Consists of 2 Principal Parts:

◼ Epidermis – Superficial, thin

portion composed of epithelial
tissue.
◼ Dermis – Deeper, thicker
composed of connective tissue.
◼ Deep to the dermis is a
subcutaneous layer called as
Hypodermis consists of aerolar &
adipose tissues
✓ Regulation of body
temperature.
✓ Protection
✓ Sensation
✓ Excretion
✓ Immunity
✓ Blood reservoir
✓ Synthesis of Vitamin D
 ASSESSMENT FINDINGS
History:

◼ Change in skin color, texture, and temperature

◼ Perspiration or dryness.
◼ Itching
◼ Brittle, thick, soft nails
◼ Fever
◼ Hair loss
◼ Rash
◼ Gently squeeze the skin on the
forearm or sternal area between
your thumb & forefinger.
◼ If the skin quickly returns to its
original shape - normal skin turgor.
◼ If the skin doesn’t return to its
original shape within 30 seconds or
if it maintains a tented position -
poor turgor.
 ASSESSMENT FINDINGS
Physical Examination:-
◼ Pattern of pigmentation & hair distribution

◼ Skin texture, turgor, color, & temperature

◼ Peripheral Edema

◼ Skin lesions

◼ Pruritus

◼ Erythema

◼ Petechiae & ecchymosis

Skin Biopsy: Removal of a
piece of skin by scalpel
to detect malignancy or
other skin disorders.
Types of Biopsy:
❑ Shave Biopsy
❑ Punch Biopsy
❑ Excisional Biopsy
Skin Scrapings:
❑ Procedure calling for cells
scraped by a scalpel and
covered with potassium
hydroxide
❑ Purpose: Microscopic
examination of scales, nails
and hair
❑ Nsg. Intervention: Check the
scraping site for bleeding &
infection.
Wood’s Light:
❑ A Wood's lamp emits ultraviolet light
and can be a diagnostic aid in
determining if someone has a fungal
or bacterial infection on the skin or
scalp. Performed in dark room with
the help of UV rays.
❑ Infected area will fluorescence or
shine under UV rays.
❑ If there is an infection on the area
where the Wood's lamp is
illuminating, the area will fluoresce.
❑ Normally the skin does not fluoresce,
or shine, under ultraviolet light.
✓ tinea capitis
✓ pityriasis versicolor
✓ vitiligo
✓ melasma
Nursing Considerations
❑ Avoid washing the area to be
tested before the procedure.
❑ Avoid using makeup, perfume,
and deodorant on the area that
will be tested.
✓ The ingredients in some of these products
can cause the skin to change color under
the light.
❑ The examination will take
place in a doctor’s or
dermatologist’s office. The
procedure is simple and does
not take a long time.
✓ The doctor will ask pt. to remove clothing
from the area that will be examined.
✓ The doctor will then darken the room and
hold the Wood’s lamp a few inches away
from pt.’s skin to examine it under the light.
PATCH TESTING:
▪ Detects allergic contact
dermatitis
▪ Done to find out the different
types of allergies.
▪ Materials are applied in patches
to the skin & checked for
reaction 48 hours after
application & possibly again
later.
▪ Erythema, swelling, papules
and vesicles indicate an allergic
contact dermatitis rather than
an irritant contact dermatitis.
Nursing Consideration

❑ Avoid direct sunlight exposure to the

back several days prior and for the
duration of testing as UV radiation may
reduce the immune response in the
skin.
❑ Keep the area of skin being tested dry
until the final reading.
❑ Avoid activities that make pt. hot and
sweaty.
❑ Avoid excessive twisting movement
which can lift the test patches.
❑ Do not apply any oil or cream on your
back the morning of the testing.
❑ If pt. is taking cortisone/prednisolone
or immunosuppressive medications,
please check with your dermatologist
as they can affect the result of patch
testing.