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Examining skin of different pigmentation

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Escalate

Escalate urgently when assessment for Examining skin of different pigmentation reveals systemic toxicity, airway or eye involvement, extensive skin failure, a non-blanching eruption in an unwell patient, or a rapidly changing lesion suspicious for aggressive malignancy.

Synopsis

Recognise inflammation, pallor, cyanosis, jaundice and pigment change across skin tones by combining colour with palpation, symptoms and appropriate anatomical sites.

  • Erythema may be bright red, violaceous, grey-brown or mainly visible as swelling, warmth and surface change in deeply pigmented skin.
  • Assess pallor at conjunctivae, oral mucosa, palms and nail beds, and interpret it beside symptoms and haemoglobin rather than colour impression alone.
  • Look for central cyanosis at tongue and oral mucosa while checking oxygenation; peripheral nail colour is altered by temperature, perfusion, polish and pigmentation.

Key red flags

Do not dismiss systemic illness because erythema, cyanosis, pallor or jaundice is subtle; abnormal physiology and rapidly evolving pain or purpura override uncertain colour.

Central oxygenation concern

Blue or grey tongue and oral mucosa with breathlessness, low oxygen saturation or altered consciousness requires immediate physiological assessment.

Investigation priorities

01
Standardised visual and tactile examinationFirst step

Identify colour, temperature, texture and elevation relative to baseline.

Management branches

Planned assessmentUse multimodal skin assessment systematically

The patient is stable and the result will alter diagnosis, referral or follow-up.

  1. Define the question for Examining skin of different pigmentation, explain the process and obtain valid consent before exposing, touching, photographing or sampling skin.
  2. Choose representative anatomy, optimise lighting or specimen technique, and document site, morphology, symptoms and relevant previous treatment. Apply that step specifically within the examining skin of different pigmentation assessment and its recorded clinical context.
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Sources and review status3 sources · checked 27 Aug 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom