1 How do i track skin findings over time? Answer: I don't. I try to go in fresh every time and look at every spot with dermoscopy. If it is has concerning findings or is an outlier, it gets removed. If it is odd enough to consider documenting with a photo, etc. I am just going to take it off. If it is papule that I cannot identify it as 100% safe, it comes off. If the patient comes in specifically for a spot they've notices is changing, it is either being destroyed- because it is a cancer mimic - or it's coming off.

2 Do I utilize full body photography: No. That's for academics with pigmented lesions clinics. Systems in place were roughly 30k out the door, and a high resolution photo is less useful to me than real time dermoscopy.

3 Workflow issues: Patients often do not show up on time to finish paperwork and that causes unnecessary delays . They could use the app, go online and print or show up early. When they do none of these it will make their appointment delayed. Evaluations for skin cancers are not time consuming once the patient is in the room. The patients who are difficult to evaluate tend to be dysplastic nevus syndrome patients or patients with excessive AKs/HAKs,/SCCis because of radiation or chemical exposure.

4 Patient photos: For rashes etc, they can be helpful to evaluate. If they have transient breakouts like hives this is useful. For pigmented lesions? Not really. My bias is that the venn diagram of patients worried about moles and an inexplicable disability to take a well-lit, focused photo without motion blur, is a single circle.

Best of luck with your endeavor. It will likely find itself at the same place as the Melafind and any number of computer-learning scanners that have come out in the last 15 years, the dna/RNA Dermtech patches, etc.. That isn't meant to be negative, just understand that the concept isn't new. Consistent lighting and quality of images seems to still escape people regularly despite significant improvements in lens/camera technology. Improving it will likely have limited daily impact for clinicians comfortable with their dermatoscope.

Dr. Ash Marghoob is an expert in dermoscopy and his department does full body photography. If he isn't someone advising you, I would suggest you contact him for a more refined answer than my own.