Welcome to the dermatology quiz on the nomenclature of skin lesions. Below you will be given a series of photographs along with a question you must answer for each picture.
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1 – Can you describe the rash on this 13-year-old girl?
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She has papules and vesicles, some of which are in a linear array. This patient has poison ivy dermatitis.
2 – Can you describe the rash on the legs of this 7-year-old girl?
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She has the macular, reticular rash of erythema infectiosum (fifth disease).
3 – What is this phenomenon called?
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This is an example of desquamation. In this case, the patient had toxic shock syndrome and had peeling in the recovery phase.
4 – This newborn has a condition called epidermolysis bullosa. How would you characterize the dermatologic findings he has?
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The patient has extensive erosions.
5 – This 9-year-old boy fell off of his bike. What is the name of this skin lesion?
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He has an abrasion. Incidentally, in the event that the bits of asphalt and grit that are evident in the abrasion are not removed, he would, after the abrasion is healed, have a tattoo from them.
6 – What type of skin lesion is this?
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He has a tumor; in this case a lipoma. Remember that in the morphologic sense, the term “tumor” refers to a large mass, no matter what the histologic diagnosis.
7 – After an IV infiltrated, what lesion does this 2-year-old boy have?
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He has a large ulcer.
8 – This 6-month-old baby has meningococcemia; what is the name of the rash that you see?
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The patient has purpura. In this case, the name of the phenomenon is purpura fulminans. Please note that we have seen another patient with meningococcemia who had a somewhat different lesion–an eschar. Although both patients had the same diagnosis and disease process; the exact skin findings that we have shown are somewhat different.
9 – What is this lesion called?
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This is an iris or target lesion.
10 – This patient has herpes simplex. What is the description of this rash?
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This 7-year-old girl has clustered vesicles.
11 – Can you describe the rash in this 13-year-old boy?
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This boy has psoriasis. He has a papulosquamous rash, with one large scaly plaque and smaller guttate lesions (papules) nearby.
Bullous impetigo is characterized by the presence of thin-roofed bullae and vesicles with abundant erosions. Herpes zoster (varicella zoster) is characterized by the presence of vesicles and papules that follow the course of a dermatome. One of these 2-year-old boys has herpes zoster, one has bullous impetigo. Which patient has which condition?
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Patient A has herpes zoster with the vesicles following the path of the S1 dermatome down the back of his leg. The rash on patient B is bullous impetigo. He has many erosions, a few intact bullae, and as he has lesions on both buttocks; his rash is not following the course of a dermatome.