Scale

• Flakes or plates resulting from accumulation of excess stratum corneum (the most superficial layer of the skin).
• Scale usually has a white or gray color.
• It is important to note whether a raised lesion is scaly or non-scaly, as the differential diagnosis of raised scaly lesions is quite different from that of raised smooth lesions.

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  Multiple follicular-based scaly papules of pityriasis rubra pilaris.

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  Thick, white, sharply bordered scaly plaques of psoriasis.

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  Thick, scaly papules on plantar foot in reactive arthritis.

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  Large annular scaly erythematous plaques typical of tinea faciei.