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Identifying Primary and Secondary Lesions

Hess, Cathy Thomas BSN, RN, CWOCN

Advances in Skin & Wound Care: July 2012 - Volume 25 - Issue 7 - p 336
doi: 10.1097/01.ASW.0000416010.08584.18

Cathy Thomas Hess, BSN, RN, CWOCN, is President and Director of Clinical Operations, Well Care Strategies, Inc (WCS). WCS specializes in focused software solutions, Your TPS® EMR, and mapping best clinical, operational, and technology practices.

Please address correspondence to: Cathy Thomas Hess, BSN, RN, CWOCN, 4080 Deer Run Court, Suite 1114, Harrisburg, PA 17112; e-mail:

Differential assessment of the skin condition or wound is essential to understanding its cause and development. First, assess the patient’s skin temperature, dryness, itching, bruising, and changes in texture of skin and nail composition. Also, assess the skin for color and uniform appearance, thickness, symmetry, and primary or secondary lesions. Document all the findings of the skin assessment. Note, too, any presence of a skin condition: erythema, itching, scratching, skin weeping, skin blistering, bruising, primary lesions, secondary lesions, and open wounds.

Use Tables 1 and 2 to assist you in your practice when differentiating between primary and secondary lesions.

Table 1

Table 1

Table 2

Table 2

© 2012 Lippincott Williams & Wilkins, Inc.