MEDizzy - A 34-year-old woman seeks evaluation for a skin lesion. On

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A 34-year-old woman seeks evaluation for a skin lesion. On examination, the lesion is present on the extensor surface of the right elbow. It measures 2.4 cm in diameter and is raised, with a flat top and distinct edge. Overlying the lesion is an excess accumulation of stratum cornea. Further examination reveals several smaller lesions also located on extensor surfaces. Which term best characterizes the primary lesion for which the patient is seeking evaluation?

ExplanationRashes and skin lesions are the most common reasons for visits to primary care physicians. Accurately characterizing a skin lesion is important for determining the underlying cause of the disease. Four basic features that are important when describing a skin lesion are the distribution, types of primary and secondary lesions, shape, and arrangement of lesions. The primary description of a skin lesion takes into account size, whether the lesion is raised or flat, and whether the lesion is fluid filled. Raised lesions can be papules, nodules, tumors, or plaques. A plaque is a raised lesion with a flat top that measures more than 1 cm in diameter. The edges may be distinct or gradually blend in with the surrounding skin. Papules, nodules, and tumors are similar raised solid lesions of the skin. These lesions differ only by size, with papules being smaller than 0.5 cm, nodules measuring 0.5–5.0 cm, and tumors measuring more than 5 cm. Macules and patches are not raised and also differ only by size, with macules being less than 2 cm and patches being greater than 2 cm. Vesicles are small (<0.5 cm) fluid-filled lesions, and pustules are vesicles containing leukocytes. Larger fluid-filled lesions are called bullae. A secondary description of a skin lesion takes into account features of the lesion. An excess accumulation of stratum corneum on a skin lesion is called a scale. Thus, this patient would be characterized as having a plaque with a scale. Other secondary descriptors include lichenification, which refers to a distinctive thickening of the skin that accentuates skinfold markings, and crusting, which refers to dried body fluids. In addition, the lesion may have erosions, ulceration, excoriation, atrophy, or scarring