How to take Dermatology Pictures

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  • 1. Dermatologic Picture-Taking(Images/information provided in thissection are courtesy of Dr. Hon Pak, LTC MC andDr. Carrie Kovarik, MD ) ClickDiagnostics, Inc. 2010

2. Standard Views Standard Viewso Human body can be separated into anatomic unitso Each anatomic units will have standard image sets Standard views/framing should be used formost if not all conditions.o Show entire anatomic unit (e.g. trunk) if a lesionor rash is within this unit ClickDiagnostics, Inc. 2008 COMPANY CONFIDENTIAL 3. Anatomic Regions or Units (Standard Sets) Hands/feet/ Nails Face/ Scalp Genitals Arms Trunk Legs ClickDiagnostics, Inc. 2008 COMPANY CONFIDENTIAL 4. Face Standard SetThen Take:- Complementary Views if appropriate- Close ups (of representative lesions) ClickDiagnostics, Inc. 2010 5. Hair Protocol Take Standard image sets forHead and Scalp Take close up of involvedarea Photos should clearly showany erythema, hair loss,scaling, or crusting o May have to part and/or clip hair to expose the involved area ClickDiagnostics, Inc. 2010 6. Truncal Standard Set Then Take: - Complementary Views if appropriate - Close ups (of representative lesions) ClickDiagnostics, Inc. 2010 7. Arm Standard Set Then Take: - Complementary Views if appropriate - Close ups (of representative lesions) ClickDiagnostics, Inc. 2010 8. Leg Standard Optional Set: Then Take: - Complementary Views if appropriate - Close ups (of representative lesions) ClickDiagnostics, Inc. 2010 9. Hand/Feet Standard SetThen Take:- Complementary Views if appropriate- Close ups (of representative lesions) ClickDiagnostics, Inc. 2010 10. Complementary Sets If a condition involves certain locations, complementaryareas may need to be examined or photographed. If Involved:Include Look / Ask / ? IncludeHandsFeetElbows/KneesFeet Hands GroinElbows Knees ScalpKneesElbowsScalpScalpFaceKnees, ElbowsPopliteal fossaAntecubital fossa Neck, Face, handsAntecubital fossaPopliteal fossa Neck, Face, handsNail (any) All nails Oral MucosaGroinButtocksHands & FeetFace (Eyebrows, NLF) ScalpOral MucosaGenitals ClickDiagnostics, Inc. 2010 11. Dermatologic Photography:Factors to Consider Orientation Framing Leveling & centering Close up & location Symmetry Background Marking lesions Preparation of room Preparation of patient ClickDiagnostics, Inc. 2010 12. Orientation Good Orient the camera to allowmaximal utilization of spaceo Most anatomic units are longer than wide just like the image frame.o Turn the camera on its side when taking most anatomic unit pictures (face)Bad ClickDiagnostics, Inc. 2010 13. Framing Ensure that the framing shows the extent of involvement Must include involved AND uninvolved area ClickDiagnostics, Inc. 2010 14. Level & Center (BAD) Examples ClickDiagnostics, Inc. 2010 15. Level & Center (Good) Examples+ + ClickDiagnostics, Inc. 2010 16. Close Ups Centered:o The primary lesion(s) mustbe clearly identified,focused and centered inthe close up view Perpendicular:o In general, the imageshould be taken on a planeperpendicular to that ofthe lesion. Anatomical Location:o Ensure that thelocation/anatomy is identifiableat least on one of the images ClickDiagnostics, Inc. 2010 17. Symmetry If the pt has multiple lesions, be sure to document symmetryo Front/back, left/righto Take pictures of symmetric parts even if there is no abnormality on other side ClickDiagnostics, Inc. 2010 18. Background Good Background can be very distracting Use a non reflectant (blue or gray) backgroundBadBad ClickDiagnostics, Inc. 2010 19. Marking If the lesion is subtle, mark it! ClickDiagnostics, Inc. 2010 20. Preparation of room/patient Room size 10 minimum o Full length photo Dark blue/ Green non-reflectant cloth o Background (Wall) o Portable drape Well lit room o Avoid direct light (window) Stools/ Exam Table ClickDiagnostics, Inc. 2010 21. Preparation of Patient Inform the patient why you are taking pictures Position the patient (and yourself) comfortablyo Leads to less movement Instruct patient to undress appropriatelyo Gown ClickDiagnostics, Inc. 2010