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

• General terms
• Terms used to describe distribution
• Terms used to describe patterns

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

Localized (to palms)

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

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

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