Lesion+Description

= Lesion Description Components =

12. Diameter


=Lesion Vocabulary=

** Primary lesions: **

 * Initial changes that are associated with a lesion; first to be recognized.
 * Include bullae, macules, nodules, papules, patches, pustules, telangiectasia and vesicles.


 * ** Macules: **
 * Circumscribed area or epidermis or mucosa that is __different in color from its surroundings.__
 * Smaller lesions (< 1 cm)
 * § **Like a freckle – not raised.**
 * ** Patch ** : **
 * Larger than a macule and can be a different color, texture, or both (from the surroundings)
 * ** Papule: **
 * Elevated, superficial solid lesion which is less than 1 cm.
 * **__ Sessile: __** attached with a broad base; can be malignant or benign.
 * **__ Pedunculated: __** on a stalk- usually benign; associated with EBV.
 * ** Nevus__:__ **
 * Flat or raised collection of nevus cells of the epithelium of skin or mucosa but can extend into the submucosa or subcutaneous tissues.
 * Many different types of nevi- can be congenital or acquired.
 * Laymen term= __mole__
 * ** Nodule **__ : __
 * Solid mass (uniform density throughout the lesion)
 * It is not superficial (like a papule)
 * It has the dimension of depth and is normally less than 1 cm diameter.
 * ** Tumor/mass: **
 * “Tumor” = swelling
 * Also can be a neoplasm
 * Solid mass of tissue that has the dimension of depth that is greater than 1 cm in diameter.
 * “Mass” is usually solid – also can be semi-solid, fluid filled, or fluctuant lesion (do not know if it is solid or not).
 * Indurated – solid
 * Fluctuant – soft
 * ** Vesicle ** :
 * Circumscribed, fluid filled elevation of skin or mucosa that is less than 1 cm in diameter**__.__**
 * Usually much smaller lesions (< 5 mm)
 * Fluid is usually lymph or serum – can have some or all blood.
 * ** Bulla: **
 * Bullous lesion that is larger than a vesicle. (> 5mm)
 * Smaller lesions which have coalesced together
 * Think Herpes!
 * ** Cyst ** :
 * Mass lined with epithelium that is located in the skin, submucosa, within bone or within an organ.
 * Can be “empty” or partially or totally filled with a fluid (or solid/semi solid substance).
 * ** Pustule ** :
 * Collection of visible pus (liquor puris and inflammatory cells) usually within the epidermis.
 * Circumscribed elevation of the skin or mucosa that is killed with exudate – usually a result of infection.
 * Usually < 1 cm in diameter.
 * Can be on the gingiva- sometimes associated with a necrotic tooth.
 * Usually superficial but can be in the submucosal or subcutaneous tissues.
 * Associated with hair follicles or sweat pores.
 * Ex: zits, muscosal herpes zoster lesions, draining dental abcesses or sinus tracts.
 * ** Sinus/Fistula: **
 * Can be used interchangeably for the purpose of this course.
 * Tract which goes from body cavity to either surface of the epithelium or another body cavity.
 * Tract which goes from body cavity to either surface of the epithelium or another body cavity.


 * Secondary Lesions: **
 * Changes that evolve from primary lesions of a disorder – either due to natural progression of symptoms or as a reaction.
 * Include atrophic (doing something its not supposed to do), edematous, eroded, erythematous, excoriated, fissured, hyperkeratotic, hyperpigmented, hypopigmented and depigmented, lichenification, scaly, scarred and ulcerated.


 * ** Erosion: **
 * Usually not below the basal cell layer (since blood vessels are below there, erosion does not usually cause bleeding)
 * Painful as ulcers without the bleeding.
 * ** Ulcers ** :
 * Deeper than erosions- extend below the basal cell layer.
 * More painful (due to exposed nerve endings) and are more erythematous (blood vessels exposed)
 * “Aymptomatic ulcer” = CAUSE FOR CONCERN – malignancy!
 * o Basal cell carcinoma - not in mouth
 * o Basilar cell carcinoma - is in mouth
 * o SSC- by far in the mouth
 * ** Wheal ** :
 * Edematous papule or plaque which is an intra-epithelial extravasation of serum.
 * It is transitory (only lasts for short time) ; bolus lesion
 * Seen in mouth frequently
 * Associated with allergies, insect bites, contact with an irriatant, mechanical trauma.
 * ** Fissure ** :
 * Normal or abnormal linear split or cleft in the skin or mucosa.
 * Well defined walls but might be ulcerated.
 * Can get a secondary infection causing more pain and inflammation – go into submucosa so spread of infection.
 * Usually in corner of the mouth or lips.
 * ** Crust ** :
 * Dried exudate, excretion or secretion of the skin or mucosa.
 * Rare intraorally (saliva keeps things moist)
 * Can occur on lips.
 * ** Scale ** :
 * Dried epithelium that is superficially located (on the surface)
 * Rare intraorally but can occur on lips.
 * “Epithelial flakes”
 * Psoriasis lesions are often scaly