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Digital Imaging and COmmunications in Dermatology (DICODerm)

(ONTODerm | DermKnowledgeBASE | SkinDeep Blog | Dermatologists Sans Borders )


The Digital Imaging and Communications in Medicine (DICOM) Standard, developed by the DICOM Standards Committee, standardizes formatting and exchanging medical images and image related information (including reports) to facilitate the connectivity of medical devices and systems into a picture archiving and communication system (PACS).

Structure of a DICOM IOD

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Dicom Data Model

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What is DICODerm?

We (Dermatologists Sans Borders ) are attempting to collate recommendations for a Dermatology specific IOD and the project is termed DICODerm. Please read our blog below for details. We intent to forward this to DICOM standards committee and WG-19 once this project is over.



Dermatology specific IOD:

  • Conceptually Series will represent Lesion in DICODerm and Study will represent an examination/consultation
Positioning Attributes

The importance of positioning is to get standardized images in dermatology for comparison between patients and also to compare between pre-treatment and post-treatment images of the same patient.

For positioning, standardizing the position of the patient anatomically as well as in relation to the photographic frame is important.

For standardizing the anatomical position, the best option would be to photograph the patient in the anatomical position, which means that the arms are best photographed in extension and a horizontal position. The palms should ideally still face forward, such that the back of the forearm should be photographed with the patient facing away from the photographer.

For facial photographs Frankfort horizontal-position is ideal. An imaginary line joining the upper external auditory meatus and the infraorbital rim is to be horizontally oriented (parallel to the ground).Full face frontal, right and left 45 degree oblique and right and left lateral photos are obtained in a facial series.

The other standard position suggested is the NHP is a standardized and reproducible orientation of the head achieved when one is looking at a distant point in front,at eye level. The NHP can be obtained by instructing the patient to look straight-ahead at a point at eye level on the wall infront of him. Modern capture devices are now available which offer a pre-set 'ghost' frame into which the patient can be easily positioned. This is similar to the technology used in gaming devices like the X-box.

For standardizing the image with respect to the photographic frame, the following parameters should be maintained

  1. Lighting
  2. Distance from the camera
  3. Camera parameters - aperture, shutter speed, ISO, white balance and zoom of the lens.
Acquisition Attributes
Other Data to encode

if you tweet or discuss in #DsB (Dermatologists Sans Borders ), please use the hashtag #DICODerm and feel free to follow me @beapen


  • Bell Eapen
  • Feroze Kaliyadan

Disclaimer: I am not a member of NEMA , Medical Imaging & Technology Alliance or WG-19 . The opinions mentioned here and internally hyperlinked pages are my own. External sites are hyperlinked in good faith, but does not mean endorsements.

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About Me

I have varied research interests ranging from eHealth, Health Information Exchange, Clinical Trials and Research, Contact Dermatitis, Bioinformatics, and Cosmetic Dermatology. I have work experience in Canada as an eHealth analyst, and in Dubai and India as a Specialist Dermatologist.


Bell Raj Eapen
Hamilton, ON