A NURSE in London is believed to be the first to highlight the importance of using a skin-tone card to spot early signs of pressure ulcers among black and Asian patients.

Now, every healthcare assistant and nurse at Ealing Hospital has been issued with a card that shows a graduation of skin colours from light to dark, to help spot a potential problem.

Luxmi Dhoonmoon was puzzled why so many of her patients from ethnic minorities were presenting with late-stage ulcers that had not previously been diagnosed.

Late-stage ulcers can cause permanent muscle damage, travelling down to the bone in the most severe cases.

“Sometimes things are so obvious we overlook them,” said Luxmi, a nurse consultant specialising in tissue viability who realised the first signs of ulcers were being hidden by patients’ darker skin tone.

Dermatologists have been using skin-tone gradients for many years, to rule out cancer, but no-one saw the benefits of using it to spot potential pressure ulcers.

Luxmi added: “The combination of a lack of awareness and potential sensitivities around clinical staff querying skin-tone discolouration means this has gone unnoticed.

“Ealing has a very diverse community, so the use of skin tone cards should be common practice.

“This isn’t about brow-beating people but providing a simple but effective visual tool that helps everyone.

“I’ve even had a doctor contact me from Australia about the huge benefits it could bring in treating his aboriginal patients.”

Luxmi says she hopes the skin-tone card can now be adapted to help identify early-stage cellulitis, a painful bacterial skin infection.