Skin Assessment in Patients with Dark Skin Tone

Abstract

There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of both common and serious integumentary and general health issues in people with dark skin tones. Nurses must be exposed to such learning resources to be adequately prepared to care for patients with diverse skin tones and to help reduce health disparities and promote health equity. This article provides faculty, nursing students, and clinicians with basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure nurses and nursing students can effectively perform skin assessments in all patients.

Current Perspectives on Pressure Injuries in Persons with Dark Skin Tones from the National Pressure Injury Advisory Panel

“…These scales offer a constitutive (baseline) skin color, facultative skin color (sun or UV exposure), and PI-induced change in skin color. 22,54 The Fitzpatrick Classification Scale was developed to identify complexion and tolerance to sunlight and designed as a measure of sun sensitivity. 22,[53][54][55][56][57] The Fitzpatrick Scale is not reliable when evaluating skin exposed to UV radiation (environmental factors) and would be best used to assess unexposed skin.…”

“…22,54 The Fitzpatrick Classification Scale was developed to identify complexion and tolerance to sunlight and designed as a measure of sun sensitivity. 22,[53][54][55][56][57] The Fitzpatrick Scale is not reliable when evaluating skin exposed to UV radiation (environmental factors) and would be best used to assess unexposed skin. The Munsell Color System, designed by an artist for painting, describes qualities of hue, lightness (value), and intensity (chroma) and was initially used in soil research.…”

“…In addition to the validity and scientific rigor in the development and design of the scales, the effectiveness of classification models is dependent on individual competence and interrater reliability, which varies from setting to setting. These scales offer a constitutive (baseline) skin color, facultative skin color (sun or UV exposure), and PI-induced change in skin color 22,54 …”

“…The Fitzpatrick Classification Scale was developed to identify complexion and tolerance to sunlight and designed as a measure of sun sensitivity 22,53-57 . The Fitzpatrick Scale is not reliable when evaluating skin exposed to UV radiation (environmental factors) and would be best used to assess unexposed skin.…”

Color Does Matter

“…However, it is critical that we recognize the variability in skin pigmentation among and within races and ethnicities. 6 Literature is scarce regarding racial groups, color, and physical assessment. The purpose of this article is to provide descriptions of differences within the physical assessment for newborns with varying shades of skin pigmentation.…”