how to take dermatology pictures
DESCRIPTION
Property of ClickDiagnosticsTRANSCRIPT
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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