Physical examination maneuver
Skin Inspection and Palpation
How to Perform
With the patient undressed and gowned in a warm room under bright, preferably natural, light, and with consent and a chaperone for the sensitive areas, examine the entire skin surface systematically from head to toe, exposing and then re-draping one region at a time to preserve dignity and so that no site is missed. Inspect the scalp (parting the hair or using a comb), the face, eyelids and conjunctivae, ears and postauricular folds, nose, lips, and oral mucosa; the neck, chest, breasts, and the inframammary folds (lifting the breasts), and the abdomen and umbilicus; the back, flanks, buttocks, and gluteal cleft; the axillae and both arms, hands, finger web spaces, and fingernails; both legs, feet, toe web spaces, soles, and toenails; and the groin, external genitalia, and perianal skin. For each area, note the skin color, vascularity, moisture, and hair distribution, and the location, distribution, configuration, type, size, and color of any lesion, using a dermatoscope where available. Palpate as needed to assess skin temperature, moisture, texture, thickness, turgor, and mobility, and to assess any lesion for consistency, tenderness, depth, and fixation.