To assess skin color in dark-skinned patients, which sites are best checked?

• A. Face and hands
• B. Lips and nail beds
• C. Palms
• D. Abdomen and chest

Answer: (B)

In darker-skinned patients, color changes from poor oxygenation show up more reliably on mucous membranes and the nail beds than on heavily pigmented skin. The lips are a mucous membrane, so they often reveal cyanosis or pallor sooner than facial skin, while the nail beds reflect perfusion and oxygenation changes and can show color shifts and be used to assess capillary refill. In contrast, areas like the face, hands, palms, and the abdomen or chest can be heavily pigmented, which can mask color changes and make it harder to detect early cyanosis or pallor. For this reason, the best sites to assess skin color in dark-skinned patients are the lips and nail beds.