2.7 Fissure

Rhagade.

Painful, fine or narrow tear extending into dermis, sharply defined, sometimes peripheral erythema.

Rhagades are generally deeper and larger than fissures.

Usually around an orifice, joint or interdigital site.

Fissures common on palms and soles.

Fissure at corner of mouth is perlèche.

Associated with scales, hyperkeratosis and dry skin.

They may be dry or moist, red, straight, curved, irregular or branching.

Very painful.

In most cases they occur when the skin is dry, atrophic, inflammatory, thickened and sclerotic.

Chronic hand and foot dermatitis (often decsribed as hyperkeratotic/rhagadiform), palmoplantar keratoderma, psoriasis, chronic lichenoid atopic dermatitis.

Fissures in dry skin.

Dry, brittle skin.

Mechanical or physical stress.

Common with chronic lichenified dermatitis.