Primary Care Dermatology Module
Nomenclature of Skin Lesions

Developed by Gary Williams, M.D. and Murray Katcher, M.D. Ph.D, Department of Pediatrics
with funding and support from the Wisconsin Area Health Education Center (AHEC) System

University of Wisconsin

Tutorial B: The Secondary Lesions

Secondary lesions may evolve from primary lesions, or may be caused by external forces such as scratching, trauma, infection, or the healing process. The distinction between a primary and secondary lesion is not always clear.


Three terms that refer to bleeding that occurs in the skin are petechiae, purpura, and ecchymoses. Generally, the term "petechiae" refers to smaller lesions. "Purpura" and "ecchymoses" are terms that refer to larger lesions. In certain situations purpura may be palpable. In all situations, petechiae, ecchymoses, and purpura do not blanch when pressed. If there is any question, press on the lesions carefully with a glass slide. Don't break the slide or cut the patient.

Petechiae Purpura Purpura Purpura and Ecchymosis

Click on each image for further information.

Go to Tutorial C Return to Master Index Help Section
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