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Table of Comparison
| Feature | Plaque | Macule |
|---|---|---|
| Definition | Elevated, flat-topped lesion >1 cm in diameter. | Flat, discolored spot <1 cm on skin or mucous membranes. |
| Texture | Raised, palpable. | Non-palpable, smooth surface. |
| Size | Greater than 1 cm. | Less than 1 cm. |
| Color | Varies; often red, white, or brownish. | Varies; red, brown, or hypopigmented. |
| Common causes | Psoriasis, eczema, lichen planus. | Freckles, flat nevi, vitiligo. |
| Clinical significance | Indicates inflammatory or hyperplastic conditions. | Usually benign pigmentation changes. |
Introduction to Plaque and Macule
Plaques are elevated, firm, and rough lesions on the skin surface that often measure greater than 1 centimeter in diameter, commonly seen in conditions like psoriasis. Macules appear as flat, distinct, and discolored spots on the skin, usually less than 1 centimeter, without any change in texture or thickness, typical of conditions such as vitiligo or freckles. Both plaques and macules serve as primary indicators in dermatological diagnoses, differentiating by their morphology and physical characteristics.
Definition of Plaque
A plaque is a raised, flat-topped lesion greater than 1 centimeter in diameter often resulting from the confluence of papules. It typically appears as a broad, elevated patch on the skin, distinguished from a macule, which is a flat, discolored spot less than 1 centimeter without surface elevation. Plaques are commonly observed in dermatological conditions such as psoriasis and eczema.
Definition of Macule
A macule is a flat, distinct, discolored area of skin less than 1 centimeter in diameter, without any elevation or depression compared to the surrounding skin. It represents a change in skin color, often resulting from pigmentation disorders, inflammation, or vascular changes. Unlike plaques, macules do not have thickness or texture alterations and are purely visual abnormalities.
Key Differences Between Plaque and Macule
Plaque and macule are distinct dermatological lesions differing primarily in texture and elevation: plaque is a raised, palpable, and often roughened area of skin greater than 1 cm, whereas a macule is a flat, non-palpable discoloration measuring less than 1 cm. Plaques commonly result from the coalescence of papules and are characteristic of conditions like psoriasis, while macules appear as changes in skin color without textural alteration, seen in conditions such as vitiligo or freckles. The key differences lie in their physical characteristics--plaque exhibiting elevation and palpability, macule presenting solely as a color change without thickness.
Common Causes of Plaque Lesions
Plaque lesions commonly result from psoriasis, characterized by thickened, scaly patches due to rapid skin cell proliferation. Other causes include chronic eczema, where inflamed plaques form from prolonged irritation and allergic reactions. Fungal infections like tinea corporis can also present as plaques, distinguished by their raised edges and central clearing.
Common Causes of Macular Lesions
Macular lesions commonly result from conditions such as eczema, drug reactions, viral infections like measles or rubella, and autoimmune diseases including lupus erythematosus. These flat, discolored areas differ from plaques, which are elevated and often caused by psoriasis, lichen planus, or chronic dermatitis. Identifying the underlying cause of macules requires careful clinical evaluation and sometimes biopsy for accurate diagnosis and treatment.
Clinical Features of Plaques
Plaques are elevated, flat-topped lesions greater than 1 cm in diameter, often formed by the coalescence of papules and typically exhibiting a rough or scaly surface. They are commonly observed in chronic inflammatory skin disorders such as psoriasis and eczema, characterized by well-demarcated borders and variable erythema. The thickened epidermis and increased scaling distinguish plaques from macules, which are flat, non-palpable skin color changes less than 1 cm in size.
Clinical Features of Macules
Macules are flat, distinct, discolored areas of skin less than 1 cm in diameter, without any change in skin texture or thickness. They exhibit a uniform color that can range from red, brown, or hypopigmented, and are often seen in conditions such as vitiligo, freckles, or petechiae. Unlike plaques, macules do not elevate above the skin surface and serve as a primary diagnostic feature in dermatological examinations.
Diagnostic Techniques for Plaque and Macule
Diagnostic techniques for plaque and macule primarily involve thorough clinical examination and dermoscopy, with plaques often presenting as elevated, palpable lesions while macules appear flat and non-palpable. Skin biopsy remains the gold standard for definitive diagnosis, allowing histopathological differentiation between plaque-forming conditions such as psoriasis and flat macular presentations like certain types of dermatitis or early melanoma. Advanced imaging modalities such as reflectance confocal microscopy and optical coherence tomography enhance visualization of skin architecture, aiding in non-invasive diagnosis and monitoring of plaques and macules.
Importance of Differentiating Plaque vs Macule in Dermatology
Differentiating plaque from macule in dermatology is crucial for accurate diagnosis and treatment planning since plaques are raised lesions often indicating chronic inflammatory conditions like psoriasis, whereas macules are flat, discolored spots suggestive of pigmentary changes or early melanoma. Misidentification can lead to inappropriate management or delayed interventions, impacting patient outcomes. Precise clinical evaluation and dermoscopic analysis enhance diagnostic accuracy and guide targeted therapeutic strategies.
Plaque Infographic
