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September 1997

On Standard Definitions: 33 Years Hence

Author Affiliations

Department of Dermatology University of Minnesota Box 98 420 Delaware St SE Minneapolis, MN 55455-0392

Carrabelle, Fla

Arch Dermatol. 1997;133(9):1169. doi:10.1001/archderm.1997.03890450121019

The lack of consensus on definitions of basic dermatologic lesions is a barrier to effective communication between physicians. Watt and Jillson stated the problem in the Archives in 1964:

It is surprising that standard definitions of most primary lesions have never been agreed upon by dermatologists. This became apparent to us in a recent departmental conference, when members of the same institution disagreed on the meanings of such elementary terms as macule, papule, nodule, tumor, vesicle, and bulla. Indeed, when we turned to various textbooks for substantiation, we found there was no unanimity of thought among several authors as to the exact definitions of these 'primary lesions.'1

We recently reviewed 20 current reference books and textbooks of dermatology and found disparate definitions for the basic dermatologic lesions. The terms macule, papule, patch, and plaque should instantly convey a distinct morphologic character to a colleague. However, depending on various published

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