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Notes

History Pruritus, rashes, nonhealing sores, changes in skin, hair or nails, eczema, psoriasis, acne, changes in mole or lesion.
Medication
  • Topical creams, gels, or ointments such as antibiotic, antifungal, anti-inflammatory.
  • Oral medications such as antibiotics, antifungal and antiviral agents, biologics, immunosuppressants, and corticosteroids.
Appearance
  • Color: Erythema, pallor, jaundice.
  • Bruising, scars, tattoos.
  • Cyanosis: Differentiation between central (lips, conjunctiva) and peripheral (nail beds, extremities) cyanosis.
  • Oral mucosa used for assessing color changes in dark skinned Pts.
  • Sclera used for assessing jaundice in Pts of Asian descent.
Hair and Scalp
  • Texture and distribution.
  • Condition of scalp.
Nails
  • Cyanosis, fungal infections.
  • Angle of attachment (normal, 160°; abnormal, >180°, indicating chronic pulmonary disease).
Temperature
  • Coolness.
  • Warmth.
Moisture
Turgor
  • Time it takes skin to flatten after pinching.
  • Poor skin turgor is a sign of dehydration.
  • Sternum or forehead skin used in older Pts.
Lesions
  • Presence and type of lesions or rashes.
  • Determining whether rashes blanch.
Wounds
  • Pressure ulcers, surgical wounds.
  • Inspection of legs and feet of diabetic Pts.