LAUSR

In a highly visual field like dermatology, standardized clinical photography is essential for longitudinal disease monitoring, inter-professional communication, education, and clinical documentation. With the rapid rise of telemedicine utilization and remote inter-professional collaborations in the setting of an ongoing global pandemic, high-quality photography plays an increasingly important role for clinical decision making and patient care. Despite the use of high-quality equipment and standardized methods, however, accurate depiction of erythematous or inflammatory conditions is inherently challenging, especially for patients with skin of color (SOC). Higher density of melanin in SOC patients leads to an increased competing background chromophore in photography, interfering with the visual assessment of the overlying erythema or inflammation. SOC patients can present with hyperpigmented cutaneous lesions, whereby the presence of the overlying or surrounding erythema can be a clinically distinguishing feature between active disease and healed, inactive post-inflammatory hyperpigmentation. To overcome the outlined challenges, cross-polarized photography can be used in conjunction with white light photography, which are the type currently used for standardized clinical photography. In this article, we summarize the advantages as well as general pitfalls of cross-polarized photography for visualizing various types of rash in SOC patients and provide practical clinical guidance and illustrative examples highlighting the differences when compared to standard white light clinical photography.