NOTRE DAME OF MIDSAYAP COLLEGE

College of Nursing

TRINAL ASSIGNMENT #7
SKIN ASSESSMENT
NCM 101 – HEALTH ASSESSMENT
Clinical Instructor: John Ryan Borja, RN, LPT, MAED, MANc
TOQUERO, KRISTINE JOY VILLAROSA
BACHELOR OF SCIENCE IN NURSING
LEVEL 1 – C
 SKIN ASSESSMENT
I. Objective of Skin Assessment

Skin assessment plays a crucial role in maintaining overall health and well-being. A complete skin assessment is essential for
holistic care. Nurses and other health professionals must perform regular skin assessments. By examining the skin, healthcare
professionals can identify potential issues early and address them promptly. Skin assessments help in the early recognition of
individuals at risk of developing skin breakdown. By identifying vulnerable areas, healthcare providers can implement preventive
measures. For instance, assessing for pressure injuries (also known as pressure ulcers) is a key goal of skin assessment.

Good skin hygiene is vital for maintaining skin integrity. Educating patients and their relatives about proper skin care can
improve skin health and reduce the risk of pressure damage and skin tears. The skin serves as a window into patients’ health.
Changes in the skin can indicate underlying health conditions or environmental factors. By assessing the skin, healthcare
professionals gain insights into overall well-being.

As individuals age, their skin changes. It becomes thinner, less elastic, and more vulnerable. Regular skin assessments help
detect age-related alterations and guide appropriate interventions.

II. Instructions

Identify five (5) skin diseases or skin conditions per skin layer and fill in the required data for each. Follow the format
below:

1. Description with Picture

 The description must be able to substantially describe each of the diseases. State your sources using APA
Format.
 Attach a picture as a visual aid for the disease or condition.
2. Identify and explain the cause of each disease or condition.
 Each of the five (5) diseases or conditions must be included.
 In stating the cause of the disease or condition, state your sources using APA Format.
III. SKIN ASSESSMENT

A. Epidermis
1. Description: Inverse Psoriasis consists of bright red, smooth and it’s not scaly patches found in the folds of the skin. The
most common areas are under the breasts, in the armpits, near the genitals, under the buttocks, or in abdominal folds.
These irritated and inflamed areas are aggravated by the sweat and skin rubbing together in the folds (Shiel, W. C. 2022).

Cause: Inverse psoriasis is caused by an abnormality in your immune system, just like other autoimmune diseases. But
moisture (in the form of sweating) and friction can trigger the symptoms of this type of psoriasis. If you have psoriasis and are
overweight, you’re at a higher risk of developing inverse psoriasis. That’s because extra body weight produces excess skin and
deeper skin folds. Other causes or triggers can include taking certain medications, stopping or starting certain medications,
infections, skin injuries, smoking, drinking alcohol, or friction within the deep skin folds (Caldwell, A. 2022).

2. Description: Ringworm is a common fungal skin infection otherwise known as tinea. It’s a fungal infection on the skin is
indicated by roundish, flat patches that have a raised, scaly border. Most commonly affects the skin on the body called
tinea corporis, the scalp called tinea capitis, the feet called tinea pedis, or athlete's foot, or the groin called tinea cruris,
or jock itch (Sachden, P. 2022).
Cause: Ringworm is caused by fungi that normally live on the skin, hair, and nails called dermatophytes. When the environment
they live in gets warm and moist, they grow out of control and start to cause symptoms. From one person to another by skin-to-
skin contact, especially in warm, damp environments to other areas of the body if a person touches the affected area and then
touches other body parts, such as the hands also from animals to people (Durami, Y. 2023).
[Link]: Common warts usually appear as rough bumps on the skin. The bumps are often round or oval in shape and
less than one centimeter wide but occasionally join together or grow larger (Goldstein, B. G. 2023).

Cause: The human papillomavirus is virus that causes warts can pass from person to person by close physical contact or from
touching something that a person with a wart touch, like a towel, bathmat, or a shower floor (Ben-Joseph, E. L. 2023).

4. Description: Epidermolysis Bullosa is a rare genetic condition that makes skin so fragile that it can tear or blister at the
slightest touch. Children born with it are often called “Butterfly Children” because their skin seems as fragile as a
butterfly wing (Gardner, S. S. 2023).
Cause: In most cases, epidermolysis bullosa is an inherited condition. In some forms, it is inherited from both parents (recessive
inheritance), which means that both parents must be carriers of the gene for the disease to appear in a child, even though the
parents themselves may have no symptoms. In other forms, the disease is inherited from one parent (dominant inheritance). A
family history of epidermolysis bullosa like a parent, grandparent, aunt or uncle with the disease, increases the likelihood that a
child will have it (Perman, M. 2022).
5. Description: Ichthyosis refers to a group of skin disorders that lead to dry, itchy skin that appears scaly, rough, and red.
The symptoms can range from mild to severe. Ichthyosis can affect only the skin, but some forms of the disease can
affect internal organs as well (Sheikh, Z. 2023).

Cause: Ichthyosis can be genetic (or inherited). It also can be acquired, meaning it happens later because of another
illness or from medicine you're taking. Inherited ichthyosisis a genetic condition. That means it's passed down to you from
your parents. Sometimes, parents who don't have ichthyosis can still pass it down. Genes are the codes that tell your
body to make proteins, which determine how your body looks and functions. When there are changes or mutations in a
gene, it can cause disease. Ichthyosis gene mutations affect the proteins that protect your skin and keep it moist. They
also affect how quickly your body gets rid of or grows new skin cells (Sheikh, Z. 25023).
 B. Dermis

1. Description: Ehlers–Danlos syndrome (EDS) is a group of inherited disorders that involve a genetic defect in collagen or
connective tissue synthesis and structure. This results in fragile and hyperelastic skin, unstable and hyperextensible
(hypermobile) joints and fragile tissue and blood vessels (Mangkorntongsakul, V. 2023)

Cause: Ehlers–Danlos syndrome (EDS) happens when your body doesn't make a protein called collagen in the right way. Collagen
helps form the connections that hold your body's bones, skin, and organs together. If there's a problem with it, those structures
can be weak and more likely to have problems. Ehlers–Danlos syndrome (EDS) is a genetic disorder. That means it's something
you get from your parents (Kumar, S. 2023).
 2. Description: Marfan syndrome is an inherited disorder that affects connective tissue, the fibers that support and anchor your
organs and other structures in your body. Marfan syndrome most commonly affects the heart, eyes, blood vessels and
skeleton (Pruthi, S. 2023).

Cause: Marfan syndrome is caused by a defect in the gene that enables your body to produce a protein that helps give connective
tissue its elasticity and strength. Most people with Marfan syndrome inherit the abnormal gene from a parent who has the disorder
(Pruthi, S. 2023).

3. Description: Scleroderma, also called systemic sclerosis, is an autoimmune disease that affects the skin and some internal
organs of the body. The body’s immune system damages normal, healthy tissues and replaces them with scar tissue,
causing thickening and tightening of the skin (Feintuch, S. 2020).
Cause: Scleroderma is thought to be an autoimmune disease. This means the symptoms are caused by the body attacking its own
healthy tissues. Genes play a role in the disease, but the environment may also play a role. Family members of people with
scleroderma have a mildly increased risk of developing scleroderma. But many people with scleroderma don't have family
members with the condition (Horowitz, D. 2022).

4. Description: Benign tumors are noncancerous growths in the body. They can occur anywhere in the body, grow slowly, and
have clear borders. Unlike cancerous tumors, they don’t spread to other parts of the body (Thomas, T. 2022).

Cause: The exact cause of a benign tumor is often unknown. It develops when cells in the body divide and grow at an excessive
rate. Typically, the body is able to balance cell growth and division. When old or damaged cells die, they are automatically
replaced with new, healthy cells. In the case of tumors, dead cells remain and form a growth known as a tumor. Cancer cells grow
in the same manner. However, unlike the cells in benign tumors, cancerous cells can invade nearby tissue and spread to other
parts of the body. While it’s unclear why benign tumors develop, potential causes have been identified. These include,
environmental factors, such as toxins, radiation, or chemicals, inflammation or infection, diet, local trauma or injury, stress and
genetics (Thomas, T. 2022).

5. Description, solar elastosis is a degenerative condition of elastic tissue in the dermis due to prolonged sun exposure. There
are a variety of clinical manifestations of solar elastosis. In its most common form, solar elastosis manifests as yellow,
thickened, coarsely wrinkled skin (Heng, J. K 2014).
Cause: The primary cause of actinic elastosis is a chronic and prolonged exposure to UV radiation, resulting in distinct histologic
features. The sun’s UV rays breaks down your skin’s collagen and elastic fibers, causing it to lose its strength, flexibility, and
structure. It’s commonly seen on areas of the body that are exposed to the sun are neck, face, and arms (Detri, C. M. 2019).

[Link]
 1. Description: Panniculitis refers to a group of conditions that involve inflammation of subcutaneous fat. Despite having very
diverse causes, most forms of panniculitis have the same clinical appearance. The diagnosis is established by a skin biopsy,
as there are characteristic microscopic features depending on the cause. The most common form of panniculitis is erythema
nodosum (Stanway, A. 2016).

Cause: Conditions like lupus, pancreatic disease, and alpha-1 antitrypsin deficiency can cause panniculitis. It can also result from
reactions in your body to things like taking certain drugs or even exposure to cold. Specifically, the causes of panniculitis are
infections (viral or bacterial), inflammatory diseases, like Crohn’s disease or ulcerative colitis, specific medicines, like certain types
of antibiotics or contraceptive pills, sarcoidosis, a rare disease that causes your cells to create clumps called granulomas in the
skin or lungs (Gardner, S. S. 2022).
2. Description: Sarcoidosis is an inflammatory disease that can affect multiple organs in the body, but most often involves the
lungs and lymph glands in the chest. If you have sarcoidosis, red, swollen lumps called granulomas form in your affected
organs. Symptoms, which can range from non-existent to severe, depend partly on where the lumps form (Begum, J. 2024).
Cause: Sarcoidosis is a condition that causes lumps or nodules (granulomas) to form in your lungs, lymph nodes, skin, eyes and
other parts of your body. Symptoms include cough, shortness of breath, tender sores on your shins, eye pain and redness. Many
cases go away on their own or with treatment, but sometimes it becomes a chronic condition (Sheikh, Z. 2023). Description:
Lipedema is an abnormal buildup of fat in your lower body. It's a long-term condition that can affect up to 11% of women. Almost
all the people who have lipedema are women. Lipedema happens when fat is distributed in an abnormal way beneath your skin,
usually in your buttocks and legs. Although it begins as a cosmetic concern, it can eventually cause pain and other problems
(Begum, J. 2023).

Cause: Lipedema occurs almost exclusively in women, so scientists suspect that female hormones play a role in its development.
Lipedema may also be an inherited condition. Patients frequently describe a family history of an inability to lose weight in the
lower body (Taub, E. 2022).
 3. Description: Hypothermia is a condition involving a low body temperature, usually below 35°C. Shivering, pale skin, unclear
speech, and a fast heart rate can be signs of hypothermia. It is a medical emergency (Ramirez, E. 2023) .

Cause: Hypothermia occurs when your body loses heat faster than it produces it. The most common causes of hypothermia are
exposure to cold-weather conditions or cold water. But prolonged exposure to any environment colder than your body can lead to
hypothermia if you aren't dressed appropriately or can't control the conditions (Ramirez, E. 2023) .

4. Description: Lipodystrophy refers to a group of conditions where the amount and / or distribution of fat tissue is abnormal. There is usually a lack of fat tissue in all
or part of the body, sometimes with extra fat accumulating elsewhere. This is different from “thinness” or “fatness” which both result from changes in the amount of fat
stored in normal fat cells (Sachden, P. 2022).
 Cause: Lipodystrophy is a group of rare syndromes that cause a person to lose fat from some parts of the body, while
gaining it in others, including on organs like the liver. A person can be born with lipodystrophy or develop it later in life. In
either case, the resulting inability to maintain fat tissue beneath the skin can have severe, life-threatening consequences
over time (Vilarihno, S. 2023).

(Ben-Joseph, E. L. 2023). [Link]

%20infections,hands%2C%20face%2C%20and%20feet
(Begum, J. 2024). [Link]
(Begum, J. 2024). [Link]
(Caldwell, A. 2022). [Link]
 (Detri, C. M. 2019). [Link]
elastosis-other-chronic-dermatitis-due-to-solar-radiation/
(Durami, Y. 2023). [Link]

(Feintuch, S. 2020). [Link]

(Gardner, S. S. 2023). [Link] treatments/epidermolysis-bullosa-what-is

(Gardner, S. S. 2022). [Link]

(Goldstein, B. G. 2023). [Link]

(Heng, J. K 2014). [Link]

(Horowitz, D. 2022). [Link]

(Kumar, S. 2023). [Link]

(Mangkorntongsakul, V. 2023) [Link]

(Ramirez, E. 2023). [Link]

fbclid=IwAR3VWbN6x3ztIX3ySfavCcNowooonpYSLG4DzbQ55WktFBInTd65QyOc_MI
(Ramirez, E. 2023). [Link]
fbclid=IwAR3VWbN6x3ztIX3ySfavCcNowooonpYSLG4DzbQ55WktFBInTd65QyOc_MI

(Sachden, P. 2022). [Link]

(Sachden, P. 2022). [Link]

(Shiel, W. C. 2022). [Link]

(Sheikh, Z. 2023). [Link]

(Sheikh, Z. 2023). [Link]

(Sheikh, Z. 2023). [Link]

(Stanway, A. 2016). [Link]
(Taub, E. 2022). [Link]
[Link]#:~:text=Lipedema%20occurs%20almost%20exclusively%20in%20women%2C%20so%20scientists%20suspect
%20that,weight%20in%20the%20lower%20bod
(Thomas, T. 2022). [Link]

(Thomas, T. 2022). [Link]

(Vilarihno, S. 2023). [Link]

IV. NURSING INTERVENTIONS

Choose from the list of conditions above and create two (2) Nursing Care Plans for the said conditions, one (1) actual and
one (1) potential NCPs.
 A. Nursing Care Plan - “Inverse Psoriasis”

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective  Impaired skin After 1 week of  Establish therapeutic communication  To maintain After 1 week of
Data:
integrity related intervention the nurse-client intervention,
“It’s very itchy
to bacterial client will be interaction the goal is
under my
 breast” as infection as taught what a  To monitor partially met
 Assess patient vital sign
verbalized by manifested by part of his/her changes the client know

the patient swelling under body is at most that can some part of

Objective Data: the breast risk skin break lead to his/her body

 Skin downs dehydration that are risk for

redness  Assess skin . skin break

 Swelling  To assess downs.

under the skin

breast  Administer medications as ordered integrity

 Skin  To give right

lession medication

 Apply ointment

 To dry skin
 Record unusuality’s
 For

continuity of
 care

B. Nursing Care Plan - “Inverse Psoriasis”

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective  Risk for infection After 1 week of  Establish therapeutic  To maintain  After 1
Data:
intervention communication nurse-client week of
“It’s very itchy
the patient will interaction intervention
under my
 breast” as be free from  To monitor , the goal is
 Assess patient vital sign
verbalized by any signs of changes partially

the patient infection that can met the

Objective Data: lead to patient is

 Skin dehydration free of any

redness  Assess skin . signs of

 Swelling  To assess infection.

under the skin

breast  Administer medications as ordered integrity

 Skin  To give right

lession medication

 Apply ointment

 To dry skin

 Teach client proper hygiene

 To minimize

bacterial
 growth
 Record unusuality’s
 For

continuity of

care