Comment on ‘‘A simple, novel method for nail photography’’ To the Editor: We appreciate the interest shown by the readers in going through our article. We appreciate the point that has been raised,1 especially in the context of patients who cannot flex their fingers. We did consider this technique too in our practice, however the following limitations prevented us from doing it routinely. 1. Clinical images look best when there is symmetry wherever possible. The symmetrical view is lost when the hands are placed one over the other and moreover the nails looked crowded. 2. Because most of the nail images are shot in a ‘‘macro’’ mode (close-up mode wherein errors may also get magnified), the chances of one hand going out of focus are high as the fingers fall in 2 levels/planes. 3. It seems relatively easier to reproduce our method for follow-up images because standardization is easier. 4. Adjusting the aspect ratio if in the final collage (as mentioned in our article) is quite

J AM ACAD DERMATOL

easy. Creating a panel along with the thumb image is easy with wider than horizontal frame as shown in the response article.2 Karalikkattil T. Ashique, MBBS, DDVL,a and Feroze Kaliyadan, MD, DNB, MNAMS, FIMSAb KIMS Al Shifa Super Specialty Hospital, Perinthalmanna, Kerala, India,a and College of Medicine, King Faisal University, Al Ahsa, Saudi Arabiab Funding sources: None. Conflicts of interest: None declared. Correspondence to: K.T. Ashique, MBBS, DDVL, Department of Dermatology, KIMS Al Shifa Super Specialty Hospital, Perinthalmanna, Kerala, PIN 679322 E-mail: [email protected] REFERENCES 1. Gupta S, Gupta S. A simple novel method for nail photography. J Am Acad Dermatol. 2015;72:e131. 2. Ashique KT, Kaliyadan F. Clinical photography of nail diseases: a simple method to include all fingernails in a frame. J Am Acad Dermatol. 2015;72:e25. http://dx.doi.org/10.1016/j.jaad.2015.01.050

MAY 2015 e133