Written descriptions versus photographs in dermatological case reports

Abstract

Background: Images are essential for dermatology. However, if a photograph has poor quality, it causes problems in conveying information. Objectives: This study aimed to evaluate the efficiency of photographs in a part of the current literature. Methods: One hundred and eighteen written descriptions and their related photographs were extracted from 89 articles selected from the journal Case Reports in Dermatological Medicine. Frequencies and confidence intervals (CIs) of mentioning 11 features, namely location, side, amount, distribution, dimension, figure, edge, color, touch perception, subjective symptom, and elementary lesion, in the written descriptions were calculated. The photographs were also evaluated to detect features other than touch perception and subjective symptom. Fifty articles randomly selected from five high-impact journals were also reviewed. Results: Touch perception and subjective symptom were mentioned only in 35.6% and 46.6% of the written descriptions, respectively. Distribution and edge were distinguishable in the photographs only in half of the cases, however other features in more than 90%. According to multinomial CIs, the written descriptions were superior only in terms of location, whereas the photographs were superior in terms of side, distribution, dimension, figure, edge, and color. Some features, such as touch perception and subjective symptom, were mentioned less frequently in the reviewed articles of the high-impact journals. Conclusion: The contribution of the photographs to the written descriptions in case reports was clear. However, the low rate for determining sharpness of edges in the photographs was a sign indicating low-quality images. In conclusion, the present study and similar studies will guide more efficient usage of developing image modalities for online publication in dermatology.