Bates’ Visual Guide to Physical Examination

Volume 2: 2.4 The Skin Video Transcript

Narrator: As you proceed through the examination and as opportunity arises, examine the skin of the infant carefully to identify both normal markings and potentially abnormal ones. In infants, the skin texture is soft and smooth because it is thinner than the skin of older children. A response to cooling and chronic exposure to radiant heat can occasionally produce cutis marmaorata, a lattice-like, bluish mottled appearance on the trunk, arms and legs. Other common skin conditions and rashes include acrocyanosis, milia, miliaria rubra, erythema toxicum, and pustular melanosis.

Note any birthmarks in the infant and palpate to assess the degree of hydration or turgor. Rule a fold of loosely adherence skin between your thumb and forefinger to determine its consistency. In well-hydrated infants, the skin returns to its normal position immediately upon release. Normal physiologic jaundice occurs and half of all infants, appearing on the second or third day of life peaking at about the fifth day and usually disappearing within 1 week. Pressing the red color from the skin allows better recognition of the yellow of jaundice. This infant displays no sign of jaundice.