Background: The rising incidence of melanoma has led to efforts to improve surveillance of patients at high risk of disease. Many skin imaging tools have been developed, some that incorporate computer-assisted analysis. Total-body photography (TBP) (FotoFinder) is a surveillance method whereby a standardized series of images are taken at specific intervals and compared over time to identify new or changing nevi in conjunction with the clinical exam. Although photography of pigmented lesions with varying computer-assisted analytic capability has been used for decades in high-risk patients, there is a paucity of information regarding patients’ concerns and overall experience with TBP when incorporated into their dermatologic care, especially given recent advances in technology.
Methods: To fill this knowledge gap and develop empirically based survey items aimed at improving quality of care, one-on-one interviews with patients in the TBP clinic were conducted to elicit patients’ perceptions regarding TBP and its utility in identifying pigmented lesions of concern. Interviews were recorded and transcribed for analysis. Inductive thematic analysis was used to code patients’ responses to the interview questions and identify common themes. Interviews were conducted until no new themes emerged.
Results: Ten clinic patients reported TBP as a positive aspect of their dermatologic care, especially the consistent imaging approach that only nominally extended the office visit. Eight patients described the benefits of full-body photography of skin lesions, including how TBP eased the burden of self-monitoring. Six patients described concerns about feeling “exposed,” “vulnerable,” or “uncomfortable,” as they are minimally dressed during TBP; however, no one, including first-time patients, reported that being exposed would prevent them from continuing with TBP. Expectations of what TBP would entail varied among participants, yet the physician’s thorough explanation of the utility of TBP during the first session alleviated patients’ concerns, which varied little across participants.
Conclusion: Despite the small sample, this study provided insight into patients’ concerns and experiences with TBP. As responses varied little, thematic saturation was reached quickly. Findings suggest that patients valued incorporating TBP in their care but emphasized the need for improved patient education before the initial session to facilitate patient understanding of the TBP process.