Color-Specific Enhancement of Digital Photographs for Identification of the Extent of Cutaneous Malignancy

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ObjectivesTo introduce the concept of active digital imaging to the literature and to support further investigation by showing the utility of photochromatography in the identification of cutaneous cancer marginsMethodsDigital color images of 10 cutaneous basal cell carcinomas were digitally enhanced to highlight color change in and around each lesion. After the most intense area of tumor coloration was located and sampled, the color was digitally changed to a sharply contrasting color across the entire region, thereby highlighting abnormal areas not readily seen by the unaided eye. The enhanced areas of predicted tumor extent were compared with digital images of the resulting defect after treatment with Mohs micrographic surgery.ResultsThe extent of tumor was predicted with good accuracy in 5 cases and with fair accuracy in 2 cases and was not determinable in the remaining 2 cases. In no case did photochromatography overestimate the extent of the lesion.ConclusionsDigital highlighting of color change not readily seen by the unaided eye (photochromatography) can improve identification and localization of cutaneous tumor. Our findings justify further investigation into algorithms for photographic color detection and enhancement in the evaluation of tissue change.

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