Necessary Elements of a Dermatologic History and Physical Evaluation

Janet M. Cole, Deanna Gray-Miceli


Dermatology Nursing. 2002;14(6) 

In This Article

Physical Examination

Examination of the skin includes mucous membranes, hair, and nails. The involvement of any or all of these areas provides diagnostic information. Physical assessment of the skin is done systematically, first with a general overview to assess skin symmetry, the existence and distribution of any lesions and, second, a lesion-specific exam.

Begin with the head. Be sure to examine the mucous membranes in the eyelids, nose, and thoroughly in the mouth - buccal, pharyngeal, sub-lingual as well as the tongue. Next examine the neck, arms, hands, chest and abdomen, legs, back, back of legs, feet, including soles and between the toes, buttocks, and genital area. Careful attention should be paid to areas where skin contacts other skin (intertriginous areas). Skin and mucous membranes should be carefully inspected for color, symmetry, uniform appearance, hygiene, and lesions. Any abnormalities should be described in terms of whether they are primary or secondary lesions. Next, descriptive adjectives regarding characteristics, exudates, pattern, location, and distribution can be added. After inspection, any lesions should be gently palpated to test for tenderness and consistency. Note temperature, moisture, texture, turgor, and fragility.