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Photographing Lesions

To take a good clinical photograph you need to remember the following:

1. Lighting

Get the lighting right!

When taking a picture of a patient, ensure that the light is shining on the subject area being photographed. Always make sure there is a direct path between the light source and the subject area.

Be careful when using a torch to illuminate the site. This can create difficulties in contrast between the dark outer area and the very bright central area.

*Portal Development Update*

Too little light

The same case taken with good external lighting (floodlight)

2. Shadow

Notice where shadows fall. Adjust the angle of the camera to take advantage of the light. Shadows may not be noticeable with the naked eye, but are more pronounced in the photograph; review the picture after you take it to ensure that your subject area is clearly visible (and in focus).

Shadows can be distracting and may cover the areas of interest

3. Background

Distracting backgrounds make it harder to get the subject in focus and can make it harder to see lesions clearly.

Medical drapes or a towel or sheet behind the area are helpful. Dark or navy blue fabric will often provide the best results.

A green surgical drape held behind the leg. Exposure is poor, and flash has created a shadow

Distractions behind the objective. Positioning & exposure are good

4. Positioning

Think about the angle you are taking the image from. Unusual or difficult angles can be confusing particularly with close-up views.

It may help to take a wider angle view and a “lesion only” picture to make the lesion details more clear.

Hold the camera or phone flat and point directly (at right angles) to the subject.

A picture of a horse grazing “over yonder” will not help the diagnostic process.

Wrong photo angle

Correct photo angle

5. Stability

Try to ensure the patient doesn’t move!

Hold the camera steady throughout.

6. Consistency

Try to always take follow-up photographs from the same angle. This will make it possible to determine an accurate assessment of the changes in the lesion.

Having a standardised process for taking photos is a great way to ensure photo consistency. The 2 images below are a well taken series of pictures that clearly illustrate the problem.