1. Purpose
Dermoscopy improves the accuracy of skin lesion diagnosis, and good documentation, including clinical images, lets a clinician see whether a lesion has changed over time. Because those images are sensitive personal data, they must be handled carefully. This policy sets out how the Service uses dermoscopy, records lesions and stores clinical images safely.
The Service must verify this policy against current British Association of Dermatologists guidance and data protection law before adoption.
2. Sources to verify before adoption
- British Association of Dermatologists, guidance on dermoscopy and clinical photography: https://www.bad.org.uk/
- NICE NG14, Melanoma: assessment and management: https://www.nice.org.uk/guidance/ng14
- Data Protection Act 2018 and the UK GDPR (clinical images are special-category personal data): https://www.legislation.gov.uk/ukpga/2018/12/contents
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12 (safe care and treatment): https://www.legislation.gov.uk/uksi/2014/2936/regulation/12
3. Scope
This policy applies to:
- the use of dermoscopy in assessing skin lesions
- the taking, storing and use of clinical and dermoscopic images
- the clinicians who use dermoscopy and the staff who handle images
4. Using dermoscopy
- dermoscopy is used by clinicians who are trained and competent in it, as one part of the assessment, not a substitute for clinical judgement
- the dermoscopic findings are recorded in the patient's record, with the lesion clearly identified by site
- where dermoscopy is uncertain or the clinical picture is worrying, the clinician refers or excises rather than relying on a reassuring image
5. Clinical and dermoscopic images
- a clinical or dermoscopic image is taken with the patient's consent, with the reason explained, and the consent recorded
- the lesion is photographed in a way that identifies its exact site, so the same lesion can be found and compared later
- where the Service offers monitoring of lesions over time, it records baseline images and compares them at review, acting on any change
6. Lesion records that support comparison
The Service records each lesion clearly enough to compare it over time:
- the site is described precisely, and a body map or numbering is used where a patient has many lesions
- the size, appearance and dermoscopic features are recorded
- a change at review triggers reassessment and, where the criteria are met, referral
7. Protecting images as personal data
Clinical images are sensitive personal data and are protected accordingly:
- images are stored securely within the Service's systems, not on personal phones or unprotected devices
- images are linked to the right patient and not mixed up
- access is limited to those who need it, and images are kept and disposed of in line with the Service's retention and data protection arrangements
- the loss or exposure of clinical images is treated as a possible data breach and reported at once
8. Consent for any wider use
An image is used only for the purpose the patient agreed to. Any wider use, such as teaching or publication, needs separate, specific and informed consent, and the patient can decline without affecting their care.
9. Training
Clinicians using dermoscopy keep their competence current and are refreshed on a stated cadence. Staff who handle images are trained in consent, identification and data protection. The Service records who is competent and the next refresher date.
10. Audit cadence
The Service checks, on a stated cadence, that:
- dermoscopy is used by competent clinicians and the findings are recorded
- clinical images are taken with recorded consent, correctly identified, and stored securely
- monitored lesions have baseline and review images that are compared and acted on
- image losses are reported as possible data breaches
The Registered Manager and the clinical lead review the results and record the improvement actions that follow.