Ask the treatment expert: signs to consider when assessing darkly pigmented skin

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What is xerosis?
What is xerosis?
What are signs to consider when assessing darkly pigmented skin?

Understanding differences of the color spectrum of skin appearance is essential for skin care, prevention and treatment of skin diseases, and injuries. Several color changes typically used for identification of wounds and skin problems are not always visible to the eye. Here are conditions and techniques to use in the assessment of darkly pigmented skin:

Cyanosis—Inspect the conjunctivae, palms, soles, oral mucosa and tongue.

Pallor—Inspect the sclera, conjunctivae, oral mucosa, tongue, lips, nail beds, palms and soles.

Jaundice—Inspect the sclera and hard palate.

Erythema—Palpate the area for warmth. The localized area of skin may be purplish/bluish or violaceous (eggplant color).

Edema—Inspect the area for decreased color. Palpate for swelling or tightness.

Symptoms of pressure ulcers:

• The color of intact dark skin often remains unchanged (does not blanch) when pressure is applied over a bony prominence. Palpate the area for temperature changes.  

• Localized skin color changes occur at the pressure site. These colors will differ from the resident's usual skin color.

• If the resident has had a pressure ulcer previously, that area of skin becomes lighter before returning to its original color.

• There is localized heat (inflammation) when compared with surrounding skin. The area of warmth eventually will be replaced by an area of coolness, which is a sign of tissue devitalization.

• The resident complains of or indicates to the caregiver current or recently relieved pain or discomfort at sites that are predisposed to the development of pressure ulcers.