Skin

• Skin color varies due to melanocytes producing melanin pigmentation.
• The dermis is the thickest layer of skin, containing blood vessels, nerves, hair follicles, sweat glands, sebaceous glands, and collagen fibers.
• Melanin protects against UV radiation by absorbing it.
• Functions of the Skin


  • Maintenance of Body Temperature
  • Production of Vitamin D
  • A Barrier (Prevents evaporative water loss, Protection for microorganisms, Protection from environment)
  • Sensations of touch, pressure and pain
  • Cosmetic Appearance
• Physical Assessment Equipment


  • Strong Direct Lighting
  • Small Centimeter ruler
  • Penlight
  • Gloves
  • Magnifying glass
• Techniques used in skin assessment

  Inspection and Palpation
• Principles of assessment


  • Exposed areas first
  • Compare
  • Fingertips for general differences/moisture
  • Dorsa (back) of hand, temperature
• Inspect and Palpate Skin


  • Color
  • Temperature
  • Moisture
  • Texture
  • Thickness
  • Edema
  • Mobility & Turgor
  • Vascularity or Bruising
  • Lesions
• Skin Assessment: Inspection


  1. Generalized Color (Normal, Pallor, Flushed, Bluish & cyanosis)

  2. Color variations in patches on body (Normal, Suntanned, White patches, Jaundice, Erythema, Ecchymosis, Petechiae)
• Skin Assessment: Palpation


  1. Texture (Normal, Rough, thick, dry)

  2. Temperature & moisture (Normal, Extremely cool, Extremely warm, Wet, oily)

  3. Turgor (Normal, Pinch up skin 30 sec or longer)

  4. Edema (Normal, Swollen, Shallow to deep pitting, Ascites)

  5. Skin Lesions (Primary lesion, Secondary lesion, Vascular lesion)
• Types of Skin Lesions


  • Macule
  • Vesicle
  • Nodule
  • Papule
  • Wheal
  • Pustule
  • Ulcer
  • Crust
  • Scale
  • Keloid
  • Scar
  • Atrophy
  • Spider Angioma
  • Cherry Angioma
  • Venous star
• Hair Inspection & Palpation


  1. Color

  2. Amount & distribution

  3. Texture

  4. Presence of parasites
• Nail inspection & palpation


  Nail Color (Normal, Pale or cyanotic, Yellow discoloration, Splinter hemorrhage, Beau's lines)
• Melanin is produced by the enzyme tyrosine, which converts tyrosine into dopa (dihydroxyphenylalanine).
• Collagen provides strength and elasticity to the skin.
• Epidermal cells are constantly being replaced through mitosis.
• Dopa is converted into DOPAquinone, which reacts with amino acids to form eumelanins or pheomelanins.
• Langerhan's cells are found throughout the epidermis and play a role in immune responses.