirm)
© Joshua Lai 2014