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Introduction
CHAPTER 8 Photography and Digital
Technology in Dermatologic Surgery
Jonathan Kantor
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 3โs, do not apply to most photography for surgical dermatology where the area of interest is generally centered in the frame.
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.
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.
Donโt 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.
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.
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.
CHAPTER 8 Photography and Digital