Common Primary Skin Lesions


A skin lesion is a generic term referring to any abnormality of the skin. Medically speaking, skin lesions are superficial growths or patches that look at odds with the skin around them. A skin lesion could be a wart, mole, rash, bump, cyst, blister, discolouration, or something else that just looks different from the usual. Skin lesions can be a result of an everyday fall, cut or scrape, or they can indicate something more serious such as cancer.

What types of skin lesions are there?

There are two types of skin lesions: primary and secondary. Primary skin lesions generally don’t change much. They are present at birth or acquired over time, and include things like birthmarks or aging spots. Secondary skin lesions are a progression of primary skin lesions. They are changes to the original lesion resulting from a natural altering of the lesion or a person aggravating or scratching it.

Primary skin lesions include:


A macule is a distinct discoloration of the skin that is flat and smaller than 1 centimetre in diameter. They do not cause a change in skin thickness or texture.


A papule is a raised skin area with no visible fluid and sized up to 1 centimetre in diameter. They come in a variety of shapes and have a very distinct border.


A nodule is a raised bump on the skin that is larger than a papule (greater than 1 centimetre in diameter). These can occur in all layers of the skin including the dermis, epidermis and subcutaneous tissue.


A tumour is a solid mass on the skin or subcutaneous tissue (under the skin). It is firm and usually larger than 2 centimetres.


A plaque is a flat-topped, raised lesion larger than 1 centimetre. It is often scaly, itchy and red. Plaques are typically found on the elbows, knees and scalp.

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A vesicle is a raised bump less than 1 centimetre in diameter. They are generally filled with air or clear liquid.


Bullae are fluid-filled sacs that form when fluid is trapped under a thin layer of skin. They are similar to blisters and vesicles except that bullae have a diameter larger than 1 centimetre.


A pustule is a small lump on the skin containing pus. They may or may not become infected.


A wheal is a swollen red mark that is often itchy. Wheals typically occur in response to a stimulus like food allergies or a bug bite. They are also known as hives or welts.


Burrows are tunnels that form in the skin. They are usually due to parasites such as scabietic mites.

Do these common lesion types seem familiar?

If you’re a frontline nurse or other healthcare professional that regularly sees disorders of the skin, you may well find our CPD courses helpful in spotting, diagnosing and treating them. Firstly there’s our one-day scheduled course Recognising and managing acute skin conditions in primary care held in London (Hamilton House) on the 14th May 2020. Highly engaging and interactive, it’s designed for practitioners who need to improve their skills in assessing and managing acute skin conditions.

Then there’s our 3-day Minor ailments essentials course. Also held at Hamilton House, it’s designed for practitioners confident in taking a history and physical examination but wanting to focus on the common and not so common patient complaints seen in primary health care. The next dates are in April and September 2020.

Then finally there’s our Five-day patient assessment skills workshop, which can either be scheduled (dates are available in February and June 2020) or we can run it in-house for you. Worth 35 hours of CPD, the programme provides practitioners with a springboard for diagnostic proficiency and clinical decision making. After studying basic history taking and physical examination techniques, you will have the opportunity to perform a complete physical examination on a colleague reflecting clinical practice requirements and helping to develop all-round confidence. The course mainly focuses on the adult patient.

All courses are specifically aimed at nurses, physiotherapists, medical students, health visitors and other allied health professionals such as pharmacists and paramedics. Course materials and refreshments are provided but as ever spaces are limited and fill up quickly so it’s well worth booking early to avoid disappointment.