Supplementary Material for: Standardized Photographic Documentation of Hidradenitis Suppurativa/Acne Inversa

<b><i>Background:</i></b> Despite existing guidelines and methods for standardized clinical photography in dermatology and plastic surgery, human skin exhibits exquisite site-specific morphologies and functions, and each body region can exhibit an individual pathologic phenotype. The aim of this work was to develop a standardized, representative and reproducible documentation of the multilocular hidradenitis suppurativa/acne inversa (HS) lesions, a disease mostly occurring in skin folds. <b><i>Method:</i></b> Optimal body positions for medical photography of candidate areas for HS involvement were evaluated. Pictures of volunteers were taken, and indicative scientific graphics were designed. <b><i>Results:</i></b> Due to the variability of HS lesions and the fact of their localization in skin folds, a standardized, reproducible photographic documentation of HS candidate skin areas (50 cm from the skin surface) is proposed. The photographic series includes: (1) right armpit, (2) left armpit, (3) right groin, (4) left groin, (5) genital area, (6) anal area and anal fold, (7) right buttock, (8) left buttock, (9) chest area, (10) mons pubis, (11) right submammary area (females), (12) left submammary area (females). The protocol is accompanied with indicative scientific graphics for photography-proper positioning of the relevant body parts for documentation of potentially flat skin areas. In addition, former proposals for technical standardization of photography in dermatology, regarding instrumentation, environmental lighting and background colour, have to be respected. <b><i>Conclusion:</i></b> Standardized photography of candidate skin areas for HS involvement will allow longitudinal intraindividual and interindividual evaluation of the disease course as well as prospective and retrospective comparative studies.

背景：尽管目前已有针对皮肤病学与整形外科学领域标准化临床摄影的指南与方法，但人体皮肤具有极为精细的部位特异性形态与功能特征，且每一身体区域均可呈现独特的病理表型。本研究旨在开发一套标准化、具代表性且可重复的化脓性汗腺炎/反向痤疮（multilocular hidradenitis suppurativa/acne inversa, HS）皮损记录方案，该疾病多发生于皮肤褶皱部位。方法：本研究对HS疑似受累部位的医学摄影最优体位展开评估，对志愿者进行拍摄，并设计了指导性科学示意图。结果：鉴于HS皮损的多样性及其好发于皮肤褶皱的特性，本研究提出针对HS疑似受累皮肤区域（拍摄距离为皮肤表面50cm）的标准化、可重复摄影记录方案。该摄影序列涵盖以下部位：(1) 右侧腋窝；(2) 左侧腋窝；(3) 右侧腹股沟；(4) 左侧腹股沟；(5) 生殖器区域；(6) 肛周区域及肛周褶皱；(7) 右侧臀部；(8) 左侧臀部；(9) 胸部区域；(10) 阴阜区域；(11) 女性右侧乳房下区域；(12) 女性左侧乳房下区域。本方案配套有用于规范拍摄体位的指导性科学示意图，以实现潜在平坦皮肤区域的标准化记录。此外，既往皮肤病学摄影技术标准化提案中关于设备、环境光照与背景色的相关要求仍需严格遵守。结论：对HS疑似受累皮肤区域开展标准化摄影，将可实现疾病病程的个体内纵向评估与个体间对比分析，同时支持前瞻性与回顾性对比研究。