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A papule is a small, well-defined bump in the
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...
. It may have a rounded, pointed or flat top, and may have a dip. It can appear with a
stalk Stalk or stalking may refer to: Behaviour * Stalk, the stealthy approach (phase) of a predator towards its prey * Stalking, an act of intrusive behaviour or unwanted attention towards a person * Deer stalking, the pursuit of deer for sport Biol ...
, be thread-like or look
wart Warts are typically small, rough, hard growths that are similar in color to the rest of the skin. They typically do not result in other symptoms, except when on the bottom of the feet, where they may be painful. While they usually occur on the ...
y. It can be soft or firm and its surface may be rough or smooth. Some have crusts or
scales Scale or scales may refer to: Mathematics * Scale (descriptive set theory), an object defined on a set of points * Scale (ratio), the ratio of a linear dimension of a model to the corresponding dimension of the original * Scale factor, a number ...
. A papule can be flesh colored, yellow, white, brown, red, blue or purplish. There may be just one or many, and they may occur irregularly in different parts of the body or appear in clusters. It does not contain fluid but may progress to a
pustule A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this ...
or
vesicle Vesicle may refer to: ; In cellular biology or chemistry * Vesicle (biology and chemistry), a supramolecular assembly of lipid molecules, like a cell membrane * Synaptic vesicle ; In human embryology * Vesicle (embryology), bulge-like features ...
. A papule is smaller than a nodule; it can be as tiny as a pinhead and is typically less than 1 cm in width, according to some sources, and 0.5 cm according to others. When merged together, it appears as a plaque. Its color might indicate its cause, such as white in milia, red in
eczema Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can v ...
, yellowish in
xanthoma A xanthoma (pl. xanthomas or xanthomata) (condition: xanthomatosis) is a deposition of yellowish cholesterol-rich material that can appear anywhere in the body in various disease states. They are cutaneous manifestations of lipidosis in which lipi ...
and black in melanoma. They may open when scratched and become infected and crusty.


Definition

A papule is a small, well-defined bump in the
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...
. It is smaller than a nodule; it can be as tiny as a pinhead and is typically less than 1 cm in width, according to some sources, and 0.5 cm according to others.


Evaluation

A papule may have a rounded, pointed or flat top, and may have a dip. It can be polygonal but is never rectangular or square. It can appear with a
stalk Stalk or stalking may refer to: Behaviour * Stalk, the stealthy approach (phase) of a predator towards its prey * Stalking, an act of intrusive behaviour or unwanted attention towards a person * Deer stalking, the pursuit of deer for sport Biol ...
, be thread-like or look
wart Warts are typically small, rough, hard growths that are similar in color to the rest of the skin. They typically do not result in other symptoms, except when on the bottom of the feet, where they may be painful. While they usually occur on the ...
y. Ulceration, oozing, bleeding or thin blood vessels may be present in a papule. It can be soft or firm and its surface may be rough or smooth. Some have crusts or
scales Scale or scales may refer to: Mathematics * Scale (descriptive set theory), an object defined on a set of points * Scale (ratio), the ratio of a linear dimension of a model to the corresponding dimension of the original * Scale factor, a number ...
. A papule can be flesh colored, yellow, white, brown, black, blue or purplish, or varying shades of red. The intensity of redness might indicate how long the papule has been present. There may be just one or many, and they may occur irregularly in different parts of the body or appear in clusters. It may progress to a pustule or vesicle.


Differential diagnosis

Angiofibromas are papules, types of which include the usually solitary fibrous papule of the nose and periungual angiofibroma, and multiple in
pearly penile papules Pearly penile papules (PPP) are benign small bumps on the human penis. They vary in size from 1–4 mm, are pearly or flesh-colored, smooth and dome-topped or filiform, and appear in one or several rows around the corona, the ridge of the ...
, and the facial angiofibromas as may be seen in
tuberous sclerosis Tuberous sclerosis complex (TSC) is a rare multisystem autosomal dominant genetic disease that causes non-cancerous tumours to grow in the brain and on other vital organs such as the kidneys, heart, liver, eyes, lungs and skin. A combinatio ...
. Papules with scale on the palms and soles may occur in secondary syphilis,
psoriasis Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complet ...
,
eczema Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can v ...
, tinea manuum,
mycosis fungoides Mycosis fungoides, also known as Alibert-Bazin syndrome or granuloma fungoides, is the most common form of cutaneous T-cell lymphoma. It generally affects the skin, but may progress internally over time. Symptoms include rash, tumors, skin lesions ...
. In
lichen planus Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, and is only named that because it looks like one. It is characterized by polygonal, f ...
papules may be itchy, flat-topped, polygonal, purplish with white streaks, and can be solitary, or occur in clusters or in a line.


See also

*
List of cutaneous conditions Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the body and composed of skin, hair, nails, and related muscle and glands. The major function of this system is as a barrier agai ...


References

{{Clinical and histological nomenclature for skin lesions Dermatologic terminology