A nurse is believed to be the first in the world to highlight the importance of using a skin tone card to spot signs of skin damage within black and Asian communities

Luxmi Dhoonmoon said she was puzzled why so many of her patients from ethnic minorities were presenting with late-stage ulcers that hadn’t 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 the nurse consultant specialising in tissue viability who realised that the first signs of ulcers - discoloured skin - where being hidden by patients’ darker skin tone.

In response, every healthcare assistant and nurse at the hospital trust has been issued with a skin tone card which shows a graduation of skin colours from light to dark helping healthcare professionals see if there is a potential problem.

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.

"North East London has a very diverse community so the use of skin tone cards should be common practice.

“This isn’t about browbeating people but providing a simple but effective visual tool that helps everyone. I’ve even had a doctor contact me from Australia saying 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.