today we discuss about secondary lesions:Secondary lesions may evolve from primary lesions, or may be caused by external forces such as scratching, trauma, infection, or the healing process. The distinction between a primary and secondary lesion is not always clear.
SCALE
Scales are heaped-up accumulations of horny epithelium[stratum corneum]
Scaly signs in dermatology[superb article on scales]
crust:
dried exudate.
EXCORIATION
Excoriations are traumatized or abraded skin caused by scratching or rubbing.
LICHENIFICATION
"Lichenification" refers to a thickening of the epidermis seen with exaggeration of normal skin lines. It is usually due to chronic rubbing or scratching of an area.
fissure:
slit in skin which extends into dermis.
erosion:
partial loss of epidermis which heals without scarring.
ulcer:
at least the full thickness of epidermis is lost.healing with scarring.
scar:
healing by replacement of fibrous tissue
KELOIDS :excessive scar
Keloids are an exaggerated connective tissue response of injured skin that extend beyond the edges of the original wound.
note:excessive formation of components of repair process complicate wound healing-
hypertrophic scar:accumulation of excessive collagen may give rise to raised scar.{but not beyond boundaries of original wound}
keloid:if scar tissue grows beyond boundaries of original wound & does not regress.more common in african-americans.
exuberant granulation[proud flesh]:formation of excessive granulation tissue,which protrudes above level of skin & blocks re-epithelialization.
desmoids/aggressive fibromatoses:exuberant proliferation of fibroblasts & other connective tissue elements.interface b/w benign & malignant.
ATROPHY
Atrophy is thinning of skin due to shrinking of epidermis ,dermis or subcutaneous fat.
thats for today,next we will deal with special skin lesions
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