What are papules
Papules: symptoms, causes, and treatment
Papules and nodules
Papules or nodules are a rash in which the skin or mucous membranes thicken like nodules. Papules are small, each measuring less than 5 mm. These are not diseases in their own right, but rather a symptom of various diseases.
Papules: definition and appearance
Depending on where the papules occur, medical professionals differentiate between three types of nodules:
Epidermal papules occur in the horny cell layer, the prickly cell layer, or the epidermis. Typical nodules of this type are, for example, warts.
Cutaneous papules form in the dermis and are a classic symptom of syphilis. Epidermo-cutaneous papules appear in the dermis and epidermis.
Lots of papules are just a nuisance. They look ugly, but arise spontaneously and just as quickly recede without forming scars. Papules are flat-oval, hemispherical or pointed conical. They can be soft or firm.
Individually or in groups
There are both single papules and multiple nodules. In the case of papules on the epidermis, the doctor can make this initial diagnosis at a glance - it looks different with thickening in the deeper layers of the skin.
Multiple papules occur primarily as a partial symptom of a disease, for example in the case of infections, but also as a reaction to medication.
Diagnosis of papules
To make an accurate diagnosis, the doctor examines the size, number, and distribution of the nodules: do they occur individually or are there many? Do they concentrate on a certain point, do they form networks?
This is followed by the assignment to the functions that could trigger the papules: Are the papules attached to the sweat and sebum glands? Do they form in places that are covered by clothing?
The spatial allocation is also important: is the inguinal skin affected? Or the face, the ear, the nose?
The shape of the individual nodules also provides information about the underlying disease: is it variable? With a sharp edge? Blurred? Jagged?
What color are the papules? Skin-colored, dull red, light red, blood red? Purple or bluish? What is the temperature of the nodules: normal body temperature, over or under temperature? What is their consistency?
What are the symptoms of the papules? Are they painless, is it an itchy rash, or are the nodules even itchy? Are they burning? Are you in any other pain? Do other symptoms occur, for example fever, nausea, fatigue?
Does the patient suffer from underlying diseases such as a metabolic disorder, weakness of the immune system or malignant tumors?
Are the papules static, do they go away by themselves, or do they keep reappearing? Are there external triggers such as heat, cold, pressure or UV light? Are there internal triggers such as bacteria, fungi, viruses or allergies?
Causes of the skin nodules
In general, papules can form in various parts of the body when cells in the skin multiply in an uncontrolled manner and the corresponding skin tissue enlarges.
This is because the cells of the cornea also multiply, and we see them on the surface of the skin. One cause of these cell formations are skin diseases that form eczema. A rare disease called "lichen planus" is characterized in particular by papules, as is the so-called nevus cell nevus, a skin change in babies.
Basic diseases with papule formation
Papules are usually caused by inflammation of the skin, which in turn usually form as a reaction to external substances.
Common triggers are rubber and latex, make-up, soaps, shampoos and gels, chemicals in clothing, toxins in plants, metals in body jewelry such as silver or nickel.
Chickenpox is caused by the varicella zoster virus, is highly contagious and manifests itself as a very itchy rash all over the body. They are easily transmitted through body contact and saliva, including coughing or sneezing.
Pregnant women are particularly at risk, as the mother's chickenpox can harm the fetus, for example by making the child deaf and dumb.
Candidiasis (also called candidosis or candidiasis) is not a virus but a fungal disease. The most common fungal infection in humans is caused by the fungus Candida albicans.
4.) Psoriasis is a skin condition in which the skin becomes red, flaky, and papules are also formed.
5.) Shingles is an infection with the herpes zoster virus that presents as a rash with papules. The painful area of skin develops papules, which turn into bubbles that are filled with fluid and stand together in small groups. The trunk, arms, legs or neck are usually affected, and the rash can also appear on the face.
6.) Insect bites are not a disease, but also lead to papules. Normal body reactions also show up as itching, pain, and burning. Wheals form and the nodules are the size of a pinhead to a lentil.
If there is an underlying disease, the doctor primarily fights this. The dermatologist is responsible. In addition to medication, surgical intervention is often necessary, on the one hand for aesthetic reasons, but on the other hand to clarify whether the papules indicate a tumor.
When it comes to small papules on invisible parts of the body, the best motto is to wait and see. They often go away on their own.
However, if they multiply and cover ever larger areas of the body, those affected should consider surgery, as well as if individual papules enlarge and become inflamed.
Everyone has papules somewhere on their body at some point in their life. That can't really be prevented. If nodules have already formed, those affected can at least control them.
You should avoid pressure on the papules as well as rubbing or intense sunlight.
However, if the skin changes indicate an underlying disease, the patient should address it.
If allergies are the trigger for the skin problems, it is advisable to avoid the substances that trigger the allergy.
You should clean the surface of the skin on and around the papules, regularly. Often the papule will then dissolve, but occasionally it will develop into eczema or become inflamed.
In no case should you try to pinch the nodules out. It is not a pimple or a pustule with pus formation. Do not rub the skin while washing.
If you do not know the cause of the papules, avoid body sprays, shampoos etc. which you are not sure whether your skin can tolerate them.
Expose the affected areas to fresh air as often as possible.
Are Papules Dangerous?
The cause of the papules can be dangerous: if cancer develops or you have syphilis, the changes are serious and life-threatening. However, the skin changes themselves are almost always harmless. (Dr. Utz Anhalt)
Author and source information
This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.
- P. Altmeyer: Dermatogical Differential Diagnosis, Springer Verlag, 2007
- Elizabeth H. Page: Description of Skin Lesions, MSD Manual, (accessed 09/09/2019), MSD
- Shinjita Das: Psoriasis, MSD Manual, (accessed 09.09.2019), MSD
- Mercedes E. Gonzalez: Dermatitis - An Overview, MSD Manual, (accessed 09.09.2019), MSD
- Dorothea Terhorst-Molawi: Dermatologie Basics, Elsevier / Urban Fischer Verlag, 4th edition, 2015
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.
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