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PHOTOGRAPHY IN DERMATOLOGIC SURGERY

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SUMMARY

  • Three fundamental physical principles govern photography: aperture size, shutter speed, and film speed (ISO).

  • Framing and composition are critical aspects of photography; traditional approaches to photographic composition, such as the rule of 3’s, do not apply to most photography for surgical dermatology where the area of interest is generally centered in the frame.

image Beginner Pearls

  • Camera choice should not be dictated by the number of advertised megapixels.

  • Lens type and lighting have a far greater impact on photograph quality than resolution.

  • Archiving and organizing photographs is an important component of digital photography, and developing a systematic approach to both image capture and storage ultimately results in a more productive and professional environment.

image Expert Pearls

  • Recent ISDIS recommendations included lighting type (broad spectrum, even illumination, possibly tangential) background color (solid, blue or black colors preferred), field of view (centering the target), orientation, focus/depth of field, resolution (to include hair follicles on regional images and skin texture on close-up images), scale (there some debate regarding whether this is of value), and image storage quality.

  • Instead of using specialized photographic equipment, standalone LED worklights may be purchased at a home improvement store.

image Don’t Forget!

  • All images should be saved at the highest-quality setting available on the device.

  • Head- or body-mounted video recording devices are very sensitive to slight body movement by the surgeon and may introduce significant camera shake, which is undesirable.

image Pitfalls and Cautions

  • Ideally, data should be stored on an encrypted drive. Encryption options are built-in to both Apple (using Filevault) and Windows (using Bitlocker) computers.

  • All photographs should be taken from the same angle and should include the same amount of surrounding skin in the field; this allows the viewer to see only the surgical procedure as the rest of the image is held constant.

image Patient Education Points

  • Dermatologic surgeons involved in education and publishing may wish to have all patients sign a blanket photography consent and release so that there is no question after the fact regarding whether individual images can be used.

  • When possible, identifying information should not be captured in a photograph unless doing so is necessary.

  • Patients may be reassured that all images will be stored in an encrypted format.

  • A separate social media release may be helpful if images are to be shared publicly.

INTRODUCTION

Dermatologic surgery is a visual field. Preserving a visual rendition of a particular disease entity, biopsy site, surgical technique, or surgical outcome is a critical part of the dermatologic surgeon’s practice.

The advent of the printing press in 15th-century Europe changed the medical landscape, as the written word could efficiently and (relatively) inexpensively be transmitted to others around the world.

Nineteenth-century dermatology texts, such as Robert Willan’s On Cutaneous Diseases, and Pierre Louis ...

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