Macula

MACULA (spot), in dermatology denotes limited changes of normal coloration of the skin of various sizes and shapes, usually lying level with the surrounding skin and not washable. This is the general definition of the Russian and German schools. The French and English schools call M. only those spotted changes in skin coloration which do not disappear from pressure; pink or red spots which disappear from pressure with a finger or glass slide and which depend upon hyperemia, they call erythema. The coloration of 'spots' can be the most diverse—from snow-white to brown-black colors, passing through all colors of the spectrum. Depending on the anatomical substrate, one can distinguish spots a) hyperemic, b) inflammatory, c) pigmented, d) achromatic, e) purpuric, f) angioma-tous, g) impregnation; transitional forms are possible. All these 'spots' can arise primarily, immediately as such, or secondarily as a further stage or outcome of initial lesions of the skin. Examples: pigmented nevus or chloasma—primary pigmented spots; brown spots at the site of syphilitic roseola or papule—the result of changes in the vessel wall under the influence of the syphilitic virus; hyperemia at the site of a subsided dermatitis—the result of a residual inflammatory process with disturbance of keratinization. A white spot can be an expression of an 'anemic' nevus, spotted scleroderma, vitiligo, depigmentation at the site of a disappeared infiltrate, absence of tan on a limited space due to having had scaling on it for any reason.