Skin's kin, the disgustin eleven!

Do you remember the first time you wanted to memorize the primary skin lesions aka the skin's kin? Did you end up confused, perplexed and mystified? If you did, you are not alone. Welcome to my club!!!

Not only were these lesions confusing, they were (are) boring. Yawn!!!
Whenever I made the slightest attempt to memorize them, I used to doze off to sleep.


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Gallons of coffee and amphetamines would not have helped me get out of the slumber.

That’s the beauty of this chapter of dermatology. Who am I kidding? That is the beauty of every chapter in dermatology ;).

Here’s how I managed to remember all the primary skin lesions with ease.

There are three numbers to be kept in mind

  • 0.5
  • 5
  • 2.

The first two are for raised lesions.
The last one is for flat lesion.

The largest lesion in the lot is a TUMOR which is defined as a raised skin lesion more than 5 cm in diameter.

The largest flat lesion is a PATCH which is more than 2 cm in diameter.

The smallest lesions are MACULE and PAPULE. To differentiate between which one is flat and raised, one may use the following tagline:
“iMac, flatter than a Papa Jones pizza.”
Additional info- macule is lesser than 2 cm in diameter and papule is lesser than 0.5 cm.

Anything raised between 0.5 cm and 5 cm on the skin is a NODULE. Why a nodule is called a nodule? Is it because it keeps on nodding?

Among the kin, there are three drunk.
PUSTULE, the self explanatory one contains pus.
BULLA and VESICLE contain clear fluid. Vesicle is usually used to denote a sac that is small, like the ones found inside the cells. Bulla would therefore be larger than a vesicle.

Time for a quiz.
Which lesion is confused?
A WHEAL as confused as a chameleon in a bag of Skittles. It may be flat or raised and it comes and goes. So, by the time the patient approaches you, it might have disappeared.

Which one is a quitter?
A PLAQUE because it is raised and flat. It first starts raising and then all of a sudden quits and becomes flat.

Finally, TELANGIECTASIA is the one where the superficial blood vessels are dilated.

Hope this article simplifies the information on primary skin lesions. Take care!

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