Family Nurse Practitioner Exam

Which of the following skin findings is not considered a macule?

1. A) A freckle

2. B) Petechiae

3. C) Acne

4. D) A flat, 0.5-cm brown birthmark

The correct answer is: C) Acne

A macule is defined as a flat, distinct, colored area of skin less than 1 centimeter wide. It is important to recognize that a macule does not have any elevation or depression compared to the skin surface. In this context, acne does not qualify as a macule due to the fact that it typically presents as either papules or pustules, both of which involve raised lesions on the skin. Papules and pustules are characterized by their elevation above the skin's surface, which distinguishes them from macules. Therefore, acne, given its nature, does not conform to the description of a macule. In contrast, a freckle, petechiae, and a flat brown birthmark can all fit the criteria of a macule. Freckles are small and flat spots on the skin, petechiae are small red or purple spots resulting from bleeding under the skin, and a flat brown birthmark can also be considered a macule. All these options involve flat, colored areas without any significant elevation, thereby fitting the definition of a macule.