Basic lesions

The different types of skin lesions play an essential role in the precise description of skin diseases. One distinguishes between primary and secondary lesions.

Primary Lesions

Primary lesions are skin lesions at the beginning of the dermatosis, without secondary changes. They have a greater diagnostic impact than secondary lesions.


International nomenclature for the description of cutaneous lesions. The international nomenclature includes 8 basic terms and over hundred descriptive additional terms. The unifying nomenclature serves as a crucial communication skill between dermato-venerologists and all medical disciplines which are confronted with skin problems or take care of the skin.

Skin and skin diseases present with signs and lesions that have distinct characteristics. The original lesions are defined as primary lesions, and the identification of such lesions is the most important aspect of the dermatologic physical examination. They tend to have a greater diagnostic impact compared to secondary lesions. They may be stable or be modified by progession or regression, trauma or other local or systemic factors, producing the secondary lesions. The four most important features in concisely describing dermatological findings are description of the lesions, and then their localisation, distribution and evolution.

Primary Lesion thumbnail 1.1 Macule

Primary Lesion thumbnail 1.2 Urtica

Primary Lesion thumbnail 1.3 Papule

Primary Lesion thumbnail 1.4 Plaque

Primary Lesion thumbnail 1.5 Nodule

Primary Lesion thumbnail 1.6 Vesicle and bulla

Primary Lesion thumbnail 1.7 Pustula (Pustule)

Primary Lesion thumbnail 1.8 Cyst

Secondary Lesions

Secondary lesions develop from primary lesions over time or by additional artifacts, like scratching. They have less diagnostic impact and often do not allow conclusions to the primary lesions, since various primary lesions may evolve to the same secondary lesion, like for example scaling.


Secondary Lesion thumbnail 2.1 Scales

Secondary Lesion thumbnail 2.2 Crust

Secondary Lesion thumbnail 2.3 Necrosis

Secondary Lesion thumbnail 2.4 Erosion

Secondary Lesion thumbnail 2.5 Excoriation

Secondary Lesion thumbnail 2.6 Ulcer

Secondary Lesion thumbnail 2.7 Fissure

Secondary Lesion thumbnail 2.8 Atrophy

Secondary Lesion thumbnail 2.9 Scar