Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology.
Keywords:
Dermatology; Review; Teaching; Terminology
| Azulay RD; Azulay DR, Abulafia-Azulay L; Dermatologia, 6ª-Ed., 2013. | Macule or spot: any and all changes in skin color, no ridges, regardless of nature, cause, or mechanism. Do not cite size. |
| Bechelli-Curban; Compêndio de Dermatologia, 6ª-Ed., 1988. | Macule or spot: change in skin color, no ridges or thickening, varied sizes: lenticular, nummular, plaque and large plaque. |
| Belda Jr W; Di Chiacchio N; Criado PR; Tratado de Dermatologia, 2ª- Ed., 2014. | Macule or spot: modifications in skin color, no change in skin ridge or con-sistency. Can be of two types: pigmentary or blood vessel. Do not cite size. |
| Bolognia JL; Jorizzo J; Rapini RP; Dermatology, 2nd Ed., 2008. | Small, flat, non-palpable lesion. Prefer to consider the size up to 1.0 cm. Cite that some authors limit the size to 0.5 cm, others to 1.0 cm, and others to any size. Consider “patch” as a macule of greater than 1.0 cm. |
| Fitzpatrick et al., Dermatology in General Medicine, 7thEd., 2013. | Flat, non-palpable lesion, at the same level as the surface around it, with change in color. Consider “patch” lesion similar to macule, but greater than 0.5 cm |
| Rook A et al.; Textbook of Dermatology, 8th - Ed., 2010. | Circumscribed change in skin color. Do not mention size. |
| Sampaio e Rivitti; Manual de Dermatologia, 3ª- Ed., 2008. | Change in skin color, no ridges or depressions. Includes blood vessel or pigmentary spots. Do not cite size. |
| Azulay RD; Azulay DR, Abulafia-Azulay L; Dermatologia,6ª- Ed., 2013. | Efflorescence of hard consistency, surface, measuring 0.5 cm. Causes certain elevation of the skin and, upon involution, does not leave a scar. Upon palpation, there is no significant dermal representation, as the changes are limited to the papillary dermis (contrary to tubercle). |
| Bechelli-Curban; Compêndio de Dermatologia, 6ª-Ed., 1988. | Solid circumscribed elevation of up to 0.5 cm (varying from punctiform to lenticular); dissemination in disc: nummular or plaque (papulous or placard plaque) |
| Belda Jr W; Di Chiacchio N; Criado PR; Tratado de Dermatologia, 2ª- Ed., 2014. | Circumscribed lesion, less than 1.0 cm, elevated, with ridges in relation to the adjacent planes, and flat surface, epidermal, dermal, and mixed. |
| Bolognia JL; Jorizzo J; Rapini RP; Dermatology, 2ndEd., 2008. | Palpable lesion, small, circumscribed, surface, elevated, less than 1.0 cm. Cited that some authors consider the size of up to 0.5 cm. |
| Fitzpatrick's et al.; Dermatology in General Medicine 7th Ed., 2013. | Solid lesions, elevated, up to 0.5 cm. |
| Rook A et al.; Textbook of Dermatology, 8th Ed., 2010. | Palpable lesion, circumscribed, up to 0.5 cm. |
| Sampaio e Rivitti; Manual de Dermatologia, 3ª- Ed., 2008. | Solid lesion, elevated, circumscribed, up to 1.0 cm, by epidermal, dermal, or mixed pathological process. |
| Azulay RD; Azulay DR, Abulafia-Azulay L; Dermatologia, 6ª-Ed., 2013. | Efflorescence of hard consistency, elevated, generally measuring more than 0.5 cm. Results from the infiltration of mesenchymal cells to the level of the entire dermis, and consequently, often leaving scars upon involution. |
| Bechelli-Curban; Compêndio de Dermatolo-gia, 6ª-Ed., 1988. | Solid circumscribed elevation, greater than 0.5 cm, located in the dermis (different from the nodule, which is in the subcutaneous tissue) |
| Belda Jr W; Di Chiacchio N; Criado PR; Tratado de Dermatologia, 2ª-Ed., 2014. | Do not cite term. |
| Bolognia JL; Jorizzo J; Rapini RP; Dermatol-ogy, 2nd Ed., 2008. | Do not cite term. |
| Fitzpatrick's et al.; Dermatology in General Medicine 7th Ed., 2013. | Do not cite term. |
| Rook A et al.; Textbook of Dermatology, 8th Ed.,2010. | Do not cite term. |
| Sampaio e Rivitti; Manual de Dermatologia, 3ª-Ed., 2008. | Consider the term to be outdated but characterize it as a papule or nodule that evolves with a scar. |
| Azulay RD; Azulay DR, Abulafia-Azulay L; Dermatologia, 6ª-Ed., 2013. | Lesion, elevates in plateau, which arises from the convergence of numerous papules. |
| Bechelli-Curban; Compêndio de Dermatologia, 6ª-Ed., 1988. | Do not cite the term in an isolated manner. Cite papulous or placard plaque upon describing coalescence of papules. |
| Belda Jr W; Di Chiacchio N; Criado PR; Tratado de Dermatologia, 2ª-Ed., 2014. | Lesion generally elevated and flat on the surface, greater than 1.0 cm. Can begin with keratinization, maceration, peeling, or crusting on the surface. Consider the term papulous plaque as the convergence of papules, and the term maculous plaque as the convergence of macules. |
| Bolognia JL; Jorizzo J; Rapini RP; Dermatology, 2ndEd., 2008. | Palpable lesion, elevated, greater than 1.0 cm. |
| Fitzpatrick's et al.; Dermatology in General Medicine 7th Ed., 2013. | Solid elevation, which occupies a surface area that is relatively large when compared to its height, and with a diameter of greater than 0.5 cm |
| Rook A et al.; Textbook of Dermatology, 8th Ed., 2010. | Elevated area of the skin, usually with a size of greater than or equal to 2.0 cm. Can be constituted by coalescence of papules or nodules. The term small plaque can be used for lesions of 0.5 cm to 2.0 cm. |
| Sampaio e Rivitti; Manual de Dermatologia, 3ª-Ed., 2008. | Do not cite term in an isolated manner. |
| Azulay RD; Azulay DR, Abulafia-Azulay L; Dermatologia, 6ª-Ed., 2013. | Efflorescence of hardened consistency, of varying dimensions, sometimes visible by simple inspection, other times recognized by palpation, resulting from the increase in the number of cells in the dermis, generally deep and/or at the level of the subcutaneous tissue. |
| Bechelli-Curban; Compêndio de Dermatologia, 6ª-Ed., 1988. | Solid formation in the subcutaneous tissue, many times more palpable than visible. Size varies from that of a pea to that of a hazelnut (larger would be called nodular plaque). Variable consistency and color. |
| Solid cell infiltrate, circumscribed, persistent, dermal (when elevated) and hypodermal (when more palpable than visible), generally quite limited, from 1.0 to 3.0 cm. | |
| Bolognia JL; Jorizzo J; Rapini RP; Dermatology, 2nd Ed., 2008. | Firm lesion (hardened), thicker and deeper than the papule or plaque. If subcutaneous, it may not elevate the skin. |
| Fitzpatrick's et al.; Dermatology in General Medicine 7thEd., 2013. | Solid lesion, palpable, round or elliptic, greater than 0.5 cm. Divides into: epidermal; epidermal/dermal; dermal; dermal/subepidermal; subcutaneous. |
| Rook A et al.; Textbook of Dermatology, 8 th Ed., 2010. | Solid mass on the skin > 0.5cm, observed as an elevation or can be palpated. Can involve the epidermis or the dermis; dermis and subcutaneous tissue; or only the subcutaneous tissue. |
| Sampaio e Rivitti; Manual de Dermatologia, 3ª-Ed., 2008. | Solid formation, circumscribed, salient or not, of 1.0 to 3.0 cm. Pathological process located in the epidermis-dermis and/or subcutaneous tissue. Greater than 3.0 cm would be called nodular plaque. |
