Clinical photography of nail diseases: A simple method to include all fingernails in a frame Karalikkattil T. Ashique, MBBS, DDVL,a and Feroze Kaliyadan, MD, DNB, MNAMS, FIMSAb Perinthalmanna, Kerala, India; and Al Ahsa, Saudi Arabia
CLINICAL CHALLENGE There are no standard guidelines for imaging the diseased nail. Since the plane of the thumb (unlike the toenails) is different from the other fingers, there is a practical challenge when attempting to take photographs as a single frame (eg, when documenting 20-nail dystrophy). Also, in cases such as psoriasis of the nails with joint involvement, it is strenuous for the patient to flex the digits, which again makes imaging difficult.
SOLUTION We have been following a very simple method that helps to overcome this problem. Two images, one of all fingernails excluding the thumb and a second image of only the thumbs, are obtained. A panel/collage is created, using any image editing software (Fig 1). This gives a detailed view of all the affected nails regardless of the plane in which they are positioned. Taking photos this way is easy for the patient too as it does not produce any strain.
Fig 1. Images of the thumbs and other fingers obtained separately and made into a panel/collage, which enhances the quality of the image.
From the Alshifa Hospital,a Perinthalmanna, Kerala, India, and Faculty of Dermatology, College of Medicine, King Faisal University,b Al Ahsa, Saudi Arabia. Funding sources: None. Conflict of interest: None declared. Correspondence to: Karalikkattil T. Ashique, MBBS, DDVL, Consultant Dermatologist, Department of Dermatology, Alshifa Hospital,
Perinthalmanna, Kerala PIN 679322. E-mail: drashique@gmail. com. J Am Acad Dermatol 2015;72:e25. 0190-9622/$36.00 Ó 2014 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2014.08.047
e25
CLINICAL CHALLENGE There are no standard guidelines for imaging the diseased nail. Since the plane of the thumb (unlike the toenails) is different from the other fingers, there is a practical challenge when attempting to take photographs as a single frame (eg, when documenting 20-nail dystrophy). Also, in cases such as psoriasis of the nails with joint involvement, it is strenuous for the patient to flex the digits, which again makes imaging difficult.
SOLUTION We have been following a very simple method that helps to overcome this problem. Two images, one of all fingernails excluding the thumb and a second image of only the thumbs, are obtained. A panel/collage is created, using any image editing software (Fig 1). This gives a detailed view of all the affected nails regardless of the plane in which they are positioned. Taking photos this way is easy for the patient too as it does not produce any strain.
Fig 1. Images of the thumbs and other fingers obtained separately and made into a panel/collage, which enhances the quality of the image.
From the Alshifa Hospital,a Perinthalmanna, Kerala, India, and Faculty of Dermatology, College of Medicine, King Faisal University,b Al Ahsa, Saudi Arabia. Funding sources: None. Conflict of interest: None declared. Correspondence to: Karalikkattil T. Ashique, MBBS, DDVL, Consultant Dermatologist, Department of Dermatology, Alshifa Hospital,
Perinthalmanna, Kerala PIN 679322. E-mail: drashique@gmail. com. J Am Acad Dermatol 2015;72:e25. 0190-9622/$36.00 Ó 2014 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2014.08.047
e25
