It takes experience to learn how to assess the skin of a dark-skinned patient. Many times the changes in a dark skinned patient's color will be far more subtle than in a lighter-skinned patient. For this reason, a health care provider has to be vigilant. She must always approach it in a systematic manner and never gloss over the assessment. It is far too easy to miss the subtle clues a dark skin color may be sending out.
Introduce yourself to the patient and explain the examination procedure. Ensure that the patient's privacy is accounted for and that there is adequate lighting in the room.
Examine the patient's sclera. Gently pull down on his lower eyelid and note the color. Check the conjunctiva of the eye as well. Examine the inside of the lips and the tongue. Check the nail beds, the palms and the soles of the feet. These areas should be pink. If they are ashen or yellow-brown, it may indicate that the patient is pale.
Examine the patient's sclera and hard palate for indications of jaundice or liver failure. A yellow cast to other areas of the body is not usually an indication of this disease. Skin rashes can usually be felt by touching the skin. Cyanosis or the blue cast that comes from lack of oxygen to the tissues can be difficult to diagnose in any patient. Be sure to check the palms, tongue and conjunctiva, as well as nail beds when assessing for this.
Chart the patient's skin color and where the color was noted in the patient's record. Report any abnormal findings to the appropriate health care provider immediately.