LANGUAGE OF DERMATOLOGY
Essential Morphologic Terms
and Definitions
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Christina P. Linton
MORPHOLOGY TERMINOLOGY
MORPHOLOGY - The form or structure of an individual
skin lesion.
LESION - Any single area of altered skin. Lesions may
be solitary or multiple.
PRIMARY LESION - A lesion directly associated with
the disease process that is described with established
dermatological terminology.
Example: Macule, papule, patch, plaque, vesicle, bulla,
and others
SECONDARY LESION - Modification of a primary
lesion that results from evolution of the primary lesion,
traumatic injury, or other external factors.
Example: Erosion, fissure, ulceration, excoriation, and others
FLAT LESIONS
MACULE - A circumscribed, flat area of discoloration
that is less than 10 mm* in diameter.
Example: Freckle
PATCH - A circumscribed, flat area of discoloration
that is greater than 10 mm* in diameter. Slight scale
may or may not be present.
Example: Vitiligo
RAISED LESIONS
PAPULE - A circumscribed, elevated, solid lesion that is
less than 10 mm* in diameter.
Example: Wart
Christina P. Linton, PhD, FNP-BC, Department of Dermatology,
Central Utah Clinic Provo, UT.
Correspondence concerning this article should be addressed to
Christina P. Linton, PhD, FNP-BC, Department of Dermatology,
Central Utah Clinic, 1055 North 500 West, Suite 111, Provo, UT
84604. E-mail: clinton@centralutahclinic.com
DOI: 10.1097/JDN.0b013e318211c6f0
102
Copyright @ 2011 Dermatology Nurses' Association. Unauthorized reproduction of this article is prohibited.
PLAQUE - A circumscribed, elevated, solid lesion that
is greater than 10 mm* in diameter and is usually
broader than it is thick.
Example: Psoriasis
NODULE - A palpable, solid lesion that is greater than
10 mm* in diameter. Nodules are usually found in the
dermal or subcutaneous tissue, and the lesion may be
above, level with, or below the skin surface.
Example: Dermatofibroma
TUMOR - A solid, firm lesion that is typically greater
than 20 mm in diameter. Tumors can be above, level
with, or beneath the skin surface. Also known as a
mass.
Example: Metastatic carcinoma
WEAL - Transient, circumscribed, edematous papules or
plaques caused by swelling in the dermis. Wheals may mani-
fest with erythematous borders and pale centers and/or a
narrow peripheral zone of pallor or vasoconstriction.
Example: Urticaria
DEPRESSED LESIONS
BURROW - A thread-like linear or serpiginous (wavy, serpent-
like) tunnel in the epidermis typically made by a parasite.
Example: Scabies
EROSION - A shallow, moist, or crusted lesion resulting
from the loss of the superficial layers of the upper epi-
dermis only, as from friction or pressure.
Example: Ruptured varicella vesicles
EXCORIATION - A skin abrasion that is usually
superficial and due to scratching of the skin. Excoria-
tions may be linear or focal.
Example: Neurotic excoriations from habitual picking
Journal of the Dermatology Nurses’ Association
LANGUAGE OF DERMATOLOGY
FISSURE - Sharply defined linear or wedge-shaped tears
in the epidermis with abrupt walls.
Example: Interdigital tinea pedis
PITS - Small, sharply demarcated depressions in the
skin or nail surface.
Example: Pitted keratolysis
ULCER - A circumscribed loss of the epidermis and at
least upper dermis. Ulcers are further classified by their
depth, border, shape, edge, and the tissue at its base.
Example: Venous stasis ulcer
FLUID-FILLED LESIONS
ABSCESS - A localized accumulation of pus in the
dermis or subcutaneous tissue that is frequently red,
warm, and tender.
Example: Methicillin-resistant Staphylococcus aureus
(MRSA) infection
BULLA (PLURAL = BULLAE) - A large, raised, circum-
scribed blister that is greater than 10 mm* in diameter and
is fluid filled. The fluid can be clear, serous, hemorrhagic,
or purulent.
Example: Pemphigus vulgaris
CARBUNCLE - An inflammatory nodule composed of
two or more confluent furuncles with separate heads.
Example: Staphylococcus aureus infection
CYST - A closed cavity or sac containing fluid or semisolid
material. A cyst may have an epithelial or endothelial lining.
Example: Epidermal inclusion cyst
FURUNCLE - An acute, round, firm, circumscribed,
follicle-centered nodule caused by infection that is usually
greater than 10 mm in diameter. Characterized by pain,
redness, and potentially visible pus.
Example: Staphylococcus aureus infection
PUSTULE - A purulent (pus filled) vesicle. Pustules are
filled with neutrophils and may be white or yellow. Not
all pustules are infected.
Example: Bacterial folliculitis
VESICLE - A small, superficial, circumscribed blister that
is less than 10 mm* in diameter and is fluid filled. The
fluid may be clear, serous, hemorrhagic, or purulent.
Example: Herpes zoster
VASCULAR LESIONS
ECCHYMOSIS (PLURAL = ECCHYMOSES) - Non-
blanching, purpuric macules or patches greater than
VOLUME 3 | NUMBER 2 | MARCH/APRIL 2011
Copyright @ 2011 Dermatology Nurses' Association. Unauthorized reproduction of this article is prohibited.
3 mm in diameter due to extravasated blood in the skin.
Color changes over time may go from blue-black to brown-
yellow, or green before fading away.
Example: Bruise from blunt trauma
HEMATOMA - A collection of extravasated blood that is
relatively or completely confined within a space. The
blood is usually clotted (or partly clotted) and, depending
on time, may manifest various degrees of organization and
color.
Example: Postsurgical bleeding
PURPURA - Bleeding into the skin that results in viola-
ceous (violet or purple) discoloration that varies accord-
ing to its duration and does not blanch with pressure.
Purpura includes petechiae and ecchymoses. When
purpuric lesions are palpable, they represent vasculitis
(vascular inflammation).
Example: Henoch-Schönlein purpura
PETECHIAE - Tiny, 1- to 2-mm (pinpoint to pinhead size)
nonblanchable purpuric macules resulting from the rup-
ture of small blood vessels. Color may be red, purple, or
brown.
Example: Rocky Mountain spotted fever
TELANGIECTASIA - Small, superficial cutaneous
blood vessels that become persistently visible because
they are dilated.
Example: Erythrotelangiectatic rosacea
*Some authorities classify lesions using a 5-mm size
designation.
RESOURCES:
Bolognia, J. L., Jorizzo, J. L., & Rapini, R. P. (2007).
Dermatology (2nd ed.). St. Louis, MO: Elsevier/Mosby.
DermNet NZ. Terminology in dermatology. http://
dermnetnz.org/terminology.html#J5
Lookingbill, J. J., & Marks, J. G. (2006). Principles of
dermatology (4th ed.). Philadelphia: Saunders/Elsevier.
University of California, San Francisco. Dermatology
glossary. http://missinglink.ucsf.edu/lm/
DermatologyGlossary/index.html
University of Rochester. Dermatology lexicon project.
http://www.dermatologylexicon.org/
Wolff, K., Fitzpatrick, T., & Johnson, R. (2009).
Fitzpatrick’s color atlas and synopsis of clinical
dermatology (6th ed.). New York: McGraw-Hill.
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