Definition
- Fever and rash are common manifestations of systemic diseases.
- Rashes are classified according to the morphology and distribution of lesions.
- Macules
- Flat lesions defined by an area of changed color (i.e., a blanchable erythema)
- Papules
- Raised, solid lesions < 5 mm in diameter
- Plaques
- Lesions > 5 mm in diameter with a flat, plateau-like surface
- Nodules
- Lesions > 5 mm in diameter with a more rounded configuration
- Wheals (urticaria, hives)
- Papules or plaques that are pale pink and may appear annular (ringlike) as they enlarge
- Classic (nonvasculitic) wheals are transient, lasting only 24–48 hours in any defined area.
- Vesicles (< 5 mm) and bullae (>5 mm)
- Circumscribed, elevated lesions containing fluid
- Pustules
- Raised lesions containing purulent exudate
- Vesicular processes, such as varicella or herpes simplex, may evolve to pustules.
- Nonpalpable purpura
- A flat lesion due to bleeding into the skin
- If < 3 mm in diameter, the purpuric lesions are termed petechiae.
- If ≥ 3 mm, they are termed ecchymoses.
- Palpable purpura
- A raised lesion due to inflammation of the vessel wall (vasculitis) with subsequent hemorrhage
- Ulcer
- A defect in the skin extending at least into the upper layer of the dermis
- Eschar (tâche noire)
- A necrotic lesion covered with a black crust
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