We would like to high light the benefits of using patients’ smartphones as tools for documenting images of skin lesions as a part of their management. Assessment of a skin lesion(s) is a common presentation to the plastic surgery outpatient clinic. Accurate assessment and documentation are vital to ensure appropriate treatment. In the United Kingdom, the incidence of skin cancer is increasing1. Skin lesion assessment represents 35-45% of referrals to the specialist clinic2. Medical illustration departments work to provide visual documentation of the lesion(s). With increased service pressures it is not always possible to access medical illustration due to workload and costs. However, smartphone cameras are able to capture high quality images and successfully document skin lesions1 . As aid et al demonstrated that smartphone cameras, whilst not able to provide the same quality image as clinical photography, can be used effectively for assessing skin lesions3.One advantage of using smartphones to document skin lesions is monitoring the lesion(s) over time and recording changes prospectively. Patients are able to present the visual timeline, supporting the diagnostic process. Smartphone images are also helpful for surveillance. In the context of pigmented lesions2, this can have significant benefits in
detecting subtle changes over a period of time. Smartphone photography can also be used to image areas not always visible to the patient ,for example the back or scalp, or if multiple lesions are present in the same area. A smartphone image can accurately locate the lesion for assessment. Furthermore, it facilitates informed counselling of the patient when discussing the diagnosis and m a n a g e m e n t , e s p e c i a l l y i f n e e d i n g reconstruction. During a busy theatre list, images stored on patients ‘ smart phones enable the surgeon to efficiently review the image with correlation to the proposed surgical site. It is not uncommon to encounter uncertainty for the correct lesion to be excised on the day of surgery as lesions may have progressed or regressed with time. For patients requiring procedures utilisingnn clear medicine, images stored on their smartphone supports the localsation process. This is particular useful in the context of melanoma where the patient may have multiple naevi and injection of the correct site is paramount3. O u r e x p e r i e n c e d e m o n s t r a t e s t h a t smartphones play asupporting role in the assessment and management of a skin lesion(s), Free of cost or ethical burden, we propose this tool as an adjunct to the overall care of patients with considerable advantages, and few drawbacks
1. Brewster DH, Bhatti LA, Inglis JH, Nairn ER. Doherty VR. Recent trends in incidence of nonmelanoma skin cancers in the East of S c o t l a n d , 1 9 9 2 – 2 0 0 3 . B r J Dermatol2007;156: 1295–1300.
2. Schofield J, Grindlay D, Williams H. Skin conditions in the UK: a health care needs assessment. Centreof Evidence Based Dermatology, University of Nottingham. 2 0 0 9 . A v a i l a b l e fromwww.library.nhs.uk/COMMISSIONIN G/ViewResource.aspx?resID=326029.
3. Asaid R, Boyce G, Padmasekara G. Use of a smartphone for monitoring dermatological lesions compared to clinical photography. jMTM 2012:1:16-18.
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