Photography in the Clinic #PACPearls

-

The WDS Practice Advisory Committee (PAC) shares dermatology photography tips including how to take quality photos and save time, before and after photography, dermoscopy and more.



Dermoscopic Photography


I find it very helpful to monitor pigmented lesions for changes using dermoscopic photography. In order to do this quickly, I have a phone case that is magnetized to hold my dermatoscope in place. Both my dermatoscope and the case are from DermLite. Using an app for EPIC, my photographs can be directly uploaded into the patient's chart for future use. I find this system to be very quick and efficient. 

Taking dermoscopic photographs of things that I biopsy has also improved my own knowledge. I review photographs when dermpath comes back to see if there are any features that I can learn from for a particular diagnosis. For anyone who teaches residents, having a library of dermoscopic images can also improve residency training.

- Lori Fiessinger, MD


Obtain Post Procedure Photographs


Baseline photographs before cosmetic procedures can easily be taken when patients come in for treatments, but obtaining post procedure photographs can be more difficult. To encourage patients to come in for photographs after their treatments, try offering follow-up appointments 2 weeks after a cosmetic procedure for possible touch-ups and photographs. This will help to motivate patients to come in at an ideal time for post procedure photographs in addition to improving patient satisfaction.

- Jeanette Black, MD


Photographing Nails


Routinely examine and photograph nails from their surface and free margin views. In this way you will document the source of a nail disorder (nail bed and distal matrix as depicted in this onychopapilloma) and document progress in response to medical or surgical treatment.

- Molly Hinshaw, MD



Create Consistency


If not ready for a more sophisticated photography setup in your practice, consider choosing a white wall in the same space, mark out on the floor a consistent distance and review with your staff the different angles using anatomical features as landmarks to lineup before and after photos.

The American Society for Dermatologic Surgery (ASDS) has a poster on photographic standards that can be put up on the wall in the photography-designated room. This can help to remind staff of face and body positioning to get greater consistency with photos (poster can be purchased online through the ASDS).

- Monica Li, MD


Not all practices have the resources and space for a sophisticated photography room. You can incorporate inexpensive techniques for photography standardization such as using black or white backdrops made of thick cardboard cut into desired sizes. These can be kept in each patient room, easily accessed and placed behind the patient to efficiently capture photos without having to move the patient. You can also place these behind the doors in patient exam rooms, again for easy access.

- Mona Sadeghpour, MD


Good before and after photos are hard to do- one must reproduce the exact lighting and position of the patient. Using the same room and buying a few lights inexpensive on amazon such as this with a dedicated space is best.

- Margo Weishar, MD 


Useful Apps


Use a program that allows “ghosting.” Overlaying the new photo with the old photo can really improve your accuracy. We use RxPhoto which is a paid program but there are free apps to try as well. iPhone 10 photos are very high quality for everyday use. For publishable quality, you will probably need a higher end camera.

- Margo Weishar, MD


In trying to keep follow-up photos uniform, I would look into an app called Imagine (NFI).

- Mark Kaufmann, MD



*Please note, all products and apps mentioned are included as examples and are not endorsed by WDS.

Comments

Post a Comment

Popular posts from this blog

WDS Book Club - Read and Recommend

-
Image
WDS Book Club - Summer Reads By the News You Can Use Committee Summer is heating up! Ready to cool off with a summer escape? Whether you’re craving a relaxing beachside book or a fun staycation read, dive into this selection of titles curated by your WDS Members   Molly Stout, MD recommends the following books: 1) The Hotel Nantucket by Elin Hildebrand – An iconic summer destination in need of a fearless leader, plus a little ghostly mystery. 2) The Covenant of Water by Abraham Vergase – A multigenerational family saga with lots of nods of medicine. Don’t be afraid of the page count, this tome is hard to put down. 3) The Burnout by Sophie Kinsella  – A young woman finds herself at a career meltdown and retreats to her childhood vacation town. For anyone feeling burnt out, this will reignite a little heat! 4) The Magnificent Lives of Marjorie Post by Allison Pataki – Consider your historical fiction itch scratched with this real-life cereal heiress. The plot thic...
Read more

Melanoma: Recent Advances and Future Possibilities

-
Image
  Melanoma: Recent Advances and Future Possibilities By Cather McKay MD, FAAD The incidence of invasive melanoma increases each year. Deaths from melanoma steadily rose until 2014, decreased until 2019, but have been on the rise again. As of 2024, the American Cancer Society predicts the lifetime risk of melanoma is 1 in 33 for White Americans, 1 in 1,000 for Black Americans, and 1 in 200 for Hispanic Americans. 1 Despite lower incidence in patients with skin of color, diagnosis tends to occur later with poorer survival as a result. We as dermatologists aim to improve diagnostic accuracy and correctly stage our patients so they can be referred to appropriate specialists. Melanoma staging and National Comprehensive Cancer Network (NCCN) guidelines are important for every dermatologist to review and are available with a free NCCN account. Here are some of the recent updates 2 :   Biopsy principles Biopsy via saucerization/deep shave removal, punch for small dia...
Read more

Consumer Alert—Is Your OTC Benzoyl Peroxide Product Safe?

-
Image
      Consumer Alert—Is Your OTC Benzoyl Peroxide Product Safe? By Susan Massick, MD In January 2024, the AAD updated its 2016 clinical guidelines for the treatment of acne with evidence-based treatment recommendations based upon a working group’s comprehensive and systematic review of current data (Reynolds). Benzoyl peroxide (BPO), a longstanding mainstay of acne treatment, remained a strongly recommended therapeutic intervention for both mild and moderate-severe acne. For many dermatologists and clinicians who regularly treat acne, BPO is efficacious, cost-effective, well-tolerated, and readily available for patients to use as an initial intervention as well as for maintenance therapy. Thus, a published report on March 6, 2024, regarding unacceptably high levels of benzene detected in over-the-counter BPO products, came as a surprise to many dermatologists. According to the CDC’s website, benzene is a colorless, flammable carcinogenic liquid that evaporates when e...
Read more