96904 Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma

Name of the Procedure:

Whole Body Integumentary Photography

• Common Names: Total Body Photography, Full-Body Skin Photography
• Technical Term: Integumentary Photography

Summary

Whole Body Integumentary Photography involves taking comprehensive, high-resolution photographs of the entire skin surface. This procedure helps in monitoring changes in skin lesions, such as dysplastic nevi, in patients at high risk of developing skin cancer, particularly melanoma.

Purpose

This procedure aims to:

• Detect early signs of melanoma and other skin cancers.
• Monitor the evolution of dysplastic nevi over time.
• Enable early intervention and treatment to improve outcomes for high-risk patients.

Indications

• Patients with dysplastic nevus syndrome
• Individuals with a history of dysplastic nevi
• Patients with a personal or familial history of melanoma
• High-risk individuals based on genetic factors or extensive sun exposure

Preparation

• Patients are typically advised to avoid applying lotions or oils to the skin before the procedure.
• Wear loose, comfortable clothing that can be easily removed.
• Patients may be asked to remove any makeup or jewelry.

Procedure Description

1. The patient changes into a gown and removes all clothing, jewelry, and makeup.
2. The patient stands or sits in a well-lit room.
3. A series of high-resolution photographs are taken of the entire body, including close-ups of any notable lesions or moles.
4. Standardized protocols are used to ensure consistent positioning and lighting for accurate comparison in future sessions.
   • No anesthesia or sedation is required for this non-invasive procedure.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the number of lesions and the complexity of the case.

Setting

The procedure is performed in a dermatology clinic or a specialized outpatient imaging center.

Personnel

• Dermatologist or trained medical photographer
• Dermatology nurse or assistant

Risks and Complications

• Minimal risks associated with the procedure.
• Possible discomfort from standing in different positions for an extended time.

Benefits

• Early detection of skin cancer, including melanoma.
• Accurate tracking of skin changes over time.
• Improved outcomes through early intervention.
• Peace of mind for patients through regular monitoring.

Recovery

• No significant recovery is needed.
• Patients can resume normal activities immediately after the procedure.
• Follow-up appointments are typically scheduled at regular intervals (e.g., every 3 to 6 months) for ongoing monitoring.

Alternatives

• Traditional skin examination without photography
• Dermoscopy: a magnified examination of skin lesions
• Confocal microscopy: detailed skin imaging
• Regular physical skin monitoring and self-exams

Pros and Cons:

• Whole body photography provides a comprehensive record and visual baseline, which can be particularly useful for detecting subtle changes over time.
• Alternative methods may not capture as thorough a baseline but can still be effective for skin monitoring.

Patient Experience

• Patients may feel slightly self-conscious but knowing the importance of early cancer detection often alleviates discomfort.
• The process is painless and only mildly inconvenient due to the need to stand or change positions.
• Medical staff ensure patient comfort and privacy throughout the procedure.