Which term would the nurse use to document a 1 cm elevated solid lesion noted on a clients skin?

Skin lesions are abnormal changes of the skin compared to the surrounding tissue. Skin lesions may look like bumps or patches, or they may be smooth. They may be a different color or texture compared to nearby skin.

There are many different types of skin lesions that you can be born with or acquire. Some are benign, which means they are harmless. Others can be severe and cancerous. They may appear all over your body, or they may be in one place.

The shape can vary, too. Some lesions are symmetrical, meaning they are the same shape all the way around. Others are irregular in shape.

The way a skin lesion looks and where it appears can help identify it. To find the cause of a skin lesion, healthcare providers consider:

• Color
• Size
• Texture
• Location

This article looks at 20 different types of skin lesions, their causes, and their treatment.

What Is a Lesion?

A lesion is an area of abnormal tissue that may or may not be cancerous.

Primary vs. Secondary Skin Lesions

Skin lesions are either primary or secondary. Primary skin lesions are either present from birth or develop during your lifetime.

Secondary skin lesions arise from primary skin lesions. This can happen when a primary skin lesion is:

• Disturbed
• Irritated
• Changes over time

For example, if eczema is scratched, a crust may form. The crust is a secondary lesion. 

Primary Skin Lesions

Primary skin lesions tend to be divided into three groups:

• Lesions formed by fluid within the skin layers: Examples include vesicles and pustules.
• Lesions that are solid masses: Examples include nodules and tumors.
• Flat lesions: Examples include patches and macules.

Types of primary lesion include:

• Bulla: A vesicle that is more than 0.5 centimeters (0.2 inch) and is filled with fluid.
• Cyst: A raised area of the skin that has clear borders and is filled with fluid or semi-solid fluid.
• Macule: A flat lesion that is different in color, and less than 0.5 centimeter (0.2 inch) in size.
• Papule or maculopapular: An elevated solid lesion, up to 0.5 centimeter (0.2 inch) in size. It has clear borders and is firm. It can appear in various colors.
• Patch: A flat lesion that is different in color and greater than 0.5 centimeter (0.2 inch) in size.
• Plaque: A lesion that is raised like a papule and is greater than 1-2 centimeter (0.4 to 0.8 inch) in size. It is solid, rough, and flat-topped. 
• Vesicle: A fluid-filled blister less than 0.5 centimeter (0.2 inch) in size.
• Pustule: Similar to a vesicle but filled with pus instead of fluid.
• Nodule: A circular, elevated, solid bump greater than 0.5 centimeter (0.2 inch) in size. 
• Telangiectasia: Clusters of "spider veins" where tiny blood vessels cause red lines on the skin.
• Tumor: A lesion that is larger than 0.5 centimeter (0.2 inch) in size but looks similar to a nodule. Tumors can be benign or cancerous.
• Wheal: An irregular-shaped, solid, elevated area that can vary in color and lasts for only a short time.

Secondary Skin Lesions

Examples of secondary skin lesions include:

• Atrophy: Skin that is paper-thin, transparent, and wrinkled. It is usually due to the use of a topical medicine like steroids.
• Crust: A rough, elevated area formed from dried fluid. The fluid may be pus, blood, or serum.
• Erosion: The loss of the top layer of skin. It is moist and glistening in appearance.
• Excoriation: Straight scratches that result in the loss of the top layer of skin.
• Fissure: Straight breaks in the skin that go deeper than the top layer of skin into the second layer of skin. They can be painful and can be caused by excessive dryness.
• Lichenification: A rough thickening of the top layer of skin.
• Maceration: Skin that is wet, wrinkly, and lighter in color. This happens when skin is in contact with water or fluid for too long. It can occur due to leaking wounds that have been improperly cared for.
• Phyma: A thickening of the skin. This is often seen in advanced rosacea.
• Scale: A build-up of cells that form patches and then flake off the skin.
• Ulcer: A wound deeper than the top layer of skin that damages the second layer of skin. It is concave and variable in size. Deeper ulcers are more serious.
• Umbilication: A dip inside a skin lesion that looks similar to a navel.

Acne

Acne presents primarily as papules. It can also cause pustules, nodules, or cysts. Acne is most common on:

• The face
• The neck
• The chest
• The upper back

Acne can leave scars if not treated.

Acne occurs when your pores become blocked with dead skin or an oily secretion called sebum. It can also be caused by too much of a certain kind of bacteria on the skin.

Mild to moderate cases of acne can usually be treated at home. Over-the-counter skin treatments and medications can help get rid of acne. If acne does not go away or is very severe, it is a good idea to see a doctor.

Actinic Keratosis

Actinic keratosis is caused by exposure to sunlight. It appears as thick, scaly crusts on the skin. It is most common in people over the age of 40. Because it is related to years of sun exposure, it doesn't usually appear until later in life.

Actinic keratosis has a scaly, raised surface. This makes it easier to feel than see. Over time, it can turn hard and wart-like. It may develop a horn-like texture.

Get It Checked

Left untreated, there is a 5% to 10% chance that actinic keratosis will turn into squamous cell skin cancer. If you are think you might have actinic keratosis, see your doctor or dermatologist.

About 40% to 60% of squamous cell cancer cases begin as actinic keratosis. Identifying and treating it early can help prevent skin cancer from developing.

Actinic keratosis can be removed by freezing, scraping, or laser. Topical creams like Adrucil (fluorouracil), Solaraze (diclofenac), and Zyclara (imiquimod) can also be used.

Blisters

Blisters are fluid-filled areas of the skin. They can be caused by friction, such as a shoe rubbing on your skin when you walk. They can also be due to a burn, skin disorder, or allergic reaction.

Most blisters can be treated at home. Try not to pop blisters. Avoid putting more pressure on the blister area. 

If a blister does pop, clean the area. Cover it with a sterile bandage until healed.

See a doctor if you have signs of infection. These include:

• Pus, a thick yellowish or greenish discharge
• Fever
• Red hot skin around the blister

When a blister is less than 0.5 cm, it is called a vesicle. When it's greater than 0.5 cm, it is called a bulla.

Cellulitis

Cellulitis is a skin infection. It happens when bacteria or fungi enter the skin. 

Symptoms of cellulitis include:

• Redness 
• Swelling
• Pain
• Leaking of fluid

Cellulitis feels hot to the touch. It can also cause a fever. You may feel unwell.

If identified early, most cases can be treated at home with antibiotics. If left untreated, severe and serious complications can occur. Sometimes hospitalization may be needed.

When to Seek Medical Attention

It is important to see a doctor if you have signs of cellulitis. If you notice areas of swelling, redness, pain, or heat in your skin, especially where you've had a cut, bite, or burn, seek medical care at once.

Chickenpox

Chickenpox is also called varicella. It is a viral skin infection.

Chickenpox causes red, fluid-filled blisters all over the body. They are typically hot and itchy. The blisters can ooze pus. They may cause secondary crusting.

Chickenpox is contagious two days before the rash first appears. It remains contagious until all the blisters have crusted over.

It is possible to recognize chickenpox at home. However, you may want to see a healthcare provider to confirm the diagnosis.

A range of topical treatments can help soothe chickenpox. You can use them until the itching and pain subside.

Comedones

Comedones are a kind of acne.

There are a few different types: 

• Blackheads are open comedones, which means the pore is still open. They have a dark spot in the middle.
• Soft closed comedones are soft, painless, and smooth.
• Hard closed comedones have white heads. They are also called milia. They are not the same as whiteheads, which are filled with pus.

Comedones can be treated with topicals. If necessary, they can be extracted by a dermatologist.

Cold Sores

Cold sores are sores on the mouth or lip area. They are caused by the herpes simplex virus (HSV).

Cold sores can be red, painful, and cause fluid-filled blisters. You may feel tingling before the sore appears. Because they are caused by a virus, you may also have flu-like symptoms. 

Cold sores usually go away on their own without treatment. Over-the-counter topical treatments can help speed up healing. 

Very severe cold sores or sores that don't seem to be healing on their own may require treatment from a healthcare provider. They can prescribe antiviral medication that may be helpful. 

HSV-1 vs. HSV-2

The differences between HSV-1 and HSV-2 include:

• HSV-1: Usually causes oral herpes. Cold sores and fever blisters appear around the lip and mouth area.
• HSV-2: Usually responsible for genital herpes.

However, oral or genital outbreaks may be caused by either virus.

Contact Dermatitis

Contact dermatitis is caused by an allergen or substance that irritates the skin. Symptoms usually appear just in the area that contacts the irritant. 

Symptoms may include:

• Redness
• Itching
• Macules
• Papules
• Fissures
• Blisters
• Swelling
• Tenderness to the touch
• Chafing

Chronic contact dermatitis can often form plaques. 

You can treat contact dermatitis by keeping your skin clean and moisturized. The key to healing is to avoid the allergen or irritant. 

If contact dermatitis does not get better at home, see a doctor. You may need a prescribed antihistamine or corticosteroid cream. If the area becomes infected, you may also need an antibiotic. 

Eczema

Eczema is also called atopic dermatitis. It appears as an itchy, red rash. Symptoms may include:

• Red, grey, brown, or yellow patches of skin
• Itching
• Dryness
• Blisters
• Fissures
• Plaques
• Sensitive and painful patches

Certain external conditions like hot or cold weather can cause symptoms to flare up. Some skin products may also contribute to irritation. Food allergies, hormonal changes, and pet/dust mites can often worsen symptoms.

The most common treatment types include:

• Keeping skin hydrated with emollient like a moisturizer
• Topical soaps and creams
• Corticosteroid cream
• Avoiding triggers and irritants

Mild eczema can be managed at home with over-the-counter remedies. If you have more severe eczema, your healthcare provider or dermatologist can help you with a treatment plan.

Freckles

Freckles are small, flat, light-brown macules on the skin. They are caused by sun exposure.

Most common freckles are harmless and rarely turn into skin cancer. They are more common in people with light, fair skin, or red hair. 

Freckles do not require any treatment unless they change and skin cancer is suspected.

Ephelides and Solar Lentigines

Two types of lesions commonly called freckles are:

• Ephelides. These are typical freckles that occur from childhood. They are more common in people with fair skin and/or red hair. They tend to be round in shape and just millimeters in size. They appear in various brown shades. 
• Solar lentigines. These are macules with clear borders. They vary from light brown to black. They are most often called sun spots, liver spots, age spots, or actinic lentigines. They are caused by chronic sun exposure and are most commonly seen in older individuals.

Hives

Hives are also called urticaria. They look like red, swollen, raised marks on the skin.

Hives are usually caused by an allergic reaction to something specific. They can also happen for unknown reasons.

Hives can itch or sting. Typically, the individual marks last less than 24 hours, though more can continue to appear.

Most cases of hives can be treated with an antihistamine and managed at home.

Urticaria vs. Angioedema

Urticaria and angioedema are very similar. Urticaria only affects the skin, though, and each mark lasts less than 24 hours. Angioedema may last for days.

Urticaria occurs on the outer layer of the skin. Angioedema occurs under the skin. Angioedema can also affect the mucous membranes, such as the eyelids and lips. It can be painful. It often presents as deep swelling around the mouth and eye areas. It can sometimes affect the genitals, hands, or feet.

Severe angioedema can cause the throat or tongue to swell. This may create breathing difficulties. It may also cause swelling of the intestinal tract lining, which can lead to gastrointestinal cramping.

It is possible to get both urticaria and angioedema at the same time. Treatment for both conditions is similar. If breathing is affected, it is essential to seek emergency medical attention immediately.

Whether it is urticaria or angioedema, call seek emergency medical care if you experience:

• Difficulty breathing
• Wheezing
• Chest tightness
• Tongue/facial swelling
• Dizziness

Impetigo

Impetigo is a bacterial skin infection. It is caused by bacteria entering the skin through a hair follicle or a small cut. The condition causes sores, crusts, and blister-like bumps.

Impetigo is very contagious. It most commonly affects young children.

Impetigo is treated with topical antibiotics or oral antibiotics prescribed by your healthcare provider.

Keloids

Keloids range in color from flesh-colored to red. They are raised scars that form after an injury. They are caused by an overgrowth of scar tissue. Keloids are often itchy and uncomfortable.

Some people are more prone to developing keloids. For these people, certain preventative measures may stop keloids from forming.

Those who have had keloids in the past have a higher risk of developing them again. To prevent this, there are a few things you can do:

• Pay close attention to any thickening skin in injured areas. If you notice this after an ear piercing, for example, immediately remove the earring and wear a pressure earring over the piercing.
• Make sure to practice good wound care. Wash with soap and water and bandage with sterile petrolatum gauze. Apply silicone gel or silicone sheets to freshly healed scars.

Keloids are harmless and do not require medical attention. Still, some people may feel distressed by the way they look. If you notice any thickening of the skin around a recently healed wound, consult your dermatologist. Treatment can help reduce their appearance.

Moles

A mole is also known as a melanocytic nevus or simply a nevus. They are usually round, brown/pink macules, papules, or nodules. They can be found anywhere on the body and may appear at any age.

Moles are usually harmless. However, see a doctor if a mole changes shape, color, size, or begins to bleed or crust. This could be a sign of melanoma, a type of skin cancer.

ABCDE Rule

When checking your moles, these changes may suggest melanoma:

• Asymmetrical: Look at the shape of the mole. Moles are usually even in shape and look similar on all sides. Melanomas tend to be uneven in shape.
• Border: Normal moles have a smooth edge. Melanomas typically have an irregular, jagged border.
• Color: Moles tend to be even in color throughout. Melanomas might be uneven in color.
• Diameter: Moles tend to be small. Melanomas are usually over 6 millimeters wide.
• Evolving: Moles don't tend to change much. Melanomas often change in size, shape, color, or texture.

Keep an eye out for changes in your moles or new moles with these qualities. If you find anything suspicious, see a healthcare provider right away.

Psoriasis

Psoriasis looks like red, flaky skin, crusty patches of skin, and silvery skin scales. It can also itch and burn.

Psoriasis happens because the body produces skin cells too quickly, over days rather than weeks. The excess growth of skin cells causes thick, raised, scaly patches.

The most common areas for psoriasis to occur are:

• Knees
• Elbows
• Scalp
• Lower back

Still, it can occur anywhere on the body.

Psoriasis is managed with a combination of treatments, inclulding:

• Self-care
• Topical medications
• Oral or injectable immune suppressants
• Ultraviolet (UV) light therapy

There is no cure for psoriasis.

Eczema vs. Psoriasis

Eczema and psoriasis look similar. There are a few differences to look out for:

• Itching tends to be much more intense with eczema and milder in psoriasis.
• Eczema tends to occur in places like the crooks of the knees and the elbows. Psoriasis most commonly occurs on the elbows, knees, scalp, and lower back.
• With eczema, the skin tends to be red, inflamed, cracked, blistered, and may leak pus. With psoriasis, the skin appears scaly, flaky, thickened, raised, and can be silvery.

If you are unsure if you have eczema or psoriasis, consult a doctor or dermatologist. The correct diagnosis will help ensure you get the right treatment.

Scabies

Scabies is caused by a mite. It begins with intense itching. A rash can also develop. The rash appears as small red papules, welts, or scaly lesions. Repeated scratching can damage the skin.

Symptoms can be worse if you have an allergy to the mite. Prescribed oral and topical medications can kill the mites.

Sebaceous Cyst

Sebaceous cysts are round and filled with keratin, a protein found in skin, hair, and nails. The nodules are firm and usually skin-colored. They usually appear on the upper body or face. They can range in size and occasionally rupture.

A ruptured cyst may become infected and needs to be treated. Otherwise, sebaceous cysts don't usually require treatment. They tend to grow slowly and are benign.

Shingles

Shingles are caused by the reactivation of the virus that causes chickenpox. A shingles rash is a very painful red rash comprised of macules, papules, and blisters. The blisters can break and weep fluid. This can lead to secondary crusting.

The rash itches, burns, and can be painful. Other symptoms can include:

• Fever
• Chills
• Headache
• Lethargy

You may hear shingles referred to as a belt or band. This is because it often appears as a belt-like formation around the rib cage or waist.

Shingles can be treated with home remedies such as a cool compress. Your doctor may also recommend:

• Antihistamines
• Pain relievers
• Antivirals or other prescription medication
  

The risk of shingles can be reduced with vaccines like Shingrix. The Centers for Disease Control and Prevention (CDC) recommends that people over 50 receive the Shingrix vaccine. The vaccine also protects againsts postherpetic neuralgia, a painful condition of the nerves. This is the most common complication of shingles.

Skin Tag

Skin tags are also called acrochordon. They are soft, small, skin-colored growths. They occur more often as people age.

Removal is not usually necessary. Skin tags usually don't require medical attention unless:

• They cause cosmetic concern
• Are in a position that causes irritation

Warts

Warts are caused by the human papillomavirus (HPV). They tend to occur in groups and are contagious.

Warts are raised, flesh-colored papules. They may contain tiny black dots in the center. They are not dangerous but can be painful and are easy to pass to others.

There are several different types of warts, including:

• Common warts
• Plantar warts
• Flat warts
• Filiform warts
• Genital warts
• Periungual warts

Most warts can be treated with over-the-counter remedies. If you have warts that are not improving with home treatments, talk to your healthcare provider. They can prescribe medication or offer in-office procedures such as freezing.

Most warts are not dangerous. Rarely, some types of human papillomavirus that cause genital warts can cause cervical or anal cancer.

Summary

Skin lesions can be present from birth or develop over your lifetime. When a skin lesion is irritated or undergoes changes, it is called a secondary lesion. Skin lesions can vary in appearance and may or may not be cancerous.

Causes of skin lesions include blocked pores, sun exposure, and organisms like viruses, bacteria, or mites. Allergens, friction, and other outside irritants can also cause skin lesions. Other lesions may be caused by chronic conditions, or may form as you get older.

Many lesions can be treated at home with topical ointments and creams. Others require treatment from a healthcare provider. If you are unsure of what type of lesion you have, it is always best to seek medical care. 

A Word From Verywell

If you are ever concerned about a skin lesion, see a dermatologist.

Sudden changes in any lesion should cause concern. Cancer is a less likely cause of skin lesion changes, but early diagnosis and treatment almost always leads to better outcomes.

Frequently Asked Questions

• What kind of doctor treats skin lesions?

  Ongoing skin conditions like acne, eczema, or psoriasis often require treatment by a dermatologist, or skin specialist. Others, like impetigo, can be treated by your primary care doctor. And some—blisters and chickenpox, for example—go away on their own.

• Are skin lesions usually cancerous?

  Not usually. However, some types of lesions can become cancerous. One example is actinic keratosis, a rough, scaly patch or bump on the skin caused by UV damage. Actinic keratosis lesions can turn into squamous cell skin cancer. As such, this type of lesion is often called precancerous.

• What does a cancerous lesion look like?

  Signs of cancerous skin lesions include any changes in the skin, including new growths, changes to existing growths, and growths that have difficulty healing.

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Which term will the nurse use when documenting a skin lesion on a patient's back that has wavy borders and resembles a snake?

What are the types of skin lesions?

What skin lesion is a solid elevated lesion less than 0.5 cm in diameter?

What is a lesion on the skin?