Advanced Health Assessment Practice Exam

Which of the following is NOT a primary skin lesion?

1. Macule

2. Papule

3. Plague

4. Cyst

The correct answer is: Cyst

To understand why the answer is D, it’s important to define what primary skin lesions are. Primary skin lesions arise from normal skin and are characterized by changes in the structure of the skin itself. They reflect a direct manifestation of an underlying pathophysiological process. Macules, papules, and plaques are all classified as primary skin lesions. A macule is a flat, distinct, colored area of skin that is less than 1 centimeter. A papule is a small raised bump that is also less than 1 centimeter in diameter. A plaque is an elevated, plateau-like area that often measures greater than 1 centimeter and can be formed by the fusion of multiple papules. In contrast, a cyst is not considered a primary skin lesion because it is formed by tissue that encapsulates fluid or other material, representing a secondary process in which the skin structure is altered. Cysts can arise from infections, blockages, or other pathological changes in the skin, rather than being a direct expression of the skin’s basic structure. Thus, while macules, papules, and plaques are developed directly from skin tissue as a primary response, the cyst is a result of a pathological process, categorizing it as a secondary lesion rather than a primary