What is the hallmark of Stage 1 pressure ulcer?

• A. Nonblanchable erythema of intact skin
• B. Partial-thickness skin loss
• C. Full-thickness tissue loss
• D. Slough with granulation tissue

Answer: (A)

Intact skin with nonblanchable redness is the hallmark of a stage I pressure injury. The key sign is a localized area of redness that does not fade when you apply light pressure, indicating persistent tissue irritation and early hypoxia beneath the surface. This means damage is starting under the epidermis, but the skin itself hasn’t broken open yet.

In lighter skin, you’ll see a clearly red patch. In darker skin, the area may appear as a color change—purple, brown, or as warmth, edema, or hardness—rather than a pale spot. Because the skin isn’t broken, this stage is the earliest sign of a pressure injury and signals the need for prompt preventive measures to prevent progression.

If the skin is partially or fully broken with tissue loss, or if there’s exposed tissue, slough, or a deep wound, those findings point to deeper stages (partial-thickness or full-thickness loss) rather than stage I. Slough with granulation tissue indicates ongoing tissue damage and a more advanced wound, not an intact-stage injury.

Understanding this distinction helps you intervene early with pressure relief, skin care, and appropriate support surfaces to stop progression.