Steven Chen 陳持威, MD, MPH, MHPEd Profile picture
Dermatologist/internist @ MGH- Love complex/onco-dermatology & MedEd | Harvard Derm APD | Dad | Husband | Recovering a cappella nerd. Tweets are mine & ≠ advice

Aug 24, 2022, 11 tweets

You've seen rashes and called them all "maculopapular," because, why not?

Does describing something accurately really make a difference?

9 words to improve your life... when calling a derm consult.

Macules are flat lesions, less than 1 cm in diameter.

If you closed your eyes and ran your finger over it, you wouldn't feel where it starts and stops.

👀Idiopathic guttate hypomelanosis

Papules are raised (or depressed) lesions, less than 1 cm in diameter.

Unlike macules, if you closed your eyes and ran your finger over it, you'd be able to tell where the lesion is.

👀Compound nevi

Patches are big macules (> 1 cm)

👀Vitiligo

Plaques are big papules (> 1 cm)

👀Psoriasis

Nodules are deeper seated lesions, think at least 1 cm deep. It's hard to measure though because part of it is under the skin surface.

👀Rheumatoid nodule

Tumors are even bigger. People disagree, but 2 cm is a reasonable cut off.

👀Cutaneous T-cell Lymphoma

Vesicles are fluid filled blisters that are <1 cm.

👀Herpes Zoster (Shingles)

Bullae are bigger blisters, >1 cm!

👀Bullous Pemphigoid

Pustules are anything filled with pus.

Remember the adjective for them is "purulent," not the other word you're thinking of.

👀Folliculitis

This has been a parody #tweetorial on #morphology!

Remember, these are primary lesions, and there's so much more you can say about the rash! Check out my original series by searching for #derm101.

#dermtwitter #medtwitter #meded #FOAMEd
📸: @visualdx

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