Good light source. Lesion and loco-regional lymph nodes exposed.

Ask: ‘Where is the lesion?’

Ask: ‘Is the lesion painful?’

S-E-I-S (Site, External, Internal, Surroundings)

Fitzpatrick classification of skin type

Location of lesion

Number of lesions

Size (in cm)

Shape:

Surface:

Scars from previous surgery (skin lesions or lymphadenectomy)

Consistency: soft, hard

Content: gas (crepitus), fluid (fluctuant and transilluminable), solid (non-transilluminable)

Dynamic interaction: pulsatile, reducible, indentable, compressible

Mobility and attachment to surrounding structures (above, below and laterally)

Percussion: dull or resonant (gas, fluid, solid)

Auscultation: bruits, bowel sounds

Assess surrounding skin: normal or satellite lesions.

Palpate for local, regional, general lymphadenopathy.

Assess nerves: local and distal sensory and motor functions.

Assess vascular supply of lesion: capillary refill time and pulses.

Palpate liver for an irregular edge or enlargement and vertebral spine for tenderness if concerned about metastatic deposits.