Assessment Variations in Light-and Dark-Skinned Persons
o Cyanosis
Light: grayish blue tone, especially in nail beds, earlobes, lips,
mucous membranes, palms, and soles
Dark: ashen or gray color most easily seen in the conjunctiva of
the eye, mucous membranes, and nail beds
o Ecchymosis
Light: dark red, purple, yellow, or green color, depending on age
of bruise
Dark: purple to brownish black; difficult to see unless occurring
in an area of light pigmentation
o Erythema
Light: reddish tone, possibly accompanied by increased skin
temperature secondary to localized inflammation
Dark: deeper brown or purple skin tone with evidence of
increased skin temperature secondary to inflammation
o Jaundice
Light: yellowish color of skin, sclera, fingernails, palms, and oral
mucosa
Dark: yellowish green color most obviously noticeable in sclera of
eye (do not confuse with yellow eye pigmentation, which may be
evident in dark-skinned patients), palms, and soles
o Pallor
Light: pale skin color that may appear white or ashen; also
evident on lips, nail beds, and mucous membranes
Dark: lack of underlying red tone in brown or black skin; in light-
skinned African Americans, yellowish brown skin; in dark-
skinned African Americans, ashen or gray skin
o Petechiae
Light: lesions appearing as small, reddish purple pinpoints, best
observed on abdomen and buttocks
Dark: difficult to see; may be evident by the buccal mucosa of the
mouth or conjunctiva of eye
o Rash
Light: may be visualized and felt with light palpation
Dark: not easily visualized, but may be felt with light palpation
o Scar
Light: generally heals, showing narrow scar line
Dark: higher incidence of keloid development, resulting in
thickened, raised scar