Patient Perceptions of Dermatologic Photography: A Scoping Review (Preprint)

BACKGROUND Medical photography is used extensively in dermatology to record disease progression, measure treatment response, and help teach patients about skin disease; such photos are also commonly utilized in teledermatology, medical education, research, and medical reference websites. Understanding patient perceptions of medical photographs obtained during dermatologic care in the clinic- or hospital- setting is critical to enable the delivery of high-quality, patient-centered medical care. OBJECTIVE The aim of this study was to elucidate patient perceptions of skin photos in dermatology, and to explore possible next steps in improving the patient experience of medical photography in the hospital- or clinic- setting. METHODS A scoping review of the literature was performed using the PubMed database, with clinic- or hospital- based full-text publications in English spanning the last ten years considered for inclusion. RESULTS The majority of included studies (n=10/11, 91%) found positive patient attitudes toward medical photographs. The majority of patients (n=1197/1511, 79.2%) felt that medical photographs could improve medical care in the clinic setting. Written consent detailing all photo uses, including secondary uses (such as research or teaching), was preferred apart from one study. Patients preferred or found it acceptable for the photographer of their medical photos to be a physician (n=1301/1444, 90.1%). Clinic-owned cameras with departmental record storage were the preferred modality. Latinx and African-American patients expressed less trust in the utility of medical photographs to improve care, compared to Asian and White patients. Study limitations include the minimal number of available publications on this topic and the inclusion of articles older than five years are limitations, since patient perceptions of medical photography may have rapidly changed during this time span, particularly in light of the COVID-19 pandemic and the subsequent increase in teledermatology visits. CONCLUSIONS Patients reported positive perceptions of dermatologic photography for improving their medical care. Ethnic disparities in patient perceptions require further exploration to better elucidate nuances and develop interventions to improve the experience of marginalized patients. Building patient trust in nonphysician photographers may enhance clinic efficiency. While clinic-owned cameras are well-accepted by patients, improved patient education surrounding the safety of EMR phone applications is needed. CLINICALTRIAL