how to take dermatology pictures

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Dermatologic Picture-Taking

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(Images/information provided in this section are courtesy of Dr. Hon Pak, LTC MC andDr. Carrie Kovarik, MD )

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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 for most if not all conditions. o Show entire anatomic unit (e.g. trunk) if a lesion

or rash is within this unit

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Anatomic Regions or Units (Standard Sets)

Hands/feet/ Nails Face/ Scalp Genitals Arms Trunk Legs

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Face Standard Set

Then Take:- Complementary Views if

appropriate- Close ups (of representative

lesions)

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Hair Protocol

Take Standard image sets for Head and Scalp

Take close up of involved area Photos should clearly show

any erythema, hair loss, scaling, or crustingo May have to part and/or clip

hair to expose the involved area

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Truncal Standard Set

Then Take: - Complementary Views if appropriate- Close ups (of representative lesions)

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Arm Standard Set

Then Take: - Complementary Views if appropriate- Close ups (of representative lesions)

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Leg Standard

Optional Set:

Then Take: - Complementary Views if appropriate- Close ups (of representative lesions)

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Hand/Feet Standard Set

Then Take:- Complementary Views if appropriate- Close ups (of representative lesions)

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Complementary SetsIf a condition involves certain locations, “complementary

areas” may need to be examined or photographed.

If Involved: Include Look / Ask / ? Include

Hands FeetElbows/KneesFeet HandsGroinElbows Knees ScalpKnees Elbows ScalpScalp Face Knees,

ElbowsPopliteal fossa Antecubital fossa Neck, Face, handsAntecubital fossa Popliteal fossa Neck, Face, handsNail (any) All nails Oral

MucosaGroin Buttocks Hands

& FeetFace (Eyebrows, NLF) ScalpOral Mucosa Genitals

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Dermatologic Photography: Factors to Consider

Orientation Framing Leveling & centering Close up & location Symmetry Background Marking lesions Preparation of room Preparation of patient

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Orientation Orient the camera to allow

maximal 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)

Good

Bad

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Framing Ensure that the framing shows

the extent of involvement Must include involved AND

uninvolved area

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Level & Center (BAD) Examples

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Level & Center (Good) Examples

++

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Close Ups Centered:

o The primary lesion(s) must be clearly identified, focused and centered in the close up view

Perpendicular: o In general, the image

should be taken on a plane perpendicular to that of the lesion.

Anatomical Location: o Ensure that the

location/anatomy is identifiable at least on one of the images

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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

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Background Background can be very

distracting Use a non reflectant (blue or gray)

background

Good

BadBad

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Marking

If the lesion is subtle, mark it!

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Preparation of room/patient

Room size 10’ minimumo Full length photo

Dark blue/ Green non-reflectant clotho Background (Wall)o Portable drape

Well lit roomo Avoid direct light (window)

Stools/ Exam Table

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Preparation of Patient

Inform the patient why you are taking pictures

Position the patient (and yourself) comfortably o Leads to less movement

Instruct patient to undress appropriatelyo Gown