Part 4

#What do you mean by systemic symptoms?#

Those general symptoms, slight or profound, which are sometimes associated, primarily or secondarily, with the cutaneous disease, as, for example, the systemic disturbance in leprosy, pemphigus, and purpura hemorrhagica.

#Into what two classes of lesions are the objective symptoms commonly divided?#

Primary (or elementary), and Secondary (or consecutive).

#Primary Lesions.#

#What are primary lesions?#

Those objective lesions with which cutaneous diseases begin. They may continue as such or may undergo modification, passing into the secondary or consecutive lesions.

#Enumerate the primary lesions.#

Macules, papules, tubercles, wheals, tumors, vesicles, blebs and pustules.

#What are macules (maculæ)?#

Variously-sized, shaped and tinted spots and discolorations, without elevation or depression; as, for example, freckles, spots of purpura, macules of cutaneous syphilis.

#What are papules (papulæ)?#

Small, circumscribed, solid elevations, rarely exceeding the size of a split-pea, and usually superficially seated; as, for example, the papules of eczema, of acne, and of cutaneous syphilis.

#What are tubercles (tubercula)?#

Circumscribed, solid elevations, commonly pea-sized and usually deep-seated; as, for example, the tubercles of syphilis, of leprosy, and of lupus.

#What are wheals (pomphi)?#

Variously-sized and shaped, whitish, pinkish or reddish elevations, of an evanescent character; as, for example, the lesions of urticaria, the lesions produced by the bite of a mosquito or by the sting of a nettle.

#What are tumors (tumores)?#

Soft or firm elevations, usually large and prominent, and having their seat in the corium and subcutaneous tissue; as, for example, sebaceous tumors, gummata, and the lesions of fibroma.

#What are vesicles (vesiculæ)?#

Pin-head to pea-sized, circumscribed epidermal elevations, containing serous fluid; as, for example, the so-called fever-blisters, the lesions of herpes zoster, and of vesicular eczema.

#What are blebs (bullæ)?#

Rounded or irregularly-shaped, pea to egg-sized epidermic elevations, with fluid contents; in short, they are essentially the same as vesicles and pustules except as to size; as, for example, the blebs of pemphigus, rhus poisoning, and syphilis.

#What are pustules (pustulæ)?#

Circumscribed epidermic elevations containing pus; as, for example, the pustules of acne, of impetigo, and of sycosis.

#Secondary Lesions.#

#What are secondary lesions?#

Those lesions resulting from accidental or natural change, modification or termination of the primary lesions.