Background: For individuals with lightly pigmented skin, early stage pressure ulcers appear as areas of redness, which have compromised microcirculation and do not blanch in response to pressure. The lack of a visible blanch (hemodynamic response) to pressure is a convenient diagnostic test for stage I sores. However, the blanch response is not visually apparent in people with highly pigmented skin color due to the overwhelming contribution of melanin to the reflectance of skin.
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