Lesson 2: Physical Assessment of the Integumentary System
2-4. PHYSICAL FINDINGS OF INSPECTION--COLOR
a. Normal Skin Pigments. Three elements are responsible for skin color: melanin, a pigment in the epidermis; carotene, a pigment mostly in the dermis; and blood in the capillaries found in the dermis. The amount of melanin causes the skin color to vary from pale yellow to black. Melanin is found primarily in the basale and spinosum layers of the skin and produced in cells called melanocytes. These cells are located either just beneath or between the cells of the stratum basale. The number of melanocytes is about the same in all races. Skin color differences in the races are due to the amount of pigment the melanocytes produce and disperse. An individual without pigment in the skin, hair, or pupils of the eyes is termed an albino. This person has inherited an inability to produce melanin. In other people, melanin has a tendency to form in patches called freckles. Carotene, a skin pigment found in Oriental people, when mixed with melanin accounts for the yellowish hue of Oriental skin. The pink color of Caucasian skin is due to blood in capillaries in the dermis without a heavy pigment in the skin to mask the color. Blood in the capillaries close to the surface of the skin is also responsible for the color of nailbeds, lining of the eyelids, oral mucose, and the underlying vascular bed.
b. Abnormal Skin Pigments. Abnormal skin pigments include hyperpigmentation, hypopigmentation, and erythema.
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