Advanced Health Assessment

Primary Lesions Video Transcript

This presentation will review primary lesions that you may see in assessing your patient's skin. There is some terminology that is important for all nurse practitioners to understand and use when they're documenting abnormalities within the skin assessment.

A macule is a flat, less than 1 cm lesion that you may see. It is usually typical reflective of a freckle, petechiae, maybe measles or scarlet fever. In this picture here, you can see a little boy with a bunch of freckles and those are macules.

A papule is a raised, solid lesion less than 1 cm. Here you can see that this lesion is a little bit raised, it's solid, and, again, small in nature.

A patch is a flat, non-palpable area greater than 1 cm. You may see this with a mongolian spot, vitiligo, or a café au lait spot.

A plaque is a raised disk shaped lesion, often a coalescence of papules. Again, you may see that with psoriasis. Here you can see it in the microscopic area. That whole area there behind the shoulder is a little bit raised, disk shaped in nature.

A nodule is a solid elevated lesion greater than 1 cm. Remember, the papule is less than 1 cm.

A tumor is essentially a large nodule greater than a few centimeters. It can be firm or can be soft, but it's deeper into the dermis.

A wheal is a superficial, raised, transient, and erythematous change of the skin. It's slightly irregular shaped. A good example of this is a mosquito bite, allergic reaction, or when you test somebody for PPD. Urticaria is something that can be associated with a wheal. You may see it with hives, intensely pruritic reaction that can happen with an allergic reaction.

A cyst is an elevated, encapsulated fluid filled cavity in the dermis or subcutaneous tissue. A vesicle is elevated cavity containing clear fluid up to 1 cm that you might see with herpes or varicella, chicken pox. A bulla is greater than 1 cm superficial fluid filled lesion. That, you might see with a blister. A pustule is elevated turbid [pussy 00:02:28] fluid filled cavity. You might see that with acne and impetigo.