Efflorescence
In dermatology, a basic element of pathological skin changes is referred to as efflorescence (outdated skin bloom ) . The doctrine of efflorescence originated in the 17th century. A distinction is made between primary and secondary fluorescences .
Primary lesions
Primary lesions are the changes that arise directly from the pathological process in the skin. Since they are not "adulterated" by secondary changes, they have a higher diagnostic value than secondary changes. The following can occur as primary fluorescence:
- Macula : a circumscribed color change in the skin level without a change in consistency.
- Plaque : Uniform protrusion of the skin with a sharp border and a smooth or rough surface
- Papula (papule, nodule): small (<0.5 cm), easily delimited, palpable elevation that extends above the skin level.
- Nodule : like papule, but larger (0.5–1.0 cm).
- Nodus (knot): like nodulus, but larger (> 1 cm).
- Vesicula (vesicles): bulging of the skin caused by accumulation of fluid (serum, blood) in the various layers of the skin.
- Bulla (bladder): more than a lens-sized, often multi-chambered cavity. A distinction is made between subcorneal, intraepidermal and subepidermal blisters.
- Pustula (pustule, pusvesicle):vesicle or bladder filledwith pus .
- Urtica (wheal):flat, soft, edematous elevation of pale to light red colorcausedby the release of histamine , which is usually associated with itching.
- Comedo (colloquially: blackheads): usually dark-colored horn plug that closes the exit of the follicular canal
- Cyst : a cavity encapsulated by tissue with a liquid content
Secondary lesions
Secondary efflorescences are changes that are characterized by additional pathological processes or that result from self-harm (e.g. scratching) from primary efflorescences. Secondary fluorescences are less meaningful for the doctor, since the actual pathological process can be superimposed and the same secondary fluorescence can arise from different primary fluorescences. Secondary fluorescences include:
- Squama (skin flakes): aggregation of corneocytes visible to the naked eye.
- Crusta (crust, bark): deposit of dried secretion.
- Cicatrix (scar): newly formed, fibrous connective tissue to replace a loss of skin substance
- Erosion (abrasion):loss of the upper epidermal cell layersreachingup to the dermis border , which can heal without scarring.
- Excoriation : erosion that affects all layers of the epidermis. Scarless healing is also possible.
- Rhagade (crack): narrow, gap-shaped division of all layers of the epidermis.
- Ulcus : deep tissue destruction with scarred healing.
- Atrophy : loss of skin and skin appendages
- Lichenification : Thickening of the skin in chronic skin diseases
- Tyloma (horny callus): demarcated thickening with increased cornification and hair loss
- Hyperpigmentation : increased storage of the skin pigment melanin
- Hypopigmentation : decreased pigmentation, especially of the hair on the affected skin area
References
- ↑ Gary White: Levene's Color Atlas of Dermatology . 5th edition, Thieme Verlag 2004.
- ↑ Wolfram Sterry , Ralf Paus: Checklist Dermatology . 3rd edition, Thieme Verlag 1999.
- ^ Ingrid Moll: Dermatology . 6th edition, Thieme Verlag 2005.