Classification of the Elementary Lesions

The firststep in diagnosis is to obtain a clear and full understanding of the different lesions, so that their true character may he recognized at a glance. Each author has a pet classification which he honestly believes to be the best.

One divides them into:
1. Maculae;
2. Erythematous;
3. Papular;
4. Vesicular;
5. Pustular;
6. Squamous;
7. Tubercular;
8. Parasitic.

Another gives:
1. Maculae or stains;
2. Erythema or redness;
3. Wheuls;
4. Papules, or pimples;
5. Squammae or scales;
6. Vesicles, or little bladders;
7. Blebs, or large vesicles;
8. Tubercula, or lumps;
9. Pustules, or mattery heads.


I have found the following divisions to be of the greatest help in diagnosing skin affections: Macules, Vesicles, Bul-lae, Pustules, Papules, Tubercles, Scales, Fissures, and Ulcers.

There is one remark I would make with a view of helping the reader to avoid a common error in regard to these lesions. It is this, that the different typical forms of lesions embrace or include each of them several varieties, and the designation of each typical form of lesion is to be regard­ed as a generic term,applicable to several varieties of the same lesion. It is not enough, for instance, to say a papule is present. Since; then; are various kinds of papules, it is necessary to state what particular kind of papule is meant. When it is said a tubercle is present, the class to which the lesion belongs has only been defined; the tubercle may be that of a cancer, lupus, or syphilis. I am convinced that one of the commonest errors into which those who are studying skin diseases fall is the neglect to recognize the fact that there are several different varieties of the same kind of elementary lesions, and their confusion of these several different varieties. This is especially the case, with papules. We will describe the several varieties of elemen­tary lesions.