THE LANGUAGE OF DERMATOLOGY

Prepared by :SIG, Dermatology Nursing,

IADVL

Why learn the language of dermatology ?

Nurses play a very important part in patient care

The dialogue between doctor and patient has to be clear and well understood

In order to report any observations, the nurse must speak the language used in dermatology which is also used by the dermatologists

CATEGORIES of TERMINOLOGY

• General terms

• Terms used to describe distribution

• Terms used to describe patterns

GENERAL TERMS

Cutaneous : related to the skin

Pruritus : used to describe the sensation of itching or an irritating sensation that causes the person to scratch

Most common dermatological complaint

Usually represents inflammation

Can be a manifestation of something simple like dry skin or more serious systemic diseases like carcinomas

Time relationship can be a clue to disease ( nocturnal in scabies; transient in urticaria; constant in systemic diseases )

Excoriation marks and shiny nails might be a clue to its severity

Lesion : An area of altered skin texture, colour or elevation which is surrounded by normal skin

• May be a papule, macule, nodule, plaque, patch etc.

• May be one or many

• May change over time

• Type of lesion is a very good indicator of possible diagnosis

Lesion around the mouth

Lesion on the foot

Lesion on the neck

Rash : A collection of many lesions

• May involve any body part

• May be long standing or last a short while

• May be itchy or non itchy

• May be bilateral or unilateral

• If bilateral, symmetrical vs asymmetrical

• May change over time

Rash on the neck

Rash on the ‘V’ of the neck

Rash on the back

Dermatome : Area of skin supplied by a cutaneous nerve on one side of the body

• Important in some conditions like Herpes Zoster and some birth marks

Herpes Zoster along a dermatome

Naevus along a dermatome

Erythema :

• Redness of the skin caused by dilatation of blood vessels

Purpura :

• Red or purple colour due to bleeding into the skin. It does not become pale on pressure

• Pin point purpura = petechiae• Large bruise like patches = ecchymosis

Petechiae

Ecchymosis

Erythroderma :

• Generalized redness of the skin associated with scaling

• May be acute or chronic

• May be the result of worsening of psoriasis or eczemas

• May cause loss of proteins due to extensive shedding of scales

Thick scales in Erythroderma

Fine scales in Erythroderma

Exfoliation :

• Separation of the outermost dead layer of the skin from the underlying layers

• This may be in the form of scales or sheets

Fissure :

• A linear gap or slit in the skin surface

• Due to thickened, rigid outer layer of the skin splitting due to excessive dryness

• If unusually large and deep, may be due to anesthetic limb in leprosy

Fissured feet

TERMS USED TO DESCRIBE DISTRIBUTION ( The pattern of spread of lesions)

• Generalized : all over the body

• Widespread : involving large areas or extensive

• Localized : Restricted to one/ some area or the body

• Flexural : Body folds like groin, neck, behind ears, popliteal and antecubital fossa

Generalized

Localized (to palms)

Flexural

COMMONLY USED TERMS

• Extensor : knees, elbows, shins

• Pressure areas : Sacrum, buttocks, ankles, heels

• Symmetrical : similar distribution on both sides of the midline

• Asymmetrical : dissimilar distribution on both sides of the midline

• Photosensitive : over areas exposed to the sun

• Acral : pertaining to peripheral parts

Extensor

Symmetrical

Asymmetrical

Photosensitive

Acral

TERMS USED TO DESCRIBE CONFIGURATION ( Pattern or shape of grouped lesions)

• Discrete : individual lesions separated from each other

• Confluent : Lesions merging together

• Linear : In a line

• Annular : Like a circle or a ring

• Target : Group of rings inside each other ( concentric)

• Discoid/ Nummular : Like a coin

Discrete

Confluent

Linear

Annular

Target lesions

TERMS USED TO DESCRIBE CHANGES IN SKIN COLOUR

• Hypopigmentation : areas of paler skin

• Depigmentation : white skin due to absence of melanin

• Hyperpigmentation : Darker skin which may be due to various causes

• Erythema/ Purpura : As previously described

Hypopigmentation

Depigmentation

Hyperpigmentation

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