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Morphology of Primary and Secondary Skin Lesions

»	Why do dermatologists use words that no one else understands?
»	But why are the descriptions so long?
»	How can I possibly learn the language of dermatology?
»	What is a primary skin lesion?
»	How is each of the primary lesions defined?
»	How do you determine whether a lesion is flat or raised?
»	How does a primary lesion differ from a secondary lesion?
»	How are secondary skin lesions defined?
»	What is a maculopapular eruption?
»	Give some examples of special skin lesions.
»	What are telangiectasias?
»	Are telangiectasias pathognomonic for a certain disease?
»	What is a burrow?
»	What is a comedo?
»	What is the difference between petechiae and purpura?
»	What are targetoid (target) lesions?
»	List some of the additional descriptive adjectives used in dermatology that refer to color or pigmentation.
»	How do atrophy and lichenification differ?
»	Do skin diseases have characteristic arrangements or configurations?
»	What is the Koebner phenomenon?
»	Do skin diseases characteristically occur in certain locations?

How do atrophy and lichenification differ?

Fig. 2.5 Atrophy.

Lichen simplex chronicus. Patient with atopic dermatitis and secondary lichenification manifesting as thickened skin with accentuation of skin markings. Secondary excoriations are also present. (Courtesy of the Fitzsimons Army Medical Center teaching files.)

Fig. 2.7 Lichen simplex chronicus. Patient with atopic dermatitis and secondary lichenification manifesting as thickened skin with accentuation of skin markings. Secondary excoriations are also present. (Courtesy of the Fitzsimons Army Medical Center teaching files.)

Atrophy (Fig. 2-5) is thinning of the epidermis, dermis, or subcutis (fat). Epidermal atrophy leads to a fine, cigarette-paper wrinkling of the skin surface, whereas dermal and fat atrophy cause a depression in the skin

Fig. 2.6 Lichenification.

surface.

A lichenified lesion (Fig. 2-6) is a focal area of thickened skin
produced by chronic scratching or rubbing. The skin lines are accentuated, resembling a washboard (Fig. 2-7).