The following symptoms and complaints may indicate a macula or macules (color change of the skin):
Leading symptoms
- Flat, abnormally colored areas of skin.
- Possible color changes:
- Red (erythema, areal skin redness; e.g., drug erythema) [there are smooth transitions between a red macule and erythema (“areal skin redness”)].
- Dark red (e.g., purpura/small capillary hemorrhages in the skin, subcutis, or mucous membranes (cutaneous hemorrhage))
- Light brown to black (melanin deposits; e.g., nevus / birthmark).
- White or colorless (e.g., pityriasis versicolor, vitiligo, “white spot disease”).
- Variable size
Warning signs (Red flags)
- Elderly persons with sun-exposed skin + large multicolored spot → think of: Lentigo maligna (synonyms: Melanoma in situ, melanotic precancerosis, melanosis circumscripta praeblastomatosa Dubreuilh, Dubreuilh’s disease or Dubreuilh’s disease); intraepidermal (located in the epidermis) neoplastic proliferation (new formation) of atypical melanocytes (cells that produce the skin pigment melanin).
- Pigmentary moles that change (ABCD(E) rule): → think of: malignant melanoma (black skin cancer; in Europeans, the changes occur preferentially on the chest, back, or extremities).
- Asymmetry
- Irregular boundary
- Irregular color (Color)
- Diameter > 5 mm
- Sublimity > 1 mm
- Child with many freckles around the lips → think of: Peutz-Jeghers syndrome (synonyms: Hutchinson-Weber-Peutz syndrome or Peutz-Jeghers hamartosis); rare, genetic and autosomal-dominant inherited gastrointestinal polyposis (occurrence of numerous polyps in the gastrointestinal tract) with characteristic pigmented spots on skin (especially in the middle of the face) and mucous membranes; clinical picture: Recurrent (recurrent) colicky abdominal pain; iron deficiency anemia; blood accumulation on stool; possible complications: Ileus (intestinal obstruction) due to invaginations of a polyp-bearing intestinal segment.
