Macule
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A macule is a flat spot on the skin that looks different in color from the surrounding skin but feels completely smooth when you touch it.
The Basics
What is it?
A macule is a flat spot on the skin that looks different in color from the surrounding skin but feels completely smooth when you touch it. Think of it like a stain on fabric - you can see it but can't feel it with your eyes closed. Macules are typically smaller than a pencil eraser (less than 1 centimeter) and can be various colors including brown, white, red, or purple.
What does it look like?
Macules appear as:
- Flat spots that are level with the skin surface
- Size of a pinpoint up to a pencil eraser (less than 1 cm)
- Various colors: brown (freckles), white (vitiligo), red (flat birthmarks), tan (café-au-lait spots)
- Smooth texture - no roughness, scaling, or elevation
- Clear or fuzzy borders depending on the cause
- Single spots or multiple spots that may cluster together
Where does it appear?
Macules can appear anywhere on the body:
- Face: Freckles, age spots, melasma
- Trunk and back: Café-au-lait spots, drug reactions
- Arms and legs: Vitiligo, post-inflammatory color changes
- Sun-exposed areas: Solar lentigines (age spots)
- Anywhere: Flat moles, medication reactions
Associated features
Macules may occur with:
- No symptoms at all (most common)
- Multiple similar spots in the same area
- Gradual color changes over time
- Darkening with sun exposure (brown macules)
- Family members with similar spots
- Other types of skin lesions if part of a rash
When to see a doctor
Seek medical evaluation for:
- New dark spots that appear suddenly
- Macules that change color, size, or shape
- Multiple café-au-lait spots (could indicate genetic condition)
- White patches that are spreading
- Red or purple spots that don't fade with pressure
- Any concerning changes in existing spots
- Macules accompanied by other symptoms like fever
References
- Description of Skin Lesions Merck Manual Professional Edition (2024)
- Terminology in Dermatology DermNet NZ (2024)
- Dermatologic Etymology: Primary Morphology of Skin Lesions Journal of the American Academy of Dermatology (2024).
- Stanford Medicine 25 Dermatology Exam
- UTMB Primary Lesions Guide