By Carolyn Crist
(Reuters Health) - More patients are bringing pictures of their skin problems to their dermatologists, which helps the doctors better observe the progression and potentially diagnose the condition, according to a new study.
The authors, a group of skin experts in France, found that almost two-thirds of patients brought pictures with them to appointments for urticaria, or hives.
"Clinical photography has grown enormously since the advent of smartphones," said Martin Li of the University Hospitals Coventry and Warwickshire in the United Kingdom, who wasn't involved with the study.
"As the authors say, sometimes skin conditions come and go, so having confirmed photography helps clinicians assess conditions," he told Reuters Health by email.
For the study, members of the Urticaria Group of the French Dermatological Society surveyed 311 patients who had appointments for hives in 2017.
Nearly all the patients had wheals, or swollen and itchy bumps, and some of them had angioedema, which is swelling beneath the skin. Only about a third of the patients had skin lesions during the appointment, according to the report in the Journal of Allergy and Clinical Immunology: In Practice.
Among the 197 patients who brought pictures, 134 didn't have lesions at the time, so the pictures were helpful in confirming a hives diagnosis in 125 cases. Photos also helped doctors rule out hives in 9 cases.
Photographs could be particularly important for skin concerns, not only because lesions may disappear by the time a patient can get an appointment, but also because they could change due to scratching or other treatments, the study authors wrote.
Patients said they took photographs because they worried they wouldn't have any lesions to show once they were able to make the appointment, and about a third said their flare-up was more severe than usual.
Doctors rated the majority of the pictures as "good" and helpful during diagnosis.
"This shows that everyday technology, including smartphones, carry good diagnostic value," Li said. And "there is motivation amongst patients to document their condition to aid diagnosis."
Li recommends taking photographs of any condition that can change over time. A clear, well-lit environment with a neutral background is ideal. Put a ruler next to the lesion to show the size, he suggested.
Most patients don't use special apps for this purpose; instead, most "still capture dermatological information by taking pictures of their skin lesion with their smartphone," said Dr. Thomas Hubiche of Centre Hospitalier Intercommunal de Frejus Saint Raphael in Frejus, France. Hubiche, who wasn't involved with this study, has researched patient photographs during dermatology appointments for children.
"It is likely that patients don't want to be annoyed by complex apps but think that pictures are an easy tool to provide information to their doctor," he told Reuters Health by email.
"Photos in healthcare are becoming increasingly used as ways to improve diagnoses and treatment," said Elizabeth Krupinski of the Emory University School of Medicine in Atlanta, Georgia. Krupinski, who wasn't involved with this study, has researched how radiologists use photographs.
"Although issues like security and privacy will always be a question for some people, it is important to realize that the significant benefits far outweigh the minimal risks," she told Reuters Health by email.
The researchers, led by Marie-Sylvie Doutre of Hopital Tenon and Sorbonne Universite in Paris, didn't respond to requests for comment.
SOURCE: http://bit.ly/2ZwWOyY Journal of Allergy and Clinical Immunology: In Practice, online May 28, 2019.