(Cracks; Rents; Clefts; Rhagades; Rimae)
Definition. Fissures are linear wounds involving the epidermis or the epidermis and corium, and due to either injury or disease.
They occur chiefly where the skin is subject to frequent movement or has become inelastic, thickened or hard. Thus they are found from disease in the normal lines of the skin, in the flexures of the joints, between the fingers and toes, at the angles of the mucous outlets of the body, back of the ears and on the palms and soles. While fissures are most common in eczema they may be found in a number of dry chronic inflammatory infiltrated diseases such as ichthyosis, scleroderma, psoriasis, lichen planus and the various forms of dermatitis. Any application that will cause dryness of the skin especially the free use of soap will aggravate, increase or even cause fissures. A naturally dry skin exposed to heat and cold will often show fissures of the lips and hands known as chapping. In congenital syphilis fissures are usually common about the angles of the mouth and at the anus. Fissures may be dry or moist and almost any variety of red or normal hued in color. They are usually straight, rarely curved or crooked and are of various lengths, widths and depths with abrupt and sharply defined margins. If they involve the corium they are likely to be painful on movement, may bleed easily or give rise to some secretion. From their nature and situation they often complicate greatly the disease in which they appear.