Bates’ Visual Guide to Physical Examination

Volume 1: 1.4 Skin Head Face and Neck — Adult Video Transcript

Narrator: Begin inspection of the patient’s skin by observing the patient’s face. Assess the facial expression, skin moisture or dryness, any facial swelling or asymmetry and check for any cyanosis in the lips. Inspect and palpate the patient’s fingernails, looking especially for any clubbing or cyanosis. Continue your assessment of the skin as you examine the other body regions. Note color, pigmentation, texture, hair distribution and thickness and any lesions. Look for nevi, scars, or other distinguishing characteristics noting their placement and dimensions

When you see nevi or moles, assess for melanomas using the ABCDE method. Inspect for:

• Asymmetry.
• Irregular Borders.
• Color variation or change, especially blue or black.
• Diameter larger than 6 mm.
• Elevation.

If any of these five aspects is present, consider referring the patient to a dermatologist for further evaluation. In some exposed areas, flaking, ulcerated lesions are suspicious for a squamous cell carcinoma and shiny, raised lesions for a basal cell carcinoma.