Rhett J. Drugge, MD
The Descriptive Language of
Form for Telemedicine
- Color - melanin, carotenoids, oxy Hgb, reduced Hgb
- Moisture - wetness or dryness of skin
- Turgor - tissue hydration
- Hair - distribution, texture and amount
- Nails - pitting, thickening, color changes,
onychodystrophy, onychomaedesis, onychogryphosis, onychoschizia,
subungual hyperkeratosis, pterygium,
- Mucous membranes - oral, ocular, genital
- Macule : a circumscribed change in
skin color without elevation or depression.
- Papule : a solid elevated lesion
usually 0.5 cm or less in diameter.
- Plaque : a raised lesion that has a
greater area as compared to its elevation above the skin
- Wheal (hive) : a rounded or
flat-topped elevated lesion formed by local dermal edema.
- Nodule: a palpable solid lesion of varying size,
greater than 0.5 cm and less than 2 cm in diameter, which may be
present in the epidermis, dermis or subcutis.
- Vesicle: a circumscribed elevated lesion which contains
free fluid. Vesicles are 0.5 cm or less in diameter.
- Bulla, blister
- Pustule: (abscess) a circumscribed elevated lesion
which contains pus. An abscess is usually in the dermis or
- Purpura : a non-blanching erythema or violaceous color
due to extravasation of blood into the tissue.
- Cyst: a sac containing liquid or semisolid material
usually in the dermis.
- scale : a heaping up of stratum corneum or
- Erosion : a loss of epidermis above the basal layer
leaving denuded surface.
- Crust: an accumulation of serum, blood, or purulent
- Excoriations: linear crusts and erosions due to
- Ulcer: a loss of epidermis and part or all of dermis
leaving depressed moist lesion.
- atrophy : a thinning of epidermis or dermis.
- sclerosis : a hardening or induration of skin.
- scar : fibrous tissue replacing normal skin in areas of
- lichenification: (1) an accentuation of skin markings
commonly associated with thickening of epidermis usually caused by
scratching or rubbing. (2) marked by the presence of fine
- scar: a variety of dermal and epidermal changes
associated with wound healing, cf. hypertrophic scar, keloid,
- poikiloderma: a combination of atrophy, hyper and
hypopigmentation and telangiectasis.
- telangiectasia: dilated superficial blood vessels,
especially of the upper reticular dermal plexus.
- Nikolsky's Sign: a disadhesion of skin assessed by
light pressure at the edge of a preexisting bulla.
- linear - factitial, nevoid, Koebner phenomenon,
- annular - ring-like-tinea, papulosquamous disorders and dermal
- iris-target - erythema multiforme
- grouped - herpetiform.
- dermatomal - zosteriform (especially metastatic disease)
- light exposed - L.E., drugs, seborrheic dermatitis , Acne
rosacea , Acne vulgaris , Acute Contact Dermatitis, Arms
- generalized - drug, infection
- palms and soles - syphilis (palms)
, Rocky Mt. Spotted Fever, erythema multiforme
- intertriginous - Candida (perleche), tinea, erythrasma.
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