Scar photo standardization

Scar Photo Standardization

Description

Use this skill to create a standardized scar or keloid photo capture protocol for clinical documentation, research registry preparation, and longitudinal before/after comparison. The skill focuses on repeatability, consent, privacy, and image quality. It does not diagnose scars, determine recurrence, or judge treatment success.

When to Use

• A clinic needs a scar or keloid photo SOP.
• A researcher is preparing cases for the OpenScar schema.
• A team wants consistent baseline and follow-up images before outcome review.
• A user needs image quality flags for image.csv.

Do Not Use

• Do not diagnose scar type from photos.
• Do not determine recurrence or treatment response from photos alone.
• Do not alter photos to exaggerate outcomes.
• Do not store or share identifiable images without appropriate consent and access control.
• Do not use public image paths for real patient media.

Required Inputs

• Anatomic site and lesion identifier, if available.
• Visit type: baseline, treatment, follow_up, complication, recurrence_check, or other.
• Intended use: clinical record, research-deidentified dataset, teaching, or public media.
• Available camera setup, room setup, and privacy constraints.
• Whether scale marker and color reference are available.

Workflow

1. Confirm consent and intended use before capture.
2. Assign or confirm patient_id, lesion_id, and planned visit_id if the case is entering a registry.
3. Define the image set:
   • overview: anatomic orientation and surrounding landmarks.
   • close_up: lesion detail with scale marker when feasible.
   • oblique: contour, height, and edge visibility.
   • profile: raised lesions or contracture-relevant views.
   • with_scale: measurement-oriented image when not already covered.
4. Standardize capture conditions:
   • same room or lighting setup when possible
   • plain background
   • camera perpendicular for close-up views
   • consistent distance, ideally recorded in distance_cm
   • no cosmetic editing, smoothing, filters, or exposure manipulation
5. Prepare the patient and field:
   • expose the full lesion and surrounding normal skin
   • remove jewelry, clothing edges, adhesive residue, or makeup when clinically appropriate
   • avoid unnecessary identifiable anatomy
   • cover or crop unrelated identifiable features when possible
6. Capture image quality metadata aligned to OpenScar:
   • view_label
   • capture_device
   • distance_cm
   • scale_marker_present
   • color_reference_present
   • lighting_quality
   • angle_quality
   • focus_quality
   • privacy_redaction_status
7. Flag limitations and repeat any photo only if doing so is clinically practical and respectful.
8. Produce a registry-ready image record draft and a human-readable capture checklist.

Quality Flag Rules

Use these labels so outputs can map directly into open-scar-starter/docs/data-schema.md.

lighting_quality

• good: lesion color and border are visible without glare or heavy shadow.
• acceptable: minor shadow, glare, or exposure variation, but lesion remains interpretable.
• poor: color, border, or surface detail is substantially obscured.
• unknown: image is unavailable or cannot be reviewed.

angle_quality

• standardized: view matches the planned protocol and is comparable to prior/future visits.
• acceptable: view is usable but has mild rotation, tilt, or distance variation.
• nonstandard: view limits comparison because angle, distance, or framing differs substantially.
• unknown: angle cannot be assessed.

focus_quality

• good: lesion edge and surface detail are sharp.
• acceptable: slight blur but main features remain visible.
• poor: blur prevents meaningful comparison.
• unknown: focus cannot be assessed.

privacy_redaction_status

• not_needed: no unnecessary identifying features are visible.
• redacted: identifying features were covered, cropped, masked, or otherwise protected.
• needs_review: image may contain identifiable features or consent/media-use uncertainty.

Output Format

Return:

• Purpose and consent check
• Required view list
• Room and camera setup
• Patient and field preparation checklist
• OpenScar image.csv field draft
• Quality flags and limitations
• Repeat-capture recommendations
• Privacy and storage notes

Example Output Skeleton

Purpose and consent:
- Intended use: research_deidentified registry
- Consent status to confirm before export: research_deidentified

View list:
- overview
- close_up with scale marker
- oblique

Image field draft:
- image_id: img_pending_001
- visit_id: v_pending_001
- lesion_id: l_pending_001
- image_uri: secure_storage_pointer_required
- view_label: close_up
- capture_device: clinic_camera_or_phone_model
- distance_cm: 30
- scale_marker_present: true
- color_reference_present: false
- lighting_quality: acceptable
- angle_quality: standardized
- focus_quality: good
- privacy_redaction_status: needs_review

Limitations:
- No color reference available.
- Confirm image storage and consent before research export.

Safety and Compliance

This skill supports documentation, research preparation, and clinician review. It does not diagnose, prescribe, determine recurrence, or replace licensed clinical judgment. Escalate urgent symptoms, suspected infection, wound breakdown, severe pain, rapid progression, bleeding, ulceration, or functional compromise to a qualified clinician.

Protect all patient media under applicable privacy rules. Use secure storage pointers for real images. Do not place real patient photos in public repositories.

Examples

Create a standardized photo checklist for an anterior chest keloid baseline visit, with fields ready for OpenScar image.csv.

Review this proposed scar photography SOP and map its quality-control items to OpenScar image schema fields.

Integration

Works well with:

• keloid-follow-up-intake
• scar-treatment-response-review
• scar-registry-entry-builder
• before-after-analysis
• consent-form-review