Dermatological System Hub
Complete clinical reference for skin, hair, and nail nursing. Evidence-based content dynamically curated from our medical library.
Understanding Dermatological Nursing Assessment
The integumentary system includes skin, hair, nails, sebaceous glands, sweat glands, and sensory receptors. It serves as a barrier against infection, regulates temperature, enables sensation, and participates in vitamin D synthesis. Nursing assessment relies on thorough inspection, palpation, and description of primary and secondary lesions.
Key descriptive terms: macule, papule, plaque, nodule, vesicle, bulla, pustule, wheal, scale, crust, erosion, ulcer, fissure, atrophy, and scarring. Assessment of skin color, temperature, moisture, turgor, and lesions guides diagnosis and tracks improvement or deterioration. The ABCDE rule (Asymmetry, Border irregularity, Color variegation, Diameter >6mm, Evolution) remains vital for skin cancer screening.
Dermatological presentations often overlap with systemic disease (e.g., rash in lupus, acanthosis nigricans in diabetes, jaundice in liver failure). Allergic, infectious, inflammatory, and neoplastic causes are common. Nursing care includes lesion description, hygiene, topical therapy, wound care, and patient education about triggers and prevention.
Core anatomy and physiology points
Skin has three layers: epidermis (with melanocytes, keratinocytes), dermis (with blood vessels, nerves, follicles, glands), and hypodermis (subcutaneous fat). Eccrine sweat glands regulate temperature; apocrine glands in axillae and groin become active at puberty. Sebaceous glands lubricate skin and hair. Wound healing involves inflammation, proliferation, and remodeling phases.
🚨 Dermatological red flags — escalate immediately
- Rapidly spreading erythema with fever, pain, or blistering (rule out Stevens-Johnson / toxic epidermal necrolysis)
- Petechiae or purpura not explained by trauma (possible sepsis, meningitis)
- New changing mole with asymmetry, irregular border, or multiple colors
- Mucosal involvement (oral, genital) with rash (Stevens-Johnson / TEN)
- Signs of anaphylaxis: urticaria with airway compromise, hypotension
Rapid Assessment Pathways
Rash / Eruption
- Onset, location, progression
- Morphology: macules, papules, vesicles?
- Itching, pain, or systemic symptoms
- Recent medications or infections
- Contact history (allergens, new products)
Skin Lesion (suspicious)
- ABCDE rule for pigmented lesions
- Change in size, shape, color
- Bleeding, crusting, non-healing ulcer
- Personal/family history of skin cancer
- Consider dermatoscopy referral
Ulcer / Wound
- Measure depth, undermining, tunneling
- Exudate amount and type
- Periwound skin condition
- Pain level and signs of infection
- Assess vascular status, pressure injury risk
Pruritus (itching)
- Generalized vs localized
- Timing: nocturnal, after bathing?
- Primary lesions or secondary excoriations
- Systemic causes: renal, hepatic, thyroid
- Current skincare routine
Dermatological Symptoms
Common Conditions
Nursing Procedures
Diagnostic Tests
Dermatological Medications
Related Body Systems
› References & Guidelines
- American Academy of Dermatology. Clinical guidelines.
- British Association of Dermatologists. Clinical guidelines.
- DermNet NZ. Online dermatology resource.
- National Institute for Health and Care Excellence (NICE). Skin conditions guidance.
- WHO. Skin diseases.
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