Vicki Sweet, RN, MSN, CEN

MED 3015 C – Week 5

Skin lesions:Defining the rash

Rashes and lesions

Usually temporary eruptions

Difficult to diagnose

No two look exactly alike

Appearance may be altered by scratching or self-treatment

But… there are some common characteristics

Describing the lesion

Macules and patches

Circumscribed, flat, nonpalpable changes in skin color

Examples: freckles, petechiae, vitiligo

Describing the lesion (cont.)

Papules, nodules and wheals

Palpable elevated solid masses

Examples: nevi, mosquito bite, hive

Describing the lesion (cont.)

Vesicles, bulla and pustules

Circumscribed superficial elevations, fluid-filled cavities within the skin layers

Typically, a vesicle bigger than a pea is called a bulla

Lesions can be combination

Examples:

Maculopapular rashes

Combination of flat and palpable lesions

Maculovesicular rashes

Combination of flat lesions, raised “blisters”

Describe what you see – very hard to “diagnose”

Dangerous rashes

Petechial rash

Meningococcal meningitis

DIC

Stevens-Johnson Syndrome

Toxic shock syndrome

Rash may look like a sunburn

Smallpox versus chicken pox

Similar virus

Progression of rash is more diagnostic

Stevens-Johnson rash

Petechial rash

Respecting what the skin can tell us!

The skin is the largest organ in the body

It can reflect so much about our health

Assess:

Color

Temperature

Moisture

Turgor

Integrity