Who Has Got Your Back? A Modification of Selfie Stick Examination

Abstract

We describe the use of screen mirroring, as a modification of the previously described “selfie-stick examination” method for the examination of skin lesions on the back of the patient. This would be especially useful in the context of patient initiated tele-dermatology for lesions over the back.

Various methods have been suggested to enhance skin self-examination over areas that are difficult to visualize, like the back. One of the methods which has been used effectively is the “selfie-skin examination,” which involves the use of a selfie stick and a full-length mirror to assist self-examination.[1] However, manipulating the camera while simultaneously visualizing the reflected image on the mirror might be difficult. The use of screen mirroring has been described as an useful method to reduce infection exposure, in the context of the COVID-19 pandemic, for both clinical and dermoscopy imaging.[2] We combined the selfie stick examination with screen mirroring (using either a television or a PC) to visualize and capture images of lesions over the back. The selfie stick is used to focus the smartphone camera over the lesions over the back, while the same is mirrored real time onto a larger screen. The main camera is used to capture the images (because the main camera usually has a higher resolution when compared with the selfie camera) [Figures 1 and 2].

Figure 1.

Focussing the smartphone camera over the back of the neck using a selfie stick, while simultaneously mirroring and visualizing the same, real-time on a PC screen

Figure 2.

Screen shot of the mirrored image on the PC

This method reduces the inconvenience of having to depend on a fixed mirror to monitor the reflections. The patient can also use the “print screen” option on the keyboard to take images as screenshots on the PC. Screen sharing using web-conferencing software can be combined with this procedure during live tele-consultations, and the dermatologists could ask the patient to focus on specific suspicious lesions. The main practical problem associated with this is the difficulty to focus the camera. In general, using the camera with the flash on (not automatic flash) tends to improve the quality of the images by reducing blur. The other limitation is use in older people, who may not be familiar with or comfortable with technology in general and selfie sticks in particular.

This method could improve the quality of images captured for patient-initiated teledermatology, especially in the context of the Covid-19 pandemic, as part of skin self-examination over areas which are difficult to visualize.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

None.

Conflicts of interest

There are no conflicts of interest.