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October 1964


Author Affiliations

Hitchcock Clinic Hanover, NH 03755

Arch Dermatol. 1964;90(4):454-455. doi:10.1001/archderm.1964.01600040082025

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To the Editor:  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 the several authors as to the exact definitions of these "primary lesions." The situation has been compounded over the years because of the failure of the authorities (1) to concur in size limitations of most of the lesions, (2) to appreciate the dimension of depth intrinsic to nodules and tumors, and (3) to expand the terminology to include such lesions as patches and plaques.For instance, most of the textbooks describe macules as circumscribed, nonelevated discolorations of the skin, of

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