Skin Assessment

Lauren L. Johannsen


Dermatology Nursing. 2005;17(2):165-166. 

Dermatology Nursing Essentials: A Core Curriculum (2nd edition) was written to provide the reader with core knowledge about the specialty of dermatology nursing. As part of a new feature in Dermatology Nursing, key points from the text will be highlighted to test and review your dermatology nursing knowledge. These quick hits of information are no substitute for the indepth analysis provided in the Core Curriculum, but are designed to wet your appetite for the comprehensive content that the Core delivers. To order your personal copy of the Core, visit DNA's Web site at or call (800) 454-4DNA.

  • The general examination of the skin considers normal variants and general changes in the skin.

  • General changes can alter color (jaundice, cyanosis, pallor), turgor, thickness, temperature, and vascularity (purpura, petechiae, flushing).

  • Specific terminology is used to describe the characteristics of skin lesions (color, configuration, distribution, type of lesion, and the lesion pattern) which can then be documented (see Table 1 & Table 2 , page 166).

  • Begin a patient history using the patient's own words regarding his/her own condition. This gives the nurse a sense of direction as to which triage questions to ask (see Table 3 , page 166).

  • Examinations should be done in an orderly manner to insure important diagnostic clues are not missed. Don't overlook hair, nails, and mouth.

  • Primary lesions are caused directly by the disease process. Pay attention to the shape, morphology, distribution, and quality of the lesion(s).

  • Some common descriptive terms of primary lesions are macule, papule, nodule, plaque, wheal, vesicle, bulla, pustule, cyst, comedo, and burrow.

  • Secondary lesions are the patient's response to a disease process.

  • Some common descriptive terms of primary lesions are scale, crust, fissures, lichenification, erosion, ulcer, excoriation, scar, and atrophy.

  • Evaluate the distribution, shape, arrangement, and color of the lesion(s).

  • As adjuncts to what is seen with the eyes or palpated with the hands, numerous diagnostic tools offer key information in making a diagnosis.

  • Four common methods used to treat lesions are cryosurgery, shave, punch, and ellipse biopsies.

  • Three methods frequently used to achieve hemostasis during or at the end of a surgical procedure are simple direct pressure, hemostatic agents, and electrocautery.

  • Numerous methods and formats for documenting are available. Variations of the S-O-A-P method, freehand illustrations, body stickers, and photography are all popular.


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